Background and Purpose: Balance impairments are prevalent in adult cancer survivors, leading to increased fall risk and reduced quality of life. To identify survivors in need of balance and fall interventions and to track change with intervention, health care providers need measures with sound psychometric properties and high clinical utility. The purpose of this systematic review was to identify reliable, valid, and clinically useful measures of balance impairments in adult cancer survivors. Secondary purposes were to obtain minimal detectable change of identified balance measures and to determine use of measures to evaluate fall risk. Methods: A systematic review was conducted to assess psychometric properties and clinical utility of balance measures identified from the literature search. Two reviewers in a team independently extracted data from articles and evaluated cumulative evidence for each balance measure using the Cancer EDGE Task Force Outcome Measure Rating Form. Results: The search located 187 articles, with 54 articles retained for quality assessment of balance measures. The Fullerton Advanced Balance Scale and gait speed were highly recommended (rated 4). Balance Evaluation Systems Test, Timed Up and Go, and Five Times Sit to Stand were recommended (rated 3). Limitations: Selection bias is possible. Samples and settings across reviewed studies were widely heterogeneous. Conclusions: We recommend 5 balance measures for use in adult cancer survivors. Future research with existing balance measures should establish norms, responsiveness, and predictive validity for fall risk, while expanding to focus on imbalance in midlife survivors. Patient-reported outcome measures are needed for cancer-related imbalance.

It is well established that it can take upward of 20 years to implement research findings into clinical practice. Research findings do not always translate well into the clinical environment for a number of reasons including organizational/individual resistance to change, disruption in workflow, lack of intervention adaptability, and the complexity of patients in the rehabilitation setting. Physical therapists will benefit from an understanding of implementation science (IS) in order to optimize the integration of evidence-based practices (EBPs) into the clinical setting. Implementation science focuses on how interventions work in real settings, how to improve them, and how to sustain them. It provides a framework for identifying barriers and facilitators to the uptake of the desired behavior and engages stakeholders of multiple levels into the process. Two frameworks, the Knowledge-to-Action framework and the Consolidated Framework for Implementation Research, are presented to provide guidance to clinicians and researchers in oncology rehabilitation who are interested in embarking upon IS projects. A hybrid version of the 2 frameworks is proposed with the aim of providing stakeholders with stronger and targeted tools to increase the likelihood of successful implementation of EBP. The purpose of this perspective is to describe IS, key frameworks, and strategies of knowledge implementation and to identify barriers and facilitators to implementation of contemporary research into clinical practices. The secondary purpose of this article is to demonstrate its application for the Academy of Oncologic Physical Therapy.

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