Review Article (Meta-Analyses)
Using the Systems Framework for Postural Control to Analyze the Components of Balance Evaluated in Standardized Balance Measures: A Scoping Review

Presented to the International Society for Posture and Gait Research meeting, June 29-July 3, 2014, Vancouver, British Columbia, Canada.
https://doi.org/10.1016/j.apmr.2014.06.021Get rights and content
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Abstract

Objective

To identify components of postural control included in standardized balance measures for adult populations.

Data Sources

Electronic searches of MEDLINE, EMBASE, and CINAHL databases using keyword combinations of postural balance/equilibrium, psychometrics/reproducibility of results/predictive value of tests/validation studies, instrument construction/instrument validation, geriatric assessment/disability evaluation, gray literature, and hand searches.

Study Selection

Inclusion criteria were measures with a stated objective to assess balance, adult populations (18y and older), at least 1 psychometric evaluation, 1 standing task, a standardized protocol and evaluation criteria, and published in English. Two reviewers independently identified studies for inclusion. Sixty-six measures were included.

Data Extraction

A research assistant extracted descriptive characteristics and 2 reviewers independently coded components of balance in each measure using the Systems Framework for Postural Control, a widely recognized model of balance.

Data Synthesis

Components of balance evaluated in these measures were underlying motor systems (100% of measures), anticipatory postural control (71%), dynamic stability (67%), static stability (64%), sensory integration (48%), functional stability limits (27%), reactive postural control (23%), cognitive influences (17%), and verticality (8%). Thirty-four measures evaluated 3 or fewer components of balance, and 1 measure—the Balance Evaluation Systems Test—evaluated all components of balance.

Conclusions

Several standardized balance measures provide only partial information on postural control and omit important components of balance related to avoiding falls. As such, the choice of measure(s) may limit the overall interpretation of an individual's balance ability. Continued work is necessary to increase the implementation of comprehensive balance assessment in research and practice.

Keywords

Accidental falls
Aging
Chronic disease
Postural balance
Psychometrics
Rehabilitation

List of Abbreviations

BESTest
Balance Evaluation Systems Test

Cited by (0)

Supported by KT Canada, the Canadian Institutes of Health Research, and the Toronto Rehabilitation Institute (which received funding under the Provincial Rehabilitation Research Program from the Ministry of Health and Long Term Care in Ontario). S.E. Straus holds a Canada Research Chair in Knowledge Translation and Quality of Care. S.B. Jaglal holds the Toronto Rehabilitation Institute Chair in Rehabilitation Research at the University of Toronto.

Disclosures: none.