Background
Standing balance is imperative for mobility and avoiding falls. Use of an excessive number of standing balance measures has limited the synthesis of balance intervention data and hampered consistent clinical practice.
Objective
To develop recommendations for a core outcome set (COS) of standing balance measures for research and practice among adults.
Methodology
A combination of scoping reviews, literature appraisal, anonymous voting and face-to-face meetings with fourteen invited experts from a range of disciplines with international recognition in balance measurement and falls prevention. Consensus was sought over three rounds using pre-established criteria.
Data sources
The scoping review identified 56 existing standing balance measures validated in adult populations with evidence of use in the past five years, and these were considered for inclusion in the COS.
Results
Fifteen measures were excluded after the first round of scoring and a further 36 after round two. Five measures were considered in round three. Two measures reached consensus for recommendation, and the expert panel recommended that at a minimum, either the Berg Balance Scale or Mini Balance Evaluation Systems Test be used when measuring standing balance in adult populations.
Limitations
Inclusion of two measures in the COS may increase the feasibility of potential uptake, but poses challenges for data synthesis. Adoption of the standing balance COS does not constitute a comprehensive balance assessment for any population, and users should include additional validated measures as appropriate.
Conclusions
The absence of a gold standard for measuring standing balance has contributed to the proliferation of outcome measures. These recommendations represent an important first step towards greater standardization in the assessment and measurement of this critical skill and will inform clinical research and practice internationally.
Kathryn M. Sibley
Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
Kathryn M. Sibley, Brian E. Maki, Susan B. Jaglal
Toronto Rehabilitation Institute- University Health Network, Toronto, Canada
Tracey Howe
School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
Sarah E. Lamb
Centre for Rehabilitation Research, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
Stephen R. Lord
Neuroscience Research Australia, University of New South Wales, Sydney, Australia
Brian E. Maki, Sharon E. Straus, Susan B. Jaglal
University of Toronto, Toronto, Canada
Debra J. Rose
California State University Fullerton, Fullerton, California, United States of America
Vicky Scott
Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, Canada
Vicky Scott
British Columbia Injury Research and Prevention Unit and Ministry of Health, Victoria, Canada
Liza Stathokostas
Canadian Centre for Activity and Aging, Western University, London, Canada
Disease Category: Orthopaedics & trauma
Disease Name: Falls prevention & balance in older people
Age Range: 18 - 100
Sex: Either
Nature of Intervention: Any
- Clinical experts
- Researchers
- Recommendations for outcome measures (measurement/how)
- Literature review
- Semi structured discussion
A combination of scoping reviews, literature appraisal, anonymous voting and face-to-face meetings with fourteen invited experts from a range of disciplines with international recognition in balance measurement and falls prevention. Consensus was sought over three rounds using pre-established criteria.