Activities-specific Balance Confidence Scale (ABC Scale)

Evidence Reviewed as of before: 07-06-2018
Author(s): Annabel Wildschut
Editor(s): Annie Rochette
Expert Reviewer: Johanne Filiatrault, erg., Ph.D.
Content consistency: Gabriel Plumier

Purpose

The Activities-specific Balance Confidence Scale (ABC Scale) is a structured questionnaire that measures an individual’s confidence in performing activities without losing balance.

In-Depth Review

Purpose of the measure

The Activities-specific Balance Confidence Scale (ABC Scale) is a structured questionnaire that measures an individual’s confidence in performing activities without losing balance.

Available versions

The ABC Scale was developed in 1995 using a convenience sample of 15 clinicians (physical and occupational therapists) and 12 physical therapy patients aged over 65 years. Clinicians were asked to ‘name the 10 most important activities essential to independent living, that while requiring some position change or walking, would be safe and nonhazardous to most elderly persons’. Seniors were asked the same question, in addition to the question: ‘Are you afraid of falling during any normal daily activities, and if so, which ones?’ (Powell & Myers, 1995). Items were chosen to include a number of difficult activities that potentially posed some hazard. A 0-100% response continuum was chosen to assess self-efficacy.

A modified version of the ABC Scale (ABC-Simplified [ABC-S]) was developed to (a) improve user friendliness by simplifying the cue question and response format; and (b) improve the scale’s congruence with public health falls prevention strategies by removing the final question regarding walking in icy conditions (Filiatrault et al., 2007). The psychometric properties of the ABC-S Scale were tested among a sample of 197 community-dwelling seniors. The ABC-S Scale has demonstrated high internal consistency (reliability index 0.86) and good convergent validity (statistically significant associations with perceived balance; performances on the one-leg stance, tandem stance, tandem walking, functional reach, and lateral reach [on the right side] tests; fear of falling; and occurrence of falls in the previous 12 months). Analyses also showed differing degrees of difficulty across items, allowing for a determination of the scale’s item hierarchy. However, no testing of the ABC-S Scale has been conducted with a stroke population.

A 6-item version of the ABC Scale (ABC-6) was also developed for clinical and research use. It includes 6 activities from the original ABC Scale on which participants demonstrated least confidence (Peretz et al., 2006). In a study conducted among a sample of 35 community-dwelling seniors, it has been shown to be a valid and reliable measure of balance confidence among community-dwelling adults. The scale could also differentiate confidence levels between fallers and non-fallers (Schepens et al., Goldberg, & Wallace, 2010). To date, no psychometric testing of the 6-item version of the ABC Scale has been conducted with a stroke population.

Features of the measure

Original items:
The ABC Scale consists of 16 questions that require the patient to rate his/her confidence that he/she will not lose balance or become unsteady while performing the following activities:

  1. Walking around the house
  2. Walking up or down stairs
  3. Bending over to pick up a slipper from the front of a closet floor
  4. Reaching for a small can off a shelf at eye level
  5. Standing on tiptoes and reaching for something above his/her head
  6. Standing on a chair to reach for something
  7. Sweeping the floor
  8. Walking outside the house to a car parked in the driveway
  9. Getting into or out of a car
  10. Walking across a parking lot to the mall
  11. Walking up or down a ramp
  12. Walking in a crowded mall where people rapidly walk past
  13. Being bumped into people as they walk through the mall
  14. Stepping on to or off an escalator while holding onto a railing
  15. Stepping onto or off an escalator while holding onto parcels (so that they are not able to hold the railing)
  16. Walking outside on icy sidewalks

If the patient does not currently perform the activity, he/she is instructed to imagine how confident he/she might be if he/she had to do the activity. If the patient normally uses a mobility aid to do the activity, he/she is instructed to rate his/her confidence level as if he/she was using this aid during the activity.

Scoring:
The patient is asked to rate his/her confidence performing activities without losing his/her balance or becoming unsteady. The original scale is a 0% to 100% continuous response scale. However, in a more recent publication, Myers (1999), replaced the 0%-to-100% continuous response scale with an 11-point response scale that includes 10% anchor increments (0%, 10%, . . ., 100%).

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

No confidence

Completely confident

The overall score is calculated by adding the item scores and dividing the total by 16 (i.e. the number of items). This total score ranges from 0% to 100%.

Myers et al. (1998) use the following cut-off scores to define level of functioning among active older adults:

  • Lower than 50 %: low level of physical functioning
  • 50-80 %: moderate level of physical functioning
  • Above 80 %: high level of physical functioning

What to consider before beginning:

The ABC Scale provides a subjective measure of balance confidence. Scores are not based on clinician observation of performance. Clinicians should also consider factors such as self-esteem and insight when using the ABC Scale.

Time:
The original ABC Scale takes approximately 10-20 minutes to administer.

Training requirements:
No training requirements have been specified for the ABC Scale.

Equipment:
The ABC Scale is a structured questionnaire that does not require specific equipment.

Alternative forms of the Activities-specific Balance Confidence Scale

None.

Client suitability

Can be used with:

  • Individuals with stroke
  • Individuals with vestibular disorders (Jarlsater & Mattsson, 2003)
  • Individuals with lower-limb amputation (Miller, Deathe & Speechley, 2003)
  • Community-dwelling seniors (Myers et al., 1995 ; Myers et al., 1998; Filiatrault et al., 2007)

Should not be used with:
Not reported.

In what languages is the measure available?

Canadian French (Salbach et al., 2006; Filiatrault et al., 2007)
Chinese (Hsu & Miller, 2006; Mak et al., 2007)
Dutch (van Heuvelen et al., 2005)
English (Powell & Myers, 2005)
German (Schott, 2008)
Hindi (Moiz et al., 2017)
Korean (Jang et al., 2003)
Portuguese (Marques et al., 2013)
Swedish (Nilsagard & Forsberg, 2012)
Turkish (Karapolat et al., 2010)

Summary

What does the tool measure?

Self-perceived confidence with mobility.

What types of clients can the tool be used for?

The ABC Scale can be used with, but is not limited to, patients with stroke.

Is this a screening or assessment tool?

Screening tool.

Time to administer

10-20 minutes.

Versions

ABC-CF (Salbach et al., 2006)
ABC-Simplified (Filiatrault et al., 2007)
ABC-6 (Peretz et al,2006)

Other Languages

French Canadian, Chinese, Dutch, German, Hindi, Korean, Portuguese, Swedish, Turkish.

Measurement Properties

Reliability

Internal consistency:
– Two studies have reported high internal consistency of the ABC Scale in a stroke population (Botner et al, 2005; Salbach et al, 2006).
– One study reported high internal consistency of the ABC-CF Scale in a stroke population (Salbach et al, 2006).
– One study reported high internal consistency of a Swedish translation of the ABC Scale in a stroke population (Nilsagard & Forsberg, 2012).

Intra-rater:
Intra-rater reliability of the ABC Scale has not been examined.

Inter-rater:
Inter-rater reliability of the ABC Scale has not been examined.

Test-retest:
– One study examined test-retest reliability of the ABC Scale within a stroke population and reported excellent test-retest reliability of the overall score and adequate to excellent item level test-retest reliability (Botner et al, 2005).

Validity

Content:
– One study conducted factor analysis of the ABC Scale within a stroke population and results revealed two factors: perceived low-risk activities and perceived high-risk activities (Botner et al, 2005).

Criterion:
Predictive Validity:
Predictive validity of the ABC Scale has not been examined within a stroke population.

 Concurrent Validity:
Concurrent validity of the ABC Scale has not been examined within a stroke population.

Construct:
Known Groups:
– Known-group validity of the ABC Scale has not been examined within a stroke population.

Convergent/Discriminant Validity:
– Three studies (Botner et al., 2005; Salbach et al., 2006; Nilsagard & Forsberg, 2012) have examined convergent validity of the ABC Scale within a stroke population and reported : an adequate correlation with the Berg Balance Scale (BBS), gait speed, 6 Minute Walk Test (6MWT), Barthel Index (BI), Functional Ambulation Categories (FAC) and modified Rivermead Mobility Index (RMI); and adequate negative correlations with the Timed Up and Go test (TUG) and 10-m timed walk test. Correlations with the Medical Outcomes Study 36-Item Short-Form Health Survey – Physical function subscale (SF-36 PF) ranged from excellent to poor among studies.
– Two studies (Salbach et al., 2006; Nilsagard & Forsberg, 2012) have examined divergent validity of the ABC Scale within a stroke population and reported: an adequate correlation with the EQ-5D visual analog scale (EQ VAS); an adequate negative correlation with the Geriatric Depression Scale (GDS); and a low correlation with the SF-36 Mental component score.
– One study (Salbach et al., 2006) examined convergent / divergent validity of the ABC-CF Scale and reported: an excellent correlation with the EQ VAS; an excellent negative correlation with the GDS; adequate correlations with the SF-36 PF, BBS, walking speed, 6MWT and BI; and an adequate negative correlation with the TUG.

Floor/Ceiling Effects

– One study (Salbach et al., 2006) reported no floor/ceiling effects for the total score of the ABC Scale or the ABC-CF Scale in a sample of patients with subacute/chronic stroke, but noted a floor effect for 3 items and a ceiling effect for 8 items of both scales.

Sensitivity / Specificity

Not reported.

Does the tool detect change in patients?

– No studies have reported on the responsiveness of the ABC Scale within a stroke population.

Acceptability

The ABC Scale is non-invasive and quick to administer. The items are considered reflective of real-life activities.

Feasibility

The ABC Scale is free and is suitable for administration in various settings. The assessment requires minimal specialist equipment or training.

How to obtain the tool?

Click here to see the ABC Scale.

Psychometric Properties

Overview

A literature search was conducted to identify all relevant publications on the psychometric properties of the Activities-specific Balance Confidence (ABC Scale). While numerous studies have been conducted on the use of the ABC Scale with other client populations, this review specifically addresses the psychometric properties of the ABC Scale with individuals with stroke. Three studies were identified (Salbach, Mayo, Hanley, Richards, & Wood-Dauphinee, 2006; Botner, Miller, & Eng, 2005; Nilsagard & Forsberg, 2012). The original paper by Powell & Myers (1995) has also been included below, although please note that this study uses a mixed population of community-dwelling adults and patients receiving physical therapy services; the number of participants who had a stroke was not specified.

Floor/Ceiling Effects

Salbach et al. (2006) examined floor/ceiling effects of the ABC Scale and the ABC-CF Scale in a sample of 86 participants (n=51 and 35, respectively) with subacute/chronic stroke and residual walking deficits. The authors reported a floor effect (whereby more than 20% of participants reported ‘no confidence’ or 0%) for 3 items of both scales; and a ceiling effect (whereby more than 20% of participants reported ‘complete confidence’ or 100%) for 8 items of both scales. There were no floor/ceiling effects for the total score of either scale.

Botner et al. (2005) reported that more than 80% of their study sample (n=77 participants with chronic stroke) scored between 40% and 80%, suggesting minimal floor or ceiling effects in their sample.

Reliability

The ABC Scale was developed using a convenience sample of 15 clinicians (physical and occupational therapists) and 12 physical therapy patients aged over 65 years (Powell & Myers, 1995).

Internal consistency:
Powell & Myers (1995) examined internal consistency of the ABC Scale in a sample of 102 community-dwelling adults aged over 65 and a convenience sample of 18 high-mobility and 7 low-mobility physiotherapy outpatients, using Cronbach’s alpha. The authors reported high internal consistency (a = 0.96). Stepwise deletion of each item did not alter internal consistency.

Botner et al. (2005) examined internal consistency of the ABC Scale in a sample of 77 participants with chronic stroke, using Cronbach’s alpha. Results revealed high internal consistency (a=0.94). Stepwise deletion did not alter internal consistency (a=0.93 – 0.94).

Salbach et al. (2006) examined internal consistency of the ABC Scale and the ABC-CF Scale in a sample of 86 participants (n=51, 35 respectively) with subacute/chronic stroke and residual walking deficit. The authors reported high internal consistency for both scales (a= 0.94, 0.93 respectively), measured using Cronbach’s alpha. Stepwise deletion of each item did not improve internal consistency of either scale.

Nilsagard & Forsberg (2012) examined internal consistency of a Swedish translation of the ABC Scale in a sample of 37 patients with acute/subacute stroke, using Cronbach’s alpha. Participants were retested 3 months later (n=31). The authors reported high internal consistency at both time points (a= 0.97, 0.94 respectively).

Absolute reliability:
Salbach et al. (2006) examined absolute reliability of the ABC Scale and the ABC-CF Scale in a sample of 86 participants (n=51, 35 respectively) with subacute/chronic stroke and residual walking deficit. Standard error of measurement of the ABC Scale was 5.05, and standard error of measurement of the ABC-CF Scale was 5.13.

Scalability:
Powell & Myers (1995) examined scalability of the ABC Scale in a sample of 102 community-dwelling adults aged over 65 and a convenience sample of 18 high-mobility and 7 low-mobility physiotherapy outpatients. Scalability encompassed (a) absence of idiosyncratic items, (b) ability of items to discriminate between respondents, and (c) presence of a fixed relation between items. Hierarchicality was measured using Mokken’s Stochastic Cumulative Scaling program (MSP), which revealed a strong cumulative scale (H coefficient = 0.59), and excellent reliability (Rho coefficient = 0.95).

Inter-rater:
No studies have reported on the inter-rater reliability of the ABC Scale. Administration of the ABC Scale does not rely on clinician-observation of patient performance.

Intra-rater:
No studies have reported on the intra-rater reliability of the ABC Scale. Administration of the ABC Scale does not rely on clinician-observation of patient performance.

Test-retest:
Powell & Myers (1995) examined 2-week test-retest reliability of the ABC Scale with a sample of 21 community-dwelling seniors. Results revealed excellent overall test-retest reliability (r=0.92, p<0.001). Correlations between the test-retest scores was not significant for two items (car transfers, r=0.19; walking in the home, r=0.36).

Botner, Miller and Eng (2005) examined 4-week test-retest reliability of the ABC Scale with a sample of 24 participants with chronic stroke, using intra-class correlation coefficients. Results indicated excellent test-retest reliability of the overall score (ICC = 0.85; 95% CI 0.68-0.93), and adequate to excellent item level test-retest reliability (ICC ranged from 0.53 – 0.93).

Validity

Content:
Botner, Miller & Eng (2005) conducted factor analysis of the ABC Scale in a sample of 77 participants with chronic stroke, using principal component analysis with Varimax rotation. Results revealed two components:
Factor 1: perceived low-risk activities (9 items; 55.7% of the variance); and
Factor 2: perceived high-risk activities (6 items; 12.9% of the variance).
One item (sweeping the floor) loaded almost equally on both components.

Criterion:
Predictive:
No studies have reported on the predictive validity of the ABC Scale.

Concurrent:
Powell & Myers (1995) examined concurrent validity of the ABC Scale by comparison with the Falls Efficacy Scale (FES) in a sample of 102 community-dwelling adults aged over 65 and a convenience sample of 18 high-mobility and 7 low-mobility physiotherapy outpatients. There was an adequate correlation between scales (r=0.84, p<0.001).

Construct:
Known Group:
Powell & Myers (1995) examined known group validity in a sample of 102 community-dwelling adults aged over 65 and a convenience sample of 18 high-mobility and 7 low-mobility physiotherapy outpatients. Participants were self-categorized according to the following categories: fallers (57%), injured fallers (38%), fear of falling (57%) and activity avoidance due to fear of falling (30%). There was no significant difference in mean ABC scores between participants who had fallen in the past year and those who had not experienced a fall. There was no significant difference in mean ABC scores between participants who had been injured during a fall and those who had not been injured during a fall. Activity avoidance due to fear of falling was significantly more common in low mobility participants compared to high mobility participants (p<0.001). There was a significant difference (p<0.001) in mean ABC scores between high mobility and low mobility participants (t=9.34, ES=1.5). All ABC Scale items excluding item 4 (reaching at eye level) showed a significant difference between high mobility and low mobility participants, indicating an ability to discriminate between the two groups. Score ranges within high and low mobility groups indicated an adequate range of responses (score range 5% – 84% confidence for low mobility participants, 36% – 95% confidence for high mobility participants).

Convergent/Discriminant:
Powell & Myers (1995) examined convergent validity in a sample of 102 community-dwelling adults aged over 65 and a convenience sample of 18 high-mobility and 7 low-mobility physiotherapy outpatients. Convergent validity was measured by comparison with the Physical Self-Efficacy Scale (PSES). There was an adequate correlation (r=0.49, p<0.001) between the ABC Scale and the PSES score, and an excellent correlation between the ABC scale and the PSES physical abilities subscale (r=0.63, p<0.001). There was no significant correlation between the ABC Scale and the PSES general self-presentation subscale (r=0.03).

Powell & Myers (1995) examined discriminant validity in a sample of 102 community-dwelling adults aged over 65 and a convenience sample of 18 high-mobility and 7 low-mobility physiotherapy outpatients. Discriminant validity was measured using the Positive and Negative Affectivity Scale (PANAS). Results were non-significant between the ABC Scale and the PANAS overall score, positive affect score and negative affect score.

Botner, Miller and Eng (2005) examined convergent validity of the ABC Scale with a sample of 77 participants with chronic stroke, using Spearman’s correlation coefficient. Convergent validity was measured by comparison with the Berg Balance Scale (BBS) and gait speed. Results showed an adequate correlation with both measures (BBS: r=0.36, p<0.001; gait speed: r=0.48, p<0.001).

Salbach et al. (2006) examined convergent validity of the ABC Scale and the ABC-CF Scale in a sample of 86 participants (n=51, 35 respectively) with subacute/chronic stroke and residual walking deficit, using Spearman correlation coefficients and associated 95% confidence intervals. Convergent validity was measured by comparison with the BBS, 5-m walking test (comfortable/maximal gait speed), Timed Up and Go test (TUG), 6-Minute Walk Test (6MWT), Barthel Index (BI), Medical Outcomes Study 36-Item Short-Form Health Survey – Physical function subscale (SF-36 PF), Geriatric Depression Scale (GDS), and the EQ-5D visual analog scale (EQ VAS). The ABC Scale showed an excellent correlation with physical function (SF-36 PF: r=0.60), adequate correlations with perceived health status (EQ VAS: r=0.52), balance function (BBS: r=0.42), walking speed (maximum: r=0.43, comfortable: r=0.42), functional walking capacity (6MWT: r=0.40) and functional independence (BI: r=0.37), and adequate negative correlations with functional mobility (TUG: r=-0.34) and depressive symptoms (GDS: r=-0.30). The ABC-CF Scale showed an excellent correlation with perceived health status (EQ VAS: r=0.68), an excellent negative correlation with depressive symptoms (GDS: r=-0.61), adequate correlations with physical function (SF-36 PF: r=0.56), balance function (BBS: r=0.49), walking speed (maximal: r=0.53; comfortable: r=0.48), functional walking capacity (6MWT: r=0.48), functional independence (BI: r=0.45), and an adequate negative correlation with functional mobility (TUG: r=-0.52).

Nilsagard & Forsberg (2012) examined convergent and divergent validity of the ABC Scale in a sample of 37 participants with acute/subacute stroke, using Kendall’s coefficient. Participants were retested 3 months later (n=31). Convergent validity was measured by comparison with the Functional Ambulation Categories (FAC), modified Rivermead Mobility Index (m-RMI), TUG, 10-m timed walk test, SF-36 Physical component (SF-36 PS), and the 12-item walking scale. The ABC Scale showed significant adequate correlations at both time points with the FAC (r=0.40, 0.49) and the modified RMI (r=0.38, 0.46), and an adequate to low correlation with the SF-36 PF (r=-0.33, 0.28). The ABC Scale showed adequate negative correlations at both time points with the TUG (r=-0.46, -0.43), 10-m timed walk test (r=-0.41 at both time points) and 12-item walking scale (r=-0.55, -0.52). Divergent validity was measured using the SF-36 Mental component score (SF-36 MF), with which the ABC Scale showed a low correlation at both time points (r=0.22, 0.12).

Responsiveness

Powell & Myers (1995) examined responsiveness of the ABC Scale in a sample of 102 community-dwelling adults aged over 65 and a convenience sample of 18 high-mobility and 7 low-mobility physiotherapy outpatients. Mean scores ranged from 21% confidence (item 16: walking on an icy sidewalk) to 90% (item 4: reaching at eye level).

Sensitivity & Specificity:
Powell & Myers (1995) examined item specificity of the ABC Scale by comparison with the Falls Efficacy Scale (FES) in a sample of 102 community-dwelling adults aged over 65 and a convenience sample of 18 high-mobility and 7 low-mobility physiotherapy outpatients. ABC Scale items 3-6 correlated significantly with the FES item ‘reach into cabinets or closets’ (r = 0.53-0.67, p<0.001), and ABC Scale items 9-15 correlated with the FES item ‘simple shopping’ (r=0.42-0.75).

References

Activities-specific Balance Confidence Scale. (2013, March 22). Retrieved from URL https://www.sralab.org/rehabilitation-measures/activities-specific-balance-confidence-scale

Botner, E.M., Miller, W.C., & Eng, J. J. (2005). Measurement properties of the Activities-specific Balance Confidence scale among individuals with stroke. Disability and Rehabilitation, 27(4), 156-63.

Filiatrault, J., Gauvin, L., Fournier, M., Parisien, M., Robitaille, Y., Laforest, S., Corriveau, H., & Richard, L. (2007). Evidence of the psychometric qualities of a simplified version of the Activities-specific Balance Confidence scale for community-dwelling seniors. Archives of Physical Medicine and Rehabilitation, 88, 664-72.

Hsu, P.C., & Miller, W.C. (2006). Reliability of the Chinese version of the Activities-specific Balance Confidence scale. Disability and Rehabilitation, 28(20), 1287-92.

Jang, S.N., Cho, S.I., Ou, S.W., Lee, E.S., & Baik, H.W. (2003). The validity and reliability of Korean Fall Efficacy Scale (FES) and Activities-specific Balance Confidence scale (ABC). Journal of the Korean Geriatrics Society, 7(4), 255-68.

Jarlsater, S. & Mattsson, E. (2003). Test of reliability of the Dizziness Handicap Inventory and the Activities-specific Balance Confidence scale for use in Sweden. Advances in Physiotherapy, 5, 137-44.

Karapolat, H., Eyigor, S., Kirazli, Y., Celebisoy, N., Bilgen, C., & Kirazli, T. (2010). Reliability, validity, and sensitivity to change of Turkish Activities Specific Balance Confidence Scale in patients with unilateral peripheral vestibular disease. International Journal of Rehabilitation Research, 33, 12-18.

Mak, M.K., Lau, A.L., Law, F.S., Cheung, C.C., & Wong, I.S. (2007). Validation of the Chinese translated Activities-specific Balance Confidence scale. Archives of Physical Medicine and Rehabilitation, 88, 496-503.

Marques, A.P., Mendes, Y.C., Taddei, U., Pereira, C.A.B., & Assumpcao, A. (2013). Brazilian-Portuguese translation and cross cultural adaptation of the activities-specific balance confidence (ABC) scale. Braz J Phys Ther. Mar-Apr; 17(2), 170-178.

Miller, W.C., Deathe, A.B., & Speechley, M. (2003). Psychometric properties of the Activities-specific Balance Confidence scale among individuals with a lower-limb amputation. Archives of Physical Medicine and Rehabilitation, 84, 656-61.

Moiz, J.A., Bansal, V., Noohu, M.M., Gaur, S.N., Hussain, M.E., Anwer, S., & Alghadir, A. (2017). Activities-specific balance confidence scale for predicting future falls in Indian older adults. Clinical Interventions in Aging, 12, 645-651.

Myers, A.M., Fletcher, P.C., Myers, A.H., & Sherk, W. (1998). Discriminative and evaluative properties of the Activities-specific Balance Confidence (ABC) scale. Journal of Gerontology: Medical Sciences, 53A(4), M287-94.

Myers, A.M. (1999). Program evaluation for exercise leaders. Waterloo: Human Kinetics.

Nilsagard, Y., & Forsberg, A. (2012). Psychometric properties of the Activities-Specific Balance Confidence Scale in persons 0-14 days and 3 months post stroke. Disability & Rehabilitation, 34(14), 1186-1191.

Peretz, C., Herman, T., Hausdorff, J.M., & Giladi, N. (2006). Assessing fear of falling: can a short version of the Activities-specific Balance Confidence scale be useful? Movement Disorders, 21(2), 2101-5.

Powell, L.E. & Myers, A.M. (1995). The Activities-specific Balance Confidence (ABC) scale. Journal of Gerontology: Medical Sciences, 50A (1), M28-34.

Salbach, N.M., Mayo, N.E., Hanley, J.A., Richards, C.L., & Wood-Dauphinee, S. (2006). Psychometric evaluation of the original and Canadian French version of the Activities-Specific Balance Confidence scale among people with stroke. Archives of Physical Medicine and Rehabilitation, 87, 1597-1604.

Schepens, S., Goldberg, A., & Wallace, M. (2010). The short version of the Activities-specific Balance Confidence (ABC) scale: Its validity, reliability, and relationship to balance impairment and falls in older adults. Archives of Gerontology and Geriatrics, 51, 9-12.

Schott, N. (2008). [German adaptation of the “Activities-Specific Balance Confidence (ABC) scale” for the assessment of falls-related self-efficacy]. Zeitschrift für Gerontologie und Geriatrie, 41, 475-85.

van Heuvelen, M.J., Hochstenbach, J., de Greef, M.H., Brouwer, W.H., Mulder, T., & Scherder, E. (2005). [Is the Activities-specific Balance Confidence Scale suitable for Dutch older persons living in the community?]. Tijdschrift Voor Gerontologie En Geriatrie, 36, 146-54.

See The Measure

How to obtain the Activities-specific Balance Confidence Scale

Click here to access the ABC Scale.

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