• Journal Article

Conceptual Limitations of Balance Measures for Community-Dwelling Older Adults

Citation

Pardasaney, P., Slavin, M. D., Wagenaar, R. C., Latham, N. K., Ni, P., & Jette, A. M. (2013). Conceptual Limitations of Balance Measures for Community-Dwelling Older Adults. Physical Therapy, 93(10), 1351-1368. DOI: 10.2522/ptj.20130028

Abstract

BACKGROUND: Psychometric limitations of balance measures for community-dwelling elderly may be related to gaps in task and environmental representation. OBJECTIVE: To conduct item-level content analysis of balance measures for community-dwelling elderly based on task and environmental factors, and develop profiles of individual measures summarizing their task and environment representation. DESIGN: Systematic content analysis. METHODS: A literature search was conducted to identify balance measures. Item-level content analysis was based on seven criteria related to task and environment: (i) task role, (ii) environmental variation, (iii) object interaction, (iv) obstacle negotiation, (v) external forces, (vi) dual-tasking, and (vii) moving persons/objects in the environment. RESULTS: 26 measures were identified, containing 167 items. Task role was fairly evenly distributed, with majority of items examining gait tasks (32.3%), followed by dynamic body stability (29.9%) and static body stability (25.1%). Majority of items involved no environmental variation (58.1%), followed by variation of support surfaces (20.4%), visual conditions (13.2%), and both support and visual conditions (8.4%). Limited task role variability was seen within measures, with 73.1% of measures examining only one task role. Environmental variation was present in 65.3% of measures, primarily during static body stability tasks. Few measures involved object interaction (23.1%), obstacle negotiation (38.5%), external forces (11.5%), dual-tasking (7.7%), or moving persons/objects (0%). LIMITATIONS: Our classification framework was not externally validated. CONCLUSIONS: Existing measures focus on single-task assessment in static environments, underrepresenting postural control demands in daily-life situations involving dynamic changing environments, person-environment interactions, and multi-tasking. New items better reflecting postural control demands in daily-life situations are needed for more ecologically valid balance assessment. Individual balance measure profiles provided can help identify the most appropriate measure for a given purpose