Using the Systems Framework for Postural Control to Analyze the Components of Balance Evaluated in Standardized Balance Measures: A Scoping Review

Sibley, Kathryn M.; Beauchamp, Marla K.; Ooteghem, Karen Van; Straus, Sharon E.; Jaglal, Susan

doi:10.1016/j.apmr.2014.06.021

Cited by 200 publications

(173 citation statements)

References 97 publications

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“…The ability to measure outcomes using a shorter instrument has many practical advantages over long-form instruments, for example better acceptability for the study population and better feasibility for the administering staff (Pollock et al, 2011;Rolstad et al, 2011). For these reasons, the MiniBESTest has increasingly been used and validated to assess balance impairments in several conditions (including a series of neurological diseases), and has recently been identified as the most comprehensive balance measure by different research groups (Pardasaney et al, 2013;Sibley et al, 2015aSibley et al, , 2015b.…”

Section: Introductionmentioning

confidence: 99%

The Mini-BESTest: a review of psychometric properties

Carlo

Bravini

Vercelli

et al. 2016

International Journal of Rehabilitation Research

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The Mini-Balance Evaluation Systems Test (Mini-BESTest) has been identified as the most comprehensive balance measure for community-dwelling adults and elderly individuals. It can be used to assess balance impairments in several other conditions, mainly Parkinson's disease and stroke. Despite increasing use of the Mini-BESTest since it was first published 5 years ago, no systematic review synthesizing its psychometric properties is available. The aim of this study was to provide a comprehensive review of the psychometric properties of the Mini-BESTest when administered to patients with balance deficits because of different diseases. A literature search was performed on articles published before July 2015 in journals indexed by MEDLINE and Scopus databases. The search produced 98 papers, 24 of which fulfilled the inclusion criteria for this review. Most papers (n=19) focused on patients affected by neurological diseases, mainly Parkinson's disease. In 21 papers, the psychometric characteristics were analyzed using Classical Test Theory methods and in only three papers was Rasch analysis carried out. This review shows the interest of researchers in the Mini-BESTest despite the short time frame since its first publication. The Mini-BESTest is used widely in both clinical practice and research. The results support the reliability, validity, and responsiveness of this instrument and it can be considered a standard balance measure. However, it would be valuable to learn more about how this scale performs in different diseases causing balance deficits and to better define the minimal clinically important difference for each disease.

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Section: Introductionmentioning

confidence: 99%

The Mini-BESTest: a review of psychometric properties

Carlo

Bravini

Vercelli

et al. 2016

International Journal of Rehabilitation Research

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“…Moreover, while it includes some components of balance, including underlying motor systems, static and dynamic stability, functional stability limits, anticipatory postural control and sensory integration, it does not evaluate verticality, reactive postural control, or cognitive influences on balance [23], which are all important for avoiding falls.…”

Section: Discussionmentioning

confidence: 99%

“…Documented ceiling effects were less than the BBS in a sample of inpatients (mean age 66 years) with balance disorders [32], however one study noted a minor ceiling effect in very high functioning neurological patients [29]. It evaluates most components of postural control: underlying motor systems; verticality; static and dynamic stability; anticipatory and reactive postural control; integration of sensory information; and cognitive influences on balance; but not functional stability limits [23]. …”

Section: Discussionmentioning

confidence: 99%

“…A scoping review identifying published standing balance measures for adult populations [23] formed the pool of measures to be considered for the COS recommendations. Full details of the review are available.…”

Section: Methodsmentioning

confidence: 99%

“…To inform their scores, members of the expert panel were provided with background information, including: (i) the original publication and test items for each measure; (ii) a description of the established psychometric properties for each measure, downloaded from the Rehabilitation Measures Database, a searchable website containing evidence-based summaries of more than 250 rehabilitation measures (www.rehabmeasures.org), or a psychometric summary prepared by KMS if one was not available; (iii) results of the scoping review findings including measure characteristics and components of balance evaluated in each measure [23]; and (iv) a publication of balance assessment practices among Canadian physiotherapists [13]. …”

Section: Methodsmentioning

confidence: 99%

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Recommendations for a Core Outcome Set for Measuring Standing Balance in Adult Populations: A Consensus-Based Approach

et al. 2015

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BackgroundStanding 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.ObjectiveTo develop recommendations for a core outcome set (COS) of standing balance measures for research and practice among adults.MethodologyA 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 sourcesThe 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.ResultsFifteen 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.LimitationsInclusion 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.ConclusionsThe 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.

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Physical Therapists’ Falls Prevention Knowledge, Beliefs, and Practices in Osteoarthritis Care: A National Cross‐Sectional Study

Ackerman

Soh

Barker

2020

Arthritis Care & Research

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Objective: To investigate physiotherapists' knowledge, beliefs and current practice around falls prevention in osteoarthritis (OA) care.Methods: Currently registered, practicing Australian physiotherapists who care for people with hip and/or knee OA were invited to participate in this cross-sectional study. A comprehensive online survey was used to collect data that were analysed descriptively or using chi-square tests; free-text responses were classified into key themes for analysis.Results: Complete responses were received from 370 eligible physiotherapists, with broad representation across Australian states and practice settings. Participants worked in public and private hospitals, community health centres, private practices and aged care facilities. The sample ranged from new graduates to experienced physiotherapists (47% had practised ≥11 years).Despite the majority having specific training or access to educational resources, physiotherapists reported only moderate confidence in assessing falls risk (median 7, interquartile range (IQR) 6-8; scale 0 (not at all confident) -10 (extremely confident)) and delivering falls prevention care (median 7, IQR 6-8). While most participants asked about falls history (88%), only 39% used falls risk screening tools and of these, relatively few used appropriate tools. Time constraints (including competing clinical priorities) were the most frequently perceived barrier to including falls prevention activities within OA care. Conclusions:This national snapshot of contemporary OA practice has revealed clear opportunities for optimising clinician confidence and skills to facilitate the uptake of best-practice falls prevention strategies. This may yield substantial benefits to patients and the health system if more falls can be prevented.

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Using the Systems Framework for Postural Control to Analyze the Components of Balance Evaluated in Standardized Balance Measures: A Scoping Review

Cited by 200 publications

References 97 publications

The Mini-BESTest: a review of psychometric properties

The Mini-BESTest: a review of psychometric properties

Recommendations for a Core Outcome Set for Measuring Standing Balance in Adult Populations: A Consensus-Based Approach

Physical Therapists’ Falls Prevention Knowledge, Beliefs, and Practices in Osteoarthritis Care: A National Cross‐Sectional Study

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