some assessment tools , including the berg balance scale ( bbs ) , postural assessment scale 
 for stroke ( pass ) , balance subscale of the fugl - meyer test , and timed up and go test ( tug ) , 
 have been developed and are often used to evaluate balance and mobility in patients with 
 stroke . however , when evaluating subjects with mild neurological impairment , the utility of 
 these scales can be limited by ceiling effects .
the community balance and mobility scale 
 ( cb&m ) was created and developed to evaluate community - level functional deficits in both 
 mobility and dynamic balance .
this scale was made for assessing sophisticated balance and 
 mobility activities such as quick direction changes and dual tasking , originally in young 
 traumatic brain injury ( tbi ) patients .
significantly , the cb&m has been validated in 
 able - bodied individuals and tbi and stroke patient populations .
the scale is easy to apply , 
 requires minimal equipment , and consists of items assessing functional balance and mobility . 

the cb&m can precisely evaluate the variability in patients and changes in scores , and 
 it does not produce the ceiling effects typically seen with the bbs and tug in the 
 assessment of balance and mobility1 .
the 
 cb&m comprises 13 tasks such as bending , turning , or looking while walking ; single - leg 
 standing ; and stair descent2 .
studies have 
 also found that the cb&m was superior to the bbs and tug for verifying improvements in 
 mobility and balance , which is important for assessing the progression of recovery and 
 efficacy of physical therapy , and it may be more appropriate for ambulatory patients with 
 moderate to mild post - stroke deficits1 . 

therefore , the purpose of this study was to examine the intra- and inter - rater reliability 
 and convergent validity of the korean version of the cb&m ( k - cb&m ) compared with 
 that of the bbs , tug , and functional reaching test ( frt ) in patients with hemiplegia whose 
 native language is korean .
the k - cb&m was originally developed by howe et al . , and its usefulness has been 
 confirmed by howe3 . the k - cb&m was 
 initially translated by two persons proficient in english whose native language is korean , 
 after the objective of the study was explained to them .
the two translations were compared , 
 and when differences were identified , the texts were modified to obtain a consensus between 
 the two translations regarding the initial translation .
subsequently , the k - cb&m was 
 translated back into english by a physical therapist whose native language is english , who 
 was unaware of the original version and the objective of the study . to test the reliability 
 of the k - cb&m in the current study , the scale ( final version )
the inclusion criteria were as follows : 1 ) a diagnosis of stroke , 2 ) more than 
 5 months after stroke onset , 3 ) more than 24 points on the mini mental state evaluation , 4 ) 
 adequate ability to follow verbal commands in korean , 5 ) first unilateral hemispheric 
 stroke , and 6 ) able to walk indoors with or without a gait aid .
all of the recruited 
 subjects gave their written informed consent before participation , and this study conformed 
 to the principles of the declaration of helsinki .
demographics and clinical characteristics 
 of the participants are shown in table 
 1table 1.demographics and clinical characteristics of the participants ( n=16)variablesall participantsage ( yrs)44.4  15.9gendermale / female5/11 ( 31.3/68.8)side of hemiplegialeft / right4/12 ( 25.0/75.0)type of strokeinfarction / hemorrhage4/12 ( 25.0/75.0)brain lesion locationcortex / subcortex / mixed3/5/8 ( 18.8/31.3/50.0)time poststroke ( months)47.6  39.4 mmse score26.80  2.8functional ambulatory scale ( 4/5)4/5 ( 0.0/100)values , n ( % ) or mean  standard deviation ; mmse : mini mental state evaluation . values , n ( % ) or mean  standard deviation ; mmse : mini mental state evaluation at each testing session , participants completed the k - cb&m , bbs4 , tug5 , and 
 frt6 .
all tests were administered by a 
 physical therapist , and participants completed the tests in an identical standardized order 
 during all testing sessions . for this study ,
the k - cb&m was scored by two trained 
 physical therapists with more than 5  years of experience .
assessment of the k - cb&m takes 
 approximately 15 minutes to complete by trained physical therapists and requires minimal 
 equipment , including 2 weighted bags , an 8  m track with a target on the wall , a stopwatch , a 
 set of 3 stair steps , and a beanbag7 . 

inter- and intra - rater reliability of the k - cb&m subscores was determined using 
 intraclass correlation coefficients , and convergent validity between the k - cb&m and 
 other tests of balance and mobility was calculated using spearman correlation 
 coefficients .
high reliability was observed for both inter- and intra - rater reliability correlation 
 coefficients , while moderate inter - rater reliability was observed for the items  walking and 
 looking  and  walk , look , and carry  , and moderate intra - rater reliability was observed for 
  forward to backward walking  .
inter- and intra - rater correlation coefficients are shown in 
 tables 2table 2.inter-rater reliability of k - cb&m subscores ( n=16)itemicc95% confidence interval ( ci)unilateral stance 0.8820.693 , 0.952tandem walking0.8420.608 , 0.942180 tandem pivot0.9470.856 , 0.981lateral foot scooting0.9220.768 , 0.973hopping forward0.9360.831 , 0.977crouch and walk0.8450.570 , 0.945lateral dodging0.8540.639 , 0.946walking & looking0.5170.067 , 0.797running with controlled stop0.8670.654 , 0.952forward to backward walking0.7210.381 , 0.892walk , look , and carry0.5420.088 , 0.811descending stairs0.8840.708 , 0.958step - ups  1 step0.8290.551 , 0.706*p<0.05 ; icc : intraclass correlation coefficient ; k - cb&m : korean version of 
 the community balance and mobility scale and 3table 3.intra-rater reliability of k - cb&m subscores ( n=16)itemicc95% confidence interval ( ci)unilateral stance0.8920.722 , 0.961tandem walking0.9570.884 , 0.985180 tandem pivot0.8500.621 , 0.945lateral foot scooting0.9420.836 , 0.980hopping forward0.9780.941 , 0.992crouch and walk0.7380.393 , 0.900lateral dodging0.9300.801 , 0.975walking & looking0.9260.807 , 0.973running with controlled stop0.9510.868 , 0.983forward to backward walking0.6400.245 , 0.856walk , look , and carry0.9570.883 , 0.985descending stairs0.9540.874 , 0.983step - ups  1 step0.8030.518 , 0.927*p<0.05 ; icc : intraclass correlation coefficient ; k - cb&m : korean version of 
 the community balance and mobility scale , respectively .
furthermore , there was a positive correlation between the 
 k - cb&m and bbs and a negative correlation between the k - cb&m and tug in the 
 assessment of convergent validity .
the convergent validity is shown in table 4table 4.convergent validity of k - cb&m with bbs , tug , and frt ( n=16)variablesk - cb&mbbstugfrtcb&m 1.000bbs 0.781**1.000tug 0.625*0.637 * 1.000frt 0.1630.5050.4101.000values are spearman correlation coefficients . *
* p<0.01 ; * p<0.05 ; k - cb&m : 
 korean version of the community balance and mobility scale ; bbs : berg balance scale ; 
 tug : timed up and go test ; frt : functional reaching test . * p<0.05 ; icc : intraclass correlation coefficient ; k - cb&m : korean version of 
 the community balance and mobility scale * p<0.05 ; icc : intraclass correlation coefficient ; k - cb&m : korean version of 
 the community balance and mobility scale values are spearman correlation coefficients . * * p<0.01 ; * p<0.05 ; k - cb&m : 
 korean version of the community balance and mobility scale ; bbs : berg balance scale ; 
 tug : timed up and go test ; frt : functional reaching test
the cb&m was created and developed to be used in clinical settings to assess the 
 complex gait skills that are important for the more difficult tasks required for functioning 
 in the community2 .
many studies have shown 
 that muscle power in the lower limbs is an important element of balance and ambulatory 
 function in able - bodied individuals as well as adults after stroke8 .
the cb&m consists of challenging tasks commonly 
 performed in the community ( e.g. , walking and looking at a target ) , to evaluate a wide range 
 of abilities related to mobility and balance of ambulatory patients .
this scale was found to 
 have high reliability ( intraclass correlation coefficients of 0.98 for intratest , intertest , 
 and test - retest reliability ) , high internal consistency ( cronbach s  of 0.96 ) , and moderate 
 content and construct validity ( r=0.62 and 0.64 , respectively)1 . in the present study , inter- and intra - rater reliability 

coefficients were high , ranging from 0.517 to 0.947 and 0.64 to 0.978 , respectively .
thus , 
 the k - cb&m can be used in clinical sessions to assess static and dynamic balance in 
 korean patients with hemiplegia after stroke .
mao et al . researched the psychometric 
 properties of the balance subscale of the fugl - meyer test , bbs , and pass among subjects 
 after strokes of varying severity . according to these authors , all 3 balance assessments 
 demonstrated excellent inter - rater reliability ( intraclass correlation coefficients ranged 
 from 0.920.97 ) and high intra - rater consistency ( cronbach s  ranged from 0.850.98)9 . in this study ,
in addition , there were important correlations of 
 moderate to outstanding magnitude between cb&m scores and all gait conditions .
this 
 finding suggests that the cb&m is an important construct to assess specific dynamic 
 balance2 .
the same result was observed 
 for the convergent validity between the k - cb&m and tug in the present study .
therefore , 
 the k - cb&m is an effective assessment tool for dynamic balance in patients with 
 hemiplegia . in this study ,
the effectiveness of the k - cb&m was demonstrated , so that , 
 clinical practitioners treating patients using the korean language can use this material for 
 assessing static and dynamic balance , like the bbs and tug .
 [ purpose ] the aim of this study was to translate and adapt the community balance and 
 mobility scale ( cb&m ) into korean ( k - cb&m ) and to verify the reliability and 
 validity of scores obtained with korean patients . [ subjects and methods ] a total of 16 
 subjects were recruited from st . 
 vincent s hospital in south korea . at each testing 
 session 
 , subjects completed the k - cb&m , berg balance scale ( bbs ) , timed up and go test 
 ( tug ) , and functional reaching test . 
 all tests were administered by a physical therapist , 
 and subjects completed the tests in an identical standardized order during all testing 
 sessions . 
 [ results ] the inter- and intra - rater reliability coefficients were high for most 
 subscores , while moderate inter - rater reliability was observed for the items  walking and 
 looking  and  walk , look , and carry  , and moderate intra - rater reliability was observed 
 for  forward to backward walking  . there was a positive correlation between the k - cb&m 
 and bbs and a negative correlation between the k - cb&m and tug in the convergent 
 validity assessments . 
 [ conclusion ] the reliability and validity of the k - cb&m was 
 high , suggesting that clinical practitioners treating korean patients with hemiplegia can 
 use this material for assessing static and dynamic balance . 
INTRODUCTION
SUBJECTS AND METHODS
RESULTS
DISCUSSION