The Validity, Reliability and Responsiveness of the Fullerton Advanced Balance Scale in Osteoarthritis
Condition: Osteo Arthritis Knee; Exercise; Balance
MeSH terms: Osteoarthritis; Osteoarthritis, Knee
Study type: Interventional

Summary: 
      The primary aim of our study is to evaluate the validity and reliability of the Fullerton
      Advanced Balance (FAB-T) scale in individuals with osteoarthritis. The secondary aim of this
      study is to evaluate the responsiveness of the FAB-T scale to change in patients with
      osteoarthritis.
    

Detailed description: 
      Osteoarthritis (OA) is the most common joint disorder (1). OA is seen 7 times more than
      rheumatoid artritis. It is the most important cause of disability seen with advanced age (1).
      It's a degenerative joint disease, usually associated with progressing age and characterized
      by biochemical and morphological changes in the synovial membrane and joint capsule, erosion
      of the joint cartilage, hypertrophy of the joint edges, subchondral sclerosis (2).

      OA, an important public health problem, affects the knee joint most frequently (3). While the
      most important risk factor is age, there are many other risk factors such as race, sex,
      obesity, genetics and trauma. In osteoarthritis; joint is damaged due to the imbalance
      between formation and destruction. It causes progressive joint damage, pain, physical
      disability, and psychological disorders (4). The clinical characteristics of OA include pain,
      stiffness, limitation of motion, crepitation, varying degrees of inflammation and effusion,
      disability, functional disability, loss of daily living activities, deterioration in quality
      of life. (4,5). Pain is diminished by increased resting and alleviated by movement but
      advanced stages may also include resting pain and night pain. (6) In painful, swollen joints;
      loss of function is inevitable. The loss of function is specific to the site which is being
      involved. In knee OA, difficulty in squatting and climbing stairs, walking distance reduction
      and fatigue, antalgic gait can be seen (7). These complaints are often associated with
      instability. With increasing age, the frequency of OA also increases. The presence of knee OA
      in addition to the complications associated with aging especially affects the quality of life
      negatively. In addition to the physiological effects of advancing age; pain, functional
      restriction, loss of proprioception and instability due to knee OA may lead to a decrease in
      balance and, consequently, to falls, which may lead to undesirable outcomes. The
      determination of the balance problems in OA patients is also important in planning the
      treatment protocol to be given and also in evaluating the effectiveness of the treatment.
      There are valid and reliable scales in Turkish language which assess balance.

      However, validity and reliability specific to the disease are also important for doing the
      assessment safeley in that population.

      The Fullerton Advanced Balance Scale (FAB) was developed by Debbie Rose in 2006 to evaluate
      patients with a high risk of falling. The test uses dynamic and static equilibrium in
      different situations to determine balance problems in the elderly. The test has 10
      parameters. These are: feet adjacent and eyes closed standing, reaching out forward to reach
      a shoulder-length object, turning in right and left directions in 360 degrees, stepping and
      passing over a 15.24 cm-length stair, tandem march, standing on one leg, eyes closed standing
      on the foam, double feet bounce, walking with head turning, reactive postural control. In
      this scale, which is scored between 0-40, a score between 0 and 4 is given for each item (8).

      According to the power analysis,a total number of 84 knee osteoarthritis patients, aged
      between 40 and 65 years of age will be included in the study. Individuals will be given
      written and oral information about the study and their written approvals will be obtained. *
      The Turkish version of the Fullerton Advanced Balance Scale (FAB) was obtained with
      permission from Debbie Rose who developed the scale and it is used on the elderly before.
      Study pattern: Familiarization will be made to the physiotherapists before the study.
      Information about the all scales will be given in detail with practical application. The
      study will be performed on 3 different days and by a single physiotherapist. 1st Evaluation:
      All evaluations of the individuals included in the study will be done by the physiotherapist
      (sociodemographic evaluations, implementation of FAB-T and other balance scales). In
      addition, to determine the acceptability of the FAB-T scale, the time during the FAB-T
      application will be recorded. 2nd Evaluation: The same individuals will be visited by the
      same physiotherapist at least 7 days after the first evaluation and only the FAB-T scale will
      be applied. 3rd Evaluation: After 6 weeks of treatment, the FAB-T scale will be applied to
      all individuals included in the study. The first two evaluations will be made for all
      participants. After the second evaluation is completed, 34 volunteer individuals who will be
      randomly choosen among 84 individuals will be given a 6-week exercise training program.
      According to this 6 week program, individuals will be admitted to the exercise training
      program for 45-60 minutes with a physiotherapist for 3 days in a week. The exercise program
      will consist of a warm-up, a strenght training and a cool-down section. Various exercise
      methods (clinical pilates exercises) and tools will be utilized to improve balance and
      mobility. Third assessment will be applied only to individuals participating in the 6-week
      exercise training program. With the study design, the reliability of testing and retesting
      ability of the FAB-T scale, its validity with respect to its correlation with other balance
      scales, its acceptability with the application period and its sensitivity to change after 6
      weeks of treatment will be evaluated.
    

Intervention name(s): Clinical Pilates Exercise
Intervention type(s): Other
Intervention description(s): All evaluations of the individuals included in the study will be done by the physiotherapist.. For the second evaluation the same individuals will be visited by the same physiotherapist at least 7 days after the first evaluation and only the FAB-T scale will be applied. 34 volunteer individuals who will be randomly choosen among 84 individuals will be given a 6-week exercise training program. According to this 6 week program, individuals will be admitted to the exercise training program for 45-60 minutes with a physiotherapist for 3 days in a week. The exercise program will consist of a warm-up, a strength training and a cool-down section. Various exercise methods (clinical pilates exercises) and tools will be utilized to improve balance and mobility. Third assessment of FAB-T will be applied only to individuals participating in the 6-week exercise training program.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: osteoarthritis; exercise; balance