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.