Functional Balance Assessment of Older Community Dwelling Adults: A Systematic Review of the Literature

Background: For allied health professionals wishing to assess the functional balance of older adults living in the community, the vast number of functional balance tests available makes it difficult to decide which assessment is most appropriate. Objective: To identify the reliability, concurrent validity and clinical practicality of functional balance tests with community dwelling older adults. Methods: A systematic review of published literature relevant to 17 functional balance tests was undertaken. The 17 functional balance tests were identified by a preliminary literature search and through consultation with an expert in the field of functional balance assessment. Studies published in English before January 2007, assessing the use of these functional balance tests with community dwelling adults aged 65 years or above were included. The CINAHL, MEDLINE, Ageline, Amed, PubMed, Cochrane library, PEDro and Joanna Briggs Institute databases were searched. The methodological quality of studies was assessed using a checklist criteria adapted from the Cochrane Working Group for Screening and Diagnostic Tests. Results: Eight databases were searched and 21 studies were included. The majority of studies demonstrated low to moderate methodological quality scores. Despite limitations reported for clinical application with community dwelling older adults, the Berg Balance Scale and the Timed Up and Go Test have been most rigorously tested. Reliability and concurrent validity of the Balance Screening Tool and the Fullerton Advanced Balance Scale had also been established in this population, however only one study was retrieved for each. Conclusion: The Berg Balance Scale and Timed Up and Go Test have published reliability and validity with community dwelling older adults. Further testing of other functional balance tests is required to establish their reliability and validity in this target population.