Retrospective assessment of the validity and use of the community balance and mobility scale among individuals with subacute spinal cord injury

Study design: This is a retrospective chart review. Objectives: The objective of this study was to evaluate the convergent validity, internal consistency and use of the Community Balance &Mobility Scale (CB&M) in individuals with incomplete spinal cord injury (iSCI) during inpatient rehabilitation. Setting: This study was conducted in an SCI rehabilitation center in Canada. Methods: Inpatient charts from January 2009 to October 2015 were screened. A chart was excluded if the inpatient was aged >65 years, did not complete a CB&M and/or had a comorbid condition. Demographics, CB&M score and injury-related characteristics were extracted. Berg Balance Scale (BBS), Six-Minute Walk Test (6 MWT) and Ten-Meter Walk Test (10 mWT) scores were obtained if completed within 1 week of the CB&M. chi(2)-Tests were used to identify CB&M items that were uniformly distributed, implying good discrimination between individuals. Convergent validity was assessed by correlating (Pearson's r) CB&M scores with BBS, 6 MWT and 10 mWT scores. Internal consistency (Cronbach's alpha) was evaluated. Results: Thirty inpatients were included (23 male, 38.3 +/- 15.3 years old, three AIS C, 26 AIS D, C1-L4, 16 traumatic). BBS scores were >= 51/56; however, CB&M scores showed a wider range (27-82/96). Unilateral Stance, Tandem Walking, Lateral Foot Scooting, Forward to Backward Walking and Descending Stairs showed uniform distributions. Scores on the CB&M correlated strongly with scores on the 6 MWT (r=0.72, P<0.001) and moderately strongly with 10 mWT and BBS scores (r=0.47-0.59, P=0.004-0.013). Cronbach's alpha=0.87. Conclusions: The CB&M is a valid measure in high-functioning individuals with iSCI. Prospective studies are required to further evaluate the psychometric properties of the CB&M as a measure of high-level balance for SCI.