Gait and Balance Assessment of Older Adults

Abstract

This review will outline seminal and contemporary balance and gait measures most commonly used with geriatric clients, along with the administration procedures, clinical utility, and psychometric qualities that support their use. Ten balance and five gait performance tests were reviewed. Balance instruments range from the simple to the complex. These tools quantify older adults’ ability to maintain postural stability during tasks that manipulate sensory conditions and functional activities, and challenge their base of support. Gait assessment is common in geriatric rehabilitation. Frail clients who ambulate with an assistive device can benefit from a more basic locomotion test, whereas seniors at higher mobility levels should be challenged with tasks superimposed on the gait sequence. Recent adaptations of traditional tests include surface changes, technology application, and clinical utility with subsets of older adults such as those with lumbar surgery and postural tremor. Timed floor rise ability more thoroughly addresses the fall risk dimension. Balance and gait assessments quantify physical performance in older adults and are utilized to establish interventions to improve mobility, reduce fall risk, and increase balance confidence. A wide variety of outcome measures exists in geriatric rehabilitation, though tests should be tapered for the functional level of the client. Practitioners should consider test administration for older adults with atypical diagnoses, along with flooring changes, technology adaptation, and timed supine to stand ability. Future research should revisit commonly accepted threshold scores for fall risk.