{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T13:21:57Z","timestamp":1794057717630,"version":"4.8.0"},"reference-count":28,"publisher":"Consortium of Multiple Sclerosis Centers","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,4,1]]},"abstract":"<jats:p>This study investigated the between-rater reliability of the Berg Balance Scale (BBS), 6-Minute Walk test (6MW), and handheld dynamometry (HHD) in people with multiple sclerosis (MS). Previous studies that examined BBS and 6MW reliability in people with MS have not used more than two raters, or analyzed different mobility levels separately. The reliability of HHD has not been previously reported for people with MS. In this study, five physical therapists assessed eight people with MS using the BBS, 6MW, and HHD, resulting in 12 pairs of data. Data were analyzed using intraclass correlation coefficients (ICCs), Spearman correlation coefficients (SCCs), and Bland and Altman methods. The results suggest excellent agreement for the BBS (SCC = 0.95, mean difference between raters [d\u0304] = 2.08, standard error of measurement [SEM] = 1.77) and 6MW (ICC = 0.98, d\u0304 = 5.22 m, SEM = 24.76 m) when all mobility levels are analyzed together. Reliability is lower in less mobile people with MS (BBS SCC = 0.6, d\u0304 = \u22121.83; 6MW ICC = 0.95, d\u0304 = 20.04 m). Although the ICC and SCC results for HHD suggest good-to-excellent reliability (0.65\u20130.85), d\u0304 ranges up to 17.83 N, with SEM values as high as 40.95 N. While the small sample size is a limitation of this study, the preliminary evidence suggests strong agreement between raters for the BBS and 6MW and decreased agreement between raters for people with greater mobility problems. The mean differences between raters for HHD are probably too high for it to be applied in clinical practice.<\/jats:p>","DOI":"10.7224\/1537-2073.2011-036","type":"journal-article","created":{"date-parts":[[2013,4,8]],"date-time":"2013-04-08T09:00:07Z","timestamp":1365411607000},"page":"1-6","source":"Crossref","is-referenced-by-count":31,"title":["Between-Rater Reliability of the 6-Minute Walk Test, Berg Balance Scale, and Handheld Dynamometry in People with Multiple Sclerosis"],"prefix":"10.7224","volume":"15","author":[{"given":"Elaine","family":"Toomey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Coote","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4242","reference":[{"key":"2020071713463754000_i1537-2073-15-1-1-b1","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1191\/026921598672178340","article-title":"Reliability of assessment tools in rehabilitation: an illustration of appropriate statistical analyses","volume":"12","author":"Rankin","year":"1998","journal-title":"Clin Rehabil."},{"key":"2020071713463754000_i1537-2073-15-1-1-b2","unstructured":"Finch\n              E\n            , BrooksD, StratfordP, MayoN.\n          Physical Rehabilitation Outcome Measures: A Guide to Enhanced Clinical Decision Making. 2nd ed. Ontario, Canada: BC Decker; 2002."},{"key":"2020071713463754000_i1537-2073-15-1-1-b3","doi-asserted-by":"crossref","first-page":"115","DOI":"10.7224\/1537-2073-12.3.115","article-title":"A profiling study of people with multiple sclerosis who access physiotherapy services in Ireland","volume":"12","author":"Coote","year":"2010","journal-title":"Int J MS Care."},{"key":"2020071713463754000_i1537-2073-15-1-1-b4","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1177\/0269215507077602","article-title":"Effects of balance exercises on people with multiple sclerosis: a pilot study","volume":"21","author":"Cattaneo","year":"2007","journal-title":"Clin Rehabil."},{"key":"2020071713463754000_i1537-2073-15-1-1-b5","doi-asserted-by":"crossref","first-page":"304","DOI":"10.3138\/ptc.41.6.304","article-title":"Measuring balance in the elderly: preliminary development of an instrument","volume":"41","author":"Berg","year":"1989","journal-title":"Physiother Can."},{"key":"2020071713463754000_i1537-2073-15-1-1-b6","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1080\/09638280500404289","article-title":"Validity of six balance disorders scales in persons with multiple sclerosis","volume":"28","author":"Cattaneo","year":"2006","journal-title":"Disabil Rehabil."},{"key":"2020071713463754000_i1537-2073-15-1-1-b7","doi-asserted-by":"crossref","first-page":"1920","DOI":"10.1080\/09638280701191859","article-title":"Reliability of four scales on balance disorders in persons with multiple sclerosis","volume":"29","author":"Cattaneo","year":"2007","journal-title":"Disabil Rehabil."},{"key":"2020071713463754000_i1537-2073-15-1-1-b8","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1002\/pri.30","article-title":"Reliability of physical functioning measures in ambulatory subjects with MS","volume":"10","author":"Paltamaa","year":"2005","journal-title":"Physiother Res Int."},{"key":"2020071713463754000_i1537-2073-15-1-1-b9","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1177\/1352458510361357","article-title":"Predicting habitual walking performance in multiple sclerosis: relevance of capacity and self-report measures","volume":"16","author":"Gijbels","year":"2010","journal-title":"Mult Scler."},{"key":"2020071713463754000_i1537-2073-15-1-1-b10","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1177\/1352458507082607","article-title":"Evaluation of the six-minute walk in multiple sclerosis subjects and healthy controls","volume":"14","author":"Goldman","year":"2008","journal-title":"Mult Scler."},{"key":"2020071713463754000_i1537-2073-15-1-1-b11","doi-asserted-by":"crossref","first-page":"1534","DOI":"10.1007\/s00415-008-0964-x","article-title":"Use of hand-held dynamometry in the evaluation of lower limb muscle strength in people with Huntington's disease","volume":"255","author":"Busse","year":"2008","journal-title":"J Neurol."},{"key":"2020071713463754000_i1537-2073-15-1-1-b12","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1093\/ptj\/66.2.206","article-title":"Test-retest reliability of hand-held dynamometry during a single session of strength assessment","volume":"66","author":"Bohannon","year":"1986","journal-title":"Phys Ther."},{"key":"2020071713463754000_i1537-2073-15-1-1-b13","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1093\/ptj\/67.6.931","article-title":"Interrater reliability of hand-held dynamometry","volume":"67","author":"Bohannon","year":"1987","journal-title":"Phys Ther."},{"key":"2020071713463754000_i1537-2073-15-1-1-b14","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.jns.2011.03.003","article-title":"Quantitative measures detect sensory and motor impairments in multiple sclerosis","volume":"305","author":"Newsome","year":"2011","journal-title":"J Neurol Sci."},{"key":"2020071713463754000_i1537-2073-15-1-1-b15","doi-asserted-by":"crossref","first-page":"185","DOI":"10.2165\/00007256-198805030-00005","article-title":"PAR-Q, Canadian Home Fitness Test and exercise screening alternatives","volume":"5","author":"Shephard","year":"1988","journal-title":"Sports Med."},{"key":"2020071713463754000_i1537-2073-15-1-1-b16","doi-asserted-by":"crossref","first-page":"483","DOI":"10.4085\/1062-6050-43.5.483","article-title":"Initial reliability of the Standardized Orthopedic Assessment Tool (SOAT)","volume":"43","author":"Lafave","year":"2008","journal-title":"J Athlet Train."},{"key":"2020071713463754000_i1537-2073-15-1-1-b17","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1080\/02687030801952709","article-title":"The reliability of rating conversation as a measure of functional communication following stroke","volume":"22","author":"Hesketh","year":"2008","journal-title":"Aphasiology."},{"key":"2020071713463754000_i1537-2073-15-1-1-b18","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1177\/0269215506072183","article-title":"The Community Balance and Mobility Scale: a balance measure for individuals with traumatic brain injury","volume":"20","author":"Howe","year":"2006","journal-title":"Clin Rehabil."},{"key":"2020071713463754000_i1537-2073-15-1-1-b19","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1191\/0269215503cr677oa","article-title":"Inter-rater reliability and concurrent validity of walking speed measurement after traumatic brain injury","volume":"17","author":"van Loo","year":"2003","journal-title":"Clin Rehabil."},{"key":"2020071713463754000_i1537-2073-15-1-1-b20","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1177\/135245859900500406","article-title":"The Guy's Neurological Disability Scale (GNDS): a new disability measure for multiple sclerosis","volume":"5","author":"Sharrack","year":"1999","journal-title":"Mult Scler."},{"key":"2020071713463754000_i1537-2073-15-1-1-b21","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1097\/01.phm.0000176452.17771.20","article-title":"How to assess the reliability of measurements in rehabilitation","volume":"84","author":"Lexell","year":"2005","journal-title":"Am J Phys Med Rehabil."},{"key":"2020071713463754000_i1537-2073-15-1-1-b22","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S0140-6736(86)90837-8","article-title":"Statistical methods for assessing agreement between two methods of clinical measurement","volume":"1","author":"Bland","year":"1986","journal-title":"Lancet."},{"key":"2020071713463754000_i1537-2073-15-1-1-b23","doi-asserted-by":"crossref","first-page":"27","DOI":"10.2310\/6640.2004.15377","article-title":"Getting more from the literature: estimating the standard error of measurement from reliability studies","volume":"56","author":"Stratford","year":"2004","journal-title":"Physiother Can."},{"key":"2020071713463754000_i1537-2073-15-1-1-b24","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1023\/A:1013138911638","article-title":"Smallest real difference, a link between reproducibility and responsiveness","volume":"10","author":"Beckerman","year":"2001","journal-title":"Qual Life Res."},{"key":"2020071713463754000_i1537-2073-15-1-1-b25","first-page":"1","article-title":"Reliability of measurement","author":"Fleiss","year":"1986","journal-title":"The Design and Analysis of Clinical Experiments"},{"key":"2020071713463754000_i1537-2073-15-1-1-b26","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/1471-2377-9-34","article-title":"Getting the balance right: a randomised controlled trial of physiotherapy and exercise interventions for ambulatory people with multiple sclerosis","volume":"9","author":"Coote","year":"2009","journal-title":"BMC Neurol."},{"key":"2020071713463754000_i1537-2073-15-1-1-b27","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1097\/MRR.0b013e328350b65f","article-title":"Reliability and clinical significance of mobility and balance assessments in multiple sclerosis","volume":"35","author":"Learmonth","year":"2012","journal-title":"Int J Rehabil Res."},{"key":"2020071713463754000_i1537-2073-15-1-1-b28","first-page":"71","article-title":"The reliability of hand held muscle testers with individuals with spinal cord injury","volume":"57","author":"Aufsesser","year":"2003","journal-title":"Clin Kinesiol: J Am Kinesiother Assoc."}],"container-title":["International Journal of MS Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/ijmsc\/article-pdf\/15\/1\/1\/2553268\/1537-2073_2011-036.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/ijmsc\/article-pdf\/15\/1\/1\/2553268\/1537-2073_2011-036.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T21:11:39Z","timestamp":1752786699000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ijmsc.org\/view\/between-rater-reliability-of-the-6-minute-walk-test-berg-balance-scale-and-handheld-dynamometry-in-people-with-multiple-sclerosis"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,4,1]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,4,1]]}},"URL":"https:\/\/doi.org\/10.7224\/1537-2073.2011-036","relation":{},"ISSN":["1537-2073"],"issn-type":[{"value":"1537-2073","type":"print"}],"subject":[],"published":{"date-parts":[[2013,4,1]]}}}