Development of a short-form balance recovery confidence (SF-BRC) scale.

Abstract

Background: Identifying confidence in recovering balance following destabilizing events is essential for helping older adults prevent falls. However, existing measures primarily assess balance confidence. The Balance Recovery Confidence (BRC) scale was developed to address this gap, but its length may limit clinical feasibility. This study aimed to develop and validate a Short-Form Balance Recovery Confidence (SF-BRC) scale that retains the psychometric integrity of the original version while improving practicality.

Methods: A cross-sectional dataset comprising 309 older adults (≥ 65 years) was analyzed. Exploratory factor analysis using unweighted least squares extraction on polychoric correlations was conducted to determine the underlying factor structure. Confirmatory factor analysis using the weighted least squares mean and variance adjusted (WLSMV) estimator evaluated model fit. Rasch modeling assessed item fit, item difficulty, and person separation reliability. Criterion and convergent validity were examined through correlations with the original BRC, Activities-specific Balance Confidence (ABC), and Falls Efficacy Scale-International (FES-I) scales.

Results: The final 7-item SF-BRC demonstrated a unidimensional structure with excellent model fit (CFI = 0.99, TLI = 0.99, RMSEA = 0.06, SRMR = 0.02). Internal consistency was high (α = 0.94), and Rasch person separation reliability was 0.93. Criterion validity with the full BRC was strong (r = 0.99), while convergent validity with ABC and FES-I scales was moderate, supporting theoretical distinctiveness of the construct.

Conclusions: The SF-BRC is a psychometrically robust instrument for assessing BRC. Its strong reliability and practical utility support its use in rehabilitation, fall prevention, and community-based settings.