The findings suggest that the ICF is a useful framework for selecting clinical measures relative to fall history and support the need for prospective study of tools in more-complex domains of the ICF for their accuracy for fall prediction in people with stroke.

Background and Purpose. The fear of falling can have detrimental effects on physical function in the elderly population, but the relationship between a persons' confidence in the ability to maintain balance and actual balance ability and functional mobility is not known. The extent to which balance confidence can be explained by balance performance, functional mobility, and sociodemographic, psychosocial, and health-related factors was the focus of this study. Subjects. The subjects were 50 community-dwelling elderly people, aged 65 to 95 years (X̄=81.7, SD=6.7). Methods. Balance was measured using the Berg Balance Scale. Functional mobility was measured using the Timed Up & Go Test. The Activities-specific Balance Scale was used to assess balance confidence. Data were analyzed using Pearson correlation, multiple regression analysis, and t tests. Results. Fifty-seven percent of the variance in balance confidence could be explained by balance performance. Functional mobility and subject characteristics examined in this study did not contribute to balance confidence. Discussion and Conclusion. Balance performance alone is a strong determinant of balance confidence in community-dwelling elderly people.

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Determining whether real change has taken place as a result of treatment and whether that change constitutes important change are challenges central to evidence-based physical therapist practice. Recently, the literature reporting these values for clinical measures has expanded considerably. In this article, we discuss some of the indices for identifying real change and important change, and how physical therapists can use these indices to enhance the interpretability of change scores derived from clinical measures. Specifically, we define and discuss the uses of the minimal detectable change and the minimal clinically important difference. We provide suggestions for how these indices can be used to make change scores more meaningful to therapists, patients, their caregivers, and third-party payers. Accurate interpretation and application of these indices are crucial to informed patient management and clinical decision making. We also present some of the limitations confronted as we try to apply these values across various patient diagnostic groups and across the spectrum of initial level of impairment. Finally, recommendations are made for directions for future research in this important area of outcomes research and how clinicians can contribute to these efforts.

Gait at preferred speed permitted the unsteady subjects and the comparison subjects to select similar IFD values, but at the cost of slower gait in the unsteady subjects. When required to walk at a "normal" pace of 120 steps/min, subjects with vestibulopathy increased their IFD. These data suggest that wide-based gait alone cannot differentiate between subjects with and without balance impairments. Base of support and other whole-body kinematic variables are mechanical compensations of vestibulopathic instability. Further studies are needed to determine whether development of active control of these whole-body control variables can occur after vestibular rehabilitation.