Application of Rasch Analysis to the Korean Version of the Fullerton Advanced Balance Scale

한국어판 플러턴 어드밴스드 균형 척도의 라쉬분석

  • Kim, Gyoung-mo (Dept. of Physical Therapy, Division of Health Science, Baekseok University)
  • 김경모 (백석대학교 보건학부 물리치료학과)
  • Received : 2016.01.04
  • Accepted : 2016.02.04
  • Published : 2016.02.19


Background: Rasch analysis estimates the probability that a respondent will endorse an item and select a particular rating for that item. It has the advantage of placing both the items and the person along a single ration scale and calibrates person ability and item difficulty onto an interval scale by logits. In addition, Rasch analysis is a useful tool for exploring the validity of questionnaires that have been developed using traditional methods. Therefore, it has been recommended as a method for developing and evaluating functional outcome measures. Objects: The purpose of this study was to investigate the item fit, item difficulty, and rating scale of the Korean version of the Fullerton Advanced Balance Scale (KFAB) using Rasch analysis. Methods: Total 97 subjects (39 males and 58 females) with dwelling elderly adults were participated, but 3 people were excluded for misfit persons. Rasch analysis was then done by means of the Winsteps program to determine the item fit, item difficulty, rating scale, and reliability of the KFAB. Results: In this study, the 'standing with feet together and eyes closed', 'two-footed jump', 'walk with head turns', and 'stand on foam, eyes closed' items shown misfit statistics. The most difficult item was 'stand on one leg', whereas the easiest item was 'turn in full circle'. The rating scale was acceptable with all criteria. Both item and person separation indices and reliability showed acceptable values. This would indicated that each domain covers a useful range of item difficulty that is appropriate for measuring a person with a wide range of functional ability. Conclusion: The KFAB has been proven reliable, valid and an appropriate tool with which to evaluate the balance of the elderly people.



Supported by : 백석대학교


  1. Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall-related injuries in older adults. Am J Public Health. 1992; 82(7):1020-1023.
  2. American Geriatrics Society, British Geriatrics Society, American Academy of Orthopaedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc. 2001;49(5):664-672.
  3. Chang WC, Chan C. Rasch analysis for outcomes measure: Some methodological considerations. Arch Phys Med Rehabil. 1995;76(10):934-939.
  4. Davidson M. Rasch analysis of three versions of the Oswestry Disability Questionnaire. Man Ther. 2008;13(3):222-231.
  5. Duncan PW, Bode RK, Min Lai S, et al. Rasch analysis of a new stroke-specific outcome scale: The Stroke Impact Scale. Arch Phys Med Rehabil. 2003;84(7):950-963.
  6. Farrell MK. Using functional assessment and screening tools with frail older adults. Top Geriatr Rehabil. 2004;20(1):14-20.
  7. Gothwal VK, Wright TA, Lamoureux EL, et al. Rasch analysis of the Quality of Life and Vision Function Questionnaire. Optom Vis Sci. 2009;86(7):E836-E844.
  8. Hausdorff JM, Rios DA, Edelberg HK. Gait variability and fall risk in community-living older adults: A l-year prospective study. Arch Phys Med Rehabil. 2004;82(8):1050-1056.
  9. Hernandez D, Rose DJ. Predicting which older adults will or will not fall using the fullerton advanced balance scale. Arch Phys Med Rehabil. 2008;89(12): 2309-2315.
  10. Huxham F, Goldie PA, Patla AE. Theoretical considerations in balance assessment. Aust J Physiother. 2001;47(2):89-100.
  11. Kim GM, Park SY, Yi CH. A Rasch analysis of the Korean version of Oswestry Disability Questionnaire according to general characteristics of patients with low back pain. Phys Ther Korea. 2011; 18(2):35-42.
  12. Kim GM. Content validity of a korean-translated version of a Fullerton Advanced Balance Scale: A pilot study. Phys Ther Korea. 2015;22(4): 51-61.
  13. Klein PJ, Fiedler RC, Rose DJ. Rasch analysis of the Fullerton Advanced Balance (FAB) Scale. Physiother Can. 2011;63(1):115-125. ptc.2009-51
  14. Ku JH, Park DW, Kim SW, et al. Cross-cultural differences for adapting translated five-item version of international index of erectile function: Results of a Korean study. Urology. 2005;65(6): 1179-1182.
  15. Lee JA, Yi CH, Park SY, et al. Application of Rasch analysis to the Korean Berg Balance Scale. Phys Ther Korea. 2006;13(3):49-56.
  16. Linacre JM. Investigating rating scale category utility. J Outcome Meas. 1999;3(2):103-122.
  17. Lord SR, Dayhew J. Visual risk factors for falls in older people. J Am Geriatr Soc. 2001;49(5): 508-515.
  18. Lord SR, Menz HB, Tiedemann A. A physiological profile approach to falls risk assessment and prevention. Phys Ther. 2003;83(3):237-252.
  19. Lunz ME, Stahl HA. The effect of rater severity on person ability measure: A Rasch model analysis. Am J Occup Ther. 1993;47(4):311-317.
  20. Lunz ME, Wright BD, Linacre JM. Measuring the impact of judge severity on examination scores. Appl Meas Educ. 1990;3(4):331-345. 10.1207/s15324818ame0304_3
  21. Nilsson AL, Sunnerhagen KS, Grimby G. Scoring alternatives for FIM in neurological disorders applying Rasch analysis. Aata Neurol Scand. 2005; 111(4):264-273.
  22. Park SY, Hwang SJ. Validation of the Korean translated Dynamic Gait Index in community-dwelling elderly. Phys Ther Korea. 2010;17(1):43-52.
  23. Rose DJ, Lucchese N, Wiersma LD. Development of a multidimensional balance scale for use with functionally independent older adults. Arch Phys Med Rehabil. 2006;87(11):1478-1485.
  24. Sohng KY. Moon JS, Song HH, et al. Risk factors for falls among the community-dwelling elderly in korea. J Korean Acad Nurs. 2004;34(8): 1483-1490.
  25. Stevens JA, Corso PS, Finkelstein EA, et al. The costs of fatal and nonfatal falls among older adults. Inj Prev. 2006;12(5):290-295.
  26. Tyson S, DeSouza L. A systematic review of methods to measure balance and walking post stroke. Part 1: Ordinal scale. Phys Ther Rev. 2002;7(3): 173-186.
  27. White LJ, Velozo CA. The use of Rasch measurement to improve the Oswestry classification scheme. Arch Phys Med Rehabil. 2002;83(6): 822-831.
  28. Wright BD, Linacre JM. Reasonable mean-square fit values. Rasch Meas Trans. 1994;8(3):370.

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