Objective The purpose of this study was to demonstrate that the construct of falls efficacy, as measured by the Activities-Specific Balance Confidence (ABC) scale, is comprised of distinct factors in those with chronic stroke.

Design This study is a cross-sectional analysis of pre-existing data from a research registry.

Setting Academic institution.

Participants 248 community-dwelling adults history of one or more strokes, verified by CT/MRI report or past provider.

Interventions Not applicable.

Main Outcome Measure(s) Goodness-of-Fit indices (Root Mean Square Error of Approximation (RMSEA), Comparative Fit Index (CFI), and Tucker-Lewis Fit Index (TLI)).

Results To test our hypothesis that the ABC scale is comprised of distinct factors linked to the balance domains, we proposed that the ABC scale items are indicative of three subdomains, 1) anticipatory control, 2) walking balance, and 3) reactive balance. A confirmatory factor analysis was performed to test this hypothesized structure. We assigned ABC Q1,2,8,10-12 to walking balance, Q3-7,9 to anticipatory control, and Q13-16 to reactive balance. All indicators significantly loaded as hypothesized. Modification indices suggested that Q6, which asks about standing on a chair and reaching for something, might be multidimensional and load onto both the anticipatory control and reactive balance latent constructs. Therefore, confidence in reaching while on a stool reflects confidence in both anticipatory and reactive balance.

Conclusion(s) These results suggest that the items in the ABC scale measure three subfactors that align with anticipatory control, walking balance, and reactive balance.

The authors have declared no competing interest.

Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number R03HD113864. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The Human Subjects Institutional Review Board of the University of Delaware gave ethical approval for this work.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data produced in the present study are available upon reasonable request to the authors. All data produced will become available online through the NICHD Data and Specimen Hub (DASH) once approved.