Cultural adaptation and psychometric validation of the Balance Recovery Confidence Scale in older Turkish adults

• Published in: Physiotherapy theory and practice pp. 1 - 10
• Main Authors: Dağbaşi, Abdulkadir, Arslan, Serdar, Yapali, Gökmen
• Format: Journal Article
• Language: English
• Published: England 29.08.2025
• Subjects: geriatrics; cultural adaptation; Balance confidence; fall risk
• ISSN: 0959-3985; 1532-5040
• DOI: 10.1080/09593985.2025.2552292

Falls cause significant morbidity/mortality in older adults. Current scales assess fear of falling and proactive balance confidence but neglect confidence in reactive balance recovery (regaining stability after perturbations). The Balance Recovery Confidence Scale (BRCS) fills this gap, requiring cultural adaptation for Turkish populations. To translate, culturally adapt, and validate the BRCS in community-dwelling Turkish older adults. Following Beaton's guidelines, BRCS underwent forward-backward translation, expert review (  = 10), and pilot testing (  = 30). Psychometric validation included 76 adults ≥65 years. Content validity used Content Validity Index (CVI) and Ratio (CVR). Construct validity employed Exploratory/Confirmatory Factor Analysis (EFA/CFA). Reliability was assessed via Cronbach's α and Intraclass Correlation Coefficient (ICC₃,₁; 7-day retest). Convergent validity examined Spearman correlations between Turkish BRCS and Falls Efficacy Scale-International (FES-I), Activities-specific Balance Confidence Scale (ABC), Tinetti Balance & Gait Test (TBT&TGT), Timed Up and Go Test (TUG), 30-Second Chair Stand Test (30s-CST), and Handgrip Strength Test (HGST). Content validity was excellent (mean CVI = 0.92, CVR = 0.70-1.00). EFA/CFA confirmed a one-factor structure with excellent fit (CFI = 0.96, RMSEA = 0.045). Internal consistency (α = 0.94) and test-retest reliability (ICC₃,₁ = 0.94) were excellent. Turkish BRCS correlated strongly negatively with FES-I (-0.68), strongly positively with ABC (0.74), and moderately with physical performance tests (all  < .05). Standard Error of Measurement (SEM) = 6.91; Minimal Detectable Change at the 95% confidence level (MDC₉₅) = 19.16. The Turkish BRCS is a valid, reliable tool for assessing reactive balance recovery confidence in older adults, suitable for clinical and research applications.