Concerns regarding falling after stroke: analysis of the psychometric properties of the Taiwan Chinese version of the Iconographical Falls Efficacy Scale in people with stroke

Disabil Rehabil. 2025 Jun 15:1-9. doi: 10.1080/09638288.2025.2517248. Online ahead of print.

Abstract

Purpose: This study evaluated the validity and reliability of the 30- and 10-item Taiwan Chinese version of the Iconographical Falls Efficacy Scale (Icon-FES (TW)) for people with stroke.

Methods: Sixty people with chronic stroke completed the Taiwanese version of the Icon-FES, the International Falls Efficacy Scale, and the World Health Organization Quality of Life Questionnaire Brief version. They also completed the Berg Balance Scale (BBS) and the Short Physical Performance Battery (SPPB). After one week, they recompleted the Icon-FES. Discriminant validity, construct validity, internal consistency, and test-retest reliability were assessed.

Results: The 30- and 10-item Icon-FESs had high internal consistency (Cronbach's α = 0.971 and 0.912). Both versions significantly correlated with the International Falls Efficacy Scale (r = 0.87, 0.92) and showed associations with the SPPB, BBS, and the physical domain of the World Health Organization Quality of Life Questionnaire. They effectively differentiated people based on concern levels and BBS/SPPB scores. Test-retest reliability was high (ICC = 0.87, 0.86).

Conclusions: The Icon-FES is a reliable and valid tool for assessing concerns regarding falling in people with stroke.

Keywords: Fear; falls; reliability; stroke; validity.

Plain language summary

The 30- and 10-item Icon-FES (TW) demonstrate strong psychometric properties, making them reliable and valid tools for assessing concerns regarding falling in people with stroke.By accurately identifying concerns regarding falling, the Icon-FES (TW) can help clinicians develop targeted fall prevention strategies, enhancing the safety of individuals at risk of falling.Early detection and intervention for concerns regarding falling can contribute to improved confidence, independence, and mobility in daily activities, ultimately supporting better rehabilitation outcomes.