Abstract
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.
Highlights
Standing balance, defined as the ability to keep the center of mass within the base of support [1], is a prerequisite for many functional activities such as mobility and fall avoidance [2, 3]
The absence of a gold standard for measuring standing balance has contributed to the proliferation of outcome measures
Individuals were not excluded if they were the developer of one of the measures under consideration, but all panel members declared at the meeting whether they had any conflicts of interest related to participating in balance core outcome set (COS) recommendations of measures under consideration for the balance COS
Summary
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. Data Availability Statement: All relevant data are within the paper and its Supporting Information files. SES holds a Canada Research Chair in Knowledge Translation and Quality of Care. SBJ holds the Toronto Rehabilitation Institute Chair in Rehabilitation
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