Reliability and Validity of the Modified O'Sullivan Functional Balance (mOFB) Test in Individuals with Stroke
DOI:
https://doi.org/10.59796/jcst.V15N3.2025.127Keywords:
modified O’Sullivan functional balance (mOFB), Reliability, Validity, Stroke, Balance assessmentAbstract
The modified O’Sullivan Functional Balance (mOFB) test is a refined version of the original OFB, developed to assess balance in sitting and standing positions in individuals with stroke using standardized perturbations and updated scoring criteria. Despite its clinical utility, the mOFB lacked standardized administration procedures and had not been validated in individuals with stroke. This study aimed to examine the intra-rater and inter-rater reliability, as well as the convergent validity of the mOFB following the development of standardized instructions and scoring criteria. The mOFB comprises four tasks that assess static and dynamic balance in both sitting and standing positions, each rated on a 5-point ordinal scale (where 0 indicates an inability to maintain balance and 4 indicates normal balance). Seventy-five individuals with a first-time stroke (aged 25–84 years) participated. For inter-rater reliability, assessment sessions were video recorded and scored independently by four raters. Intra-rater reliability was assessed by having the same rater evaluate the recordings twice. Convergent validity was examined using the Berg Balance Scale (BBS) and the Trunk Impairment Scale (TIS). Statistical analyses included intraclass correlations coefficients (ICCs) and Spearman’s rank correlation. The mOFB demonstrated excellent intra-rater (ICC = 0.97; 95% CI: 0.96–0.98) and inter-rater reliability (ICC = 0.91; 95% CI: 0.85–0.95). Strong correlations with the BBS (r = 0.82, p < 0.001) and moderate correlations with the TIS (r = 0.60, p < 0.001) supported its convergent validity. No floor or ceiling effects were observed in the total scores. These findings support the mOFB as a reliable and valid tool for assessing balance in individuals with stroke. Its simplicity, brief administration time, and appropriate difficulty across stroke stages make it suitable as a clinical screening tool in high-volume clinical settings.
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