Outcome Measure Toolkit - for Geriatric Fall/Balance Assessment

Outcome Measure Toolkit

for Geriatric Fall/Balance Assessment

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Table of Contents

Introduction ------------------------------------------------------------------------------------------------------------------------- 2

Background of the Outcome Measure Toolkit Project ---------------------------------------------------------------------------------- 3

Taskforce Members ------------------------------------------------------------------------------------------------------------------------- 5

Outcome Measure Toolkit Project Searching Key Words and Database ----------------------------------------------------------- 6

Outcome Measure Toolkit Project Search/Review Flow Chart -------------------------------------------------------------------------- 8

Master List of Outcome Measures Assessing Balance/Fall Risk Being Reviewed ------------------------------------------- 9

Outcome Measures with Evidence of Psychometric Properties and Fall Risk Predictability ---------------------------------- 12

Outcome Measures Not Supported in Relation to Balance/Fall Assessment in the Older Adult Population and Rationales ----- 13

Outcome Measures Related to Balance/Fall Risk Assessment but Warranting Additional Research for Further Validation ---- 15

Outcome Measures Widely Used, but With Limited Recent Evidence Related to Fall Risks ---------------------------------- 18

Outcome Measures Divided by Setting ----------------------------------------------------------------------------------------------- 20

Summary Tables of Each Individual Outcome Measure (in alphabetic order) -------------------------------------------------- 26

Discussion ------------------------------------------------------------------------------------------------------------------------------ 121

Appendix

a. Compiled List of Outcome Measures Found During Phase 1 Search ------------------------------------------------ 122

b. Outcome Measure Toolkit Project Article Review Instructions -------------------------------------------------------- 126

c. Outcome Measure Summary Table Template ----------------------------------------------------------------------- 127

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Introduction

November 2019

Dear fellow therapists:

Welcome to the Outcome Measure Toolkit. I am excited to present this document to you. The Outcome Measure Toolkit project

is a product of the Balance & Falls Special Interest Group (BFSIG) of APTA Geriatrics, an Academy of the American Physical

Therapy Association (APTA).

Falls are the most common cause of injuries and hospital admissions in older adults, and balance is a potentially modifiable

factor known to contribute to falls—choosing proper tests and measures is a critical component of balance and fall risk

assessment. Evidence-based interventions can then be implemented to improve participation, activity limitations, and

impairments of body structure and function for people with balance deficits and risks of falling. In recent decades, an enormous

amount of outcome measures have been developed to evaluate balance and to predict fall risk. As fall risks and balance

assessments are multidimensional and multifaceted, selecting the optimal outcome measure is challenging.

The BFSIG decided to take on the challenge to create the Outcome Measures Toolkit, providing our members with an updated

summary of current outcome measures related to balance and fall risk assessment. As the BFSIG Research Liaison, I am

humbled and honored to lead the project.

The Outcome Measure Toolkit took over two years to ready itself; fourteen taskforce members volunteered their time, effort,

and knowledge to make this project possible. We started using keywords to search related outcome measures. The original

compiled list had over 245 outcome measures! After multiple conferences, discussions, and endless hours of hard working, we

now present you with the final list of 107 outcome measures. We hope you find this Toolkit helpful, clinically and

academically. For this Toolkit to remain current, the list needs to be updated every three to five years. We hope to see more

volunteers devote themselves to updating this project in the future. Your participation and contribution help the BFSIG grow

and expand!

Sincerely,

Elizabeth Wang-Hsu, PT, PhD

Chair, the Outcome Measure Toolkit Project

Research Liaison, Balance and Fall Special Interest Group

University of Pennsylvania Health System

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Background of the Outcome Measure Toolkit Project

• Purposes:

1. Create an updated summary in the form of an Outcome Measure Toolkit for balance and fall

assessment, including the psychometric properties, fall predictability, population validated, and

references of each outcome measure in a simple, easy to understand table format.

2. Provide all APTA Geriatrics members a toolkit to easily access current and existing BF outcome

measures, with their psychometric properties and fall predictability in the geriatric population at various

settings or with different diagnosis.

• Process and Phases of the Project:

The project was initiated immediately after CSM 2017. Originally, 8 members from BFSIG

volunteered to form the taskforce for this project. A few members withdrew from the project due to

various personal reasons, but new members joined the project. The taskforce members in various stages

are acknowledged in the following page.

The project was conducted in five phases:

 Phase 1 was finding combinations of key words used to thoroughly search for any existing outcome

measures that are appropriate for balance and fall assessment. From this search, 260 outcome

measures were identified. The results were then streamlined to make a consensus master list of 107

outcome measures.

 Phase 2 was the literature review process. The master list of outcome measures was assigned to

taskforce members to review. Each member in each timeline was assigned 3 to 5 outcome measures.

Phone conferences were held between each timeline to discuss issues and concerns from taskforce

members.

 Phase 3 was cross-validation and recommendations.

 Phase 4 was updating of literature from 2018-2019.

 Phase 5 was formatting of the BFSIG Outcome Measure Toolkit and dissemination.

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• The Outcome Measure Toolkit is a toolkit based on consensus opinion of experts from the BFSIG. It is a

resource/toolkit for members but should not be confused or mistaken for peer-reviewed evidence-based

document. The BFSIG Outcome Measure Toolkit seeks to offer a quick summary with generalizability, as

well as various practice settings, in addition to community-dwelling. Furthermore, the emphasis of this

project was placed on current literature in the past 5 or so years. This allows us to make recommendations

on outcome measures which may no longer be valid with the changing features of the human population

including the prevalence rate of medical comorbidities, life expectancy, and medical advances.

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Taskforce Members

The APTA Geriatrics Balance & Fall Special Interest Group would like to recognize and extend its

gratitude to the taskforce members, who volunteered their time, effort, and knowledge to this project.

Elizabeth Wang-Hsu, PT, PhD (Chair)

Research Liaison for APTA Geriatrics Balance and Falls SIG 2016-2019

Heidi Moyer*†, PT, DPT (Co-Chair for the initial phases)

Secretary, APTA Geriatrics Balance and Falls SIG

Eastern Regional Coordinator, APTA Geriatrics State Advocate Program

Carmen Casanova Abbott, PT, PhD (Co-Chair for the final phases)

Core Taskforce Members

Anne Reilley*, PT, DPT, MS

Susan Glenney*†, PT, DPT

Mariana Wingood*†, PT, DPT

Adjunct Taskforce Members

Ryan Allison, PT, DPT

Harsha Dhingra†, PT, MS

Emma Phillips, PT, DPT

Haim Nesser†,

PT, DPT

Paula Graul*†, PT, MS

Shweta Subramani†, PT, MHS

Ashley Bell, PTA

Jennifer Vincenzo*, PT, MPH, PhD (Chair, BFSIG)

* Board Certified Clinical Specialist in Geriatric Physical Therapy (GCS)

† Certified Exercise Expert for Aging Adults (CEEAA)

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Outcome Measure Toolkit Project Searching Key Words and Database

Combination of Words:

Falls, Fall Risk, Balance, Functional Mobility, Strength, Older Adults, Aged, Geriatric, Elderly, Frail, Community-Dwelling,

Independent Living, Nursing Home, Institutionalized, Skilled Nursing Facility, Residential Care, Long Term Care, Outcome

Measure, Assessment.

Database Searched:

PubMed, CINAHL, Google Scholar, PsychInfo

Falls

Word

Definition

Falls

Any event that leads to an unplanned, unexpected contact with a supporting surface

.

This does NOT include falls that are the

result of an outside force such as a push or shove or falls that are the result of a medical event such as a MI, syncope or fainting.

Population Examined

Word

Definition

Older Adults

According to Medicare, a person over the age of 65 years.

Elderly

Older adults or aged individuals.

Aged

A person 65 through 79 years of age. For a person older than 79 years, AGED, 80 and over is available

Aged, 80 and over

A person 80 years of age and older.

Frail elderly (Elderly, Frail)

Older adults or aged individuals who are lacking in general strength and are unusually susceptible to disease or to other

infirmity.

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Frail Older Adults

A person 65 or older who are lacking in general strength and are unusually susceptible to disease or to other infirmity.

Community-Dwelling Adults

According to SoG CPG Committee: a person over age of 65 residing in the community or assisted living without distinction

about health/frailty status.

Independent Living

A housing and community arrangement that maximizes independence and self-determination.

Item Examined

Word

Definition

Outcome Assessment

Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result

or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of

abnormal states (such as elevated blood pressure).

Outcome Measure

Evaluations of the efficacy/effectiveness of an intervention on the premise of gauges taken prior to, during, and following the

intervention.

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Outcome Measure Toolkit Project Search/Review Flow Chart

Presentation of the Purpose/Mission of Outcome Measure Project to BFSIG

executives; Recruit Taskforce Members via BFSIG emails

December 2016

February 2017

First Conference Call;

Discuss Search Strategies, Keywords, Database, etc.

Initial Delegation; Key Words Search Balance/Fall-Related Outcome Measure

March 2017

Compile List From All Members : 245 Outcome Measures Identified

(By

Heidi

Moyer & Elizabeth Wang

-Hsu)

April 2017

Master List of Outcome Measures: 107 Outcome Measures

(By Taskforce Consensus)

Not Related to Balance, Falls, Functional

Mobility, or Stength (i.e., MiniCog, MMSE)

May 2017

Outcome measures critically reviewed

Outcome

measure tables developed

First recommendations made

(By Taskforce Members)

June 2017

Cross validation of outcome measures

Outcome measure recommendation finalized

December 2018

Update outcome measures literature review

May 2019

Format BFSIG Outcome Measure Toolkit (By Carmen Abbott & Elizabeth Wang-Hsu)

BFSIF Executives Internal Review

AGPT review of Outcome Measure Toolkit

October 2019

Dissemination

Excluded

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Master List of Outcome Measures Assessing Balance/Fall Risk Being Reviewed

1. 2 Minute Walk Test & other similar timed

walks such e.g., 6 Minute Walk

2. 21 Item Fall Risk Index

3. 25 Question Geriatric Locomotive Function

Scale

4. 30 Second Chair Stand Test

5. 360 Degree Turn Time

6. 4 Step Square Test

7. 4 Stage Test, or Frailty and Injuries:

Cooperative Studies of Intervention

Techniques (FICSIT-4)

8. 5 Times Sit to Stand &10 Times Sit to Stand

9. Activities Specific Balance Confidence Scale

(ABC)

10. Activities Specific Fall Caution Scale

11. Activity-Based Balance and Gait

12. Alternate Step Test

13. Attitudes to Falls-Related Interventions

Scales

14. Balance Evaluation Systems Test (BESTest;

BESTmini; BESTbrief)

15. Balance Outcome Measure for Elder

Rehabilitation (BOOMER)

16. Balance Self-Efficacy Test

17. Balance Self-Perceptions Test

18. Bed Rise Difficulty (BRD) Scale

19. Berg Balance Scale

20. Brunel Balance Assessment

21. Canadian Occupational Performance

Measure

22. Clinical Test of Sensory Interaction and

Balance (CTSIB)

23. Community Balance and Mobility Scale

24. Scale of Balance Confidence (CONFbal)

25. Conley Scale

26. Demura's Fall Risk Assessment Chart

(DFRA)

27. Downton Fall Risk Index

28. Dynamic Gait Index

29. Elderly Fall Screening Test

30. Elderly Mobility Scale

31. Euroqual

32. Fall Handicap Inventory

33. Fall Perception Questionnaire

34. Fall Prevention Strategy Survey

35. Fall Risk for Older People in the Community

Assessment

36. Falls Behavioral Scale

37. Falls Efficacy Scale (FES)

38. Fear Avoidance Beliefs Questionnaire

(FABQ)

39. Figure 8 Walking Test

40. Floor Rise Test

41. Frenchay Activity Index

42. Fugl-Meyer Motor Assessment

43. Fullerton Advanced Balance Scale (FAB)

44. Functional Ambulation Category

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45. Functional Fitness Test

46. Functional Gait Assessment

47. Functional Independence Measure (FIM)

48. Functional Mobility Assessment Tools (FMA)

49. Functional Reach Test

50. Gait Abnormality Rating Scale

51. Gait Efficacy Scale

52. Gait Speed (m/s)

53. Geriatric Fear of Falling Assessment

54. Global Deterioration Scale

55. Goal Attainment Scale

56. Gorningen Activity Restriction Scale

57. Grip Strength

58. Guralnik Test Battery

59. Hauser Ambulation Index

60. Health-Related Quality of Life

61. Hendrich II Fall Risk Model

62. High Level Mobility Assessment Tool

63. Home Falls and Accidental Screening Tool

64. International Physical Activity Questionnaire

65. L Test of Functional Mobility

66. LASA Fall Risk Profile

67. Late-Life Function and Disability Instrument

68. Missouri Alliance for Home Care

(MAHC-10)

69. Melbourne Fall Risk Assessment Tool

(MFRAT)

70. Minimal Chair Height Standing Ability

71. Mobility Interaction Fall Chart

72. Morse Fall Scale

73. Motor Fitness Scale

74. Multiple Lunge Test

75. Multiple Sclerosis Walking Scale-12

76. Norwegian General Motor Function

Assessment

77. Penisual Health Fall Risk Assessment Tool

(PHRAT)

78. Perceived Participation and Autonomy

79. Peter James Centre Fall Risk Assessment

Tool

80. Physical Activity Questionnaire

81. Physical Mobility Scale

82. Physical Performance Scale

83. Physiological Profile Assessment

84. Push and Release Test

85. Queensland Fall Risk Assessment Tool

(QFRAT)

86. Rivermead Mobility Index

87. Rogers Modular Obstacle Course

88. Romberg Test (Tandem)

89. Self-Efficacy Scale (SES)

90. Short Health Form Survey (SF8, SF12, SF36)

91. Short Physical Performance Battery (SPPB)

92. Shuttle Walk

93. Sickness Impact Profile Physical Dimension

94. Single Leg Stance

95. St. Thomas Risk Assessment Tool

(STRATIFY)

96. Stopping Elderly Accidents, Deaths, &

Injuries (STEADI)

97. Stroke Assessment Fall Risk

98. Stroop Stepping Test

99. Subjective Risk Rating of Specific Tasks

100. Survey of Activities and Fear of Falling in the

Elderly

101. The Obstacle Course

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102. Timed Up and Go

103. Timed Up and Go: Dual Task

104. Tinetti Performance-Oriented Mobility

Assessment (POMA)

105. University of Illinois at Chicago Fear of

Falling Measure (UIC FFM)

106. Western Ontario and McMaster

Osteoarthritis Index (WOMAC)

107. World Health Organization Quality of Life

(WHOQoL )

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Outcome Measures with Evidence of Psychometric Properties and Fall Risk Predictability

• 4 Step Square Test

• Activities Specific Balance Confidence Scale

• Balance Evaluation Systems Test (BESTest; BESTmini; BESTbrief)

• Berg Balance Scale

• Figure 8 Walking Test

• 5 Times Sit to Stand (more commonly used/researched than 10 Times Sit to Stand)

• Functional Gait Assessment

• Functional Reach Test

• Gait Speed (m/s)

• Grip Strength

• Hendrich II Fall Risk Model (inpatient population only)

• Morse Fall Scale

• The Obstacle Course

• Tinetti Performance-Oriented Mobility Assessment (POMA)

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Outcome Measures Not Supported in Relation to Balance/Fall Assessment in the Older Adult

Population and Rationales

● Attitudes to Falls-Related Interventions Scales: From Prevention of Falls Network Europe [ProFaNE] (2006). This is a

questionnaire to assess attitudes related to balance and fall interventions. The web link no longer works; therefore, no

summary table presented in this document.

● Balance Self-Efficacy Test: Studies on this test only looked at activity participation, not falls. In addition, there are no

studies that validate this test; therefore, no summary table presented in this document.

● Canadian Occupational Performance Measure (COPM): The COPM is used as a measure of life satisfaction and

reintegration into normal living. It has no evidence in fall risk.

● Euroqual: Euroqual is a descriptive profile and index of health status measure from the early 1990s. It is not

recommended for fall risk assessment due to minimal evidence and no recent literature.

● Fall Handicap Inventory: There is no further study since the original report. In addition, the report was a letter to the

editor, not an article.

● Frenchay: It was validated in 1993, but there is little evidence following this validation. Therefore, no summary table is

presented in this document.

● Fugl-Meyer Motor Assessment: This measure is great for assessing motor recovery post stroke, but it is not correlated

with falls or balance. It is used mainly in studies to classify subjects and can be used to assess intervention efficacy with

other balance measures. There is no evidence on psychometric properties; therefore, no summary table presented in this

document.

● Functional Fitness Test – Senior Fitness Test: The test was developed in 1999 to measure the key components to

fitness. Age group and gender norms for fitness have been established and updated in 2013 along with some criterion

norms for loss of independence and mobility decline. This test battery as a whole has not been researched for fall risk

screening or assessment; therefore, no summary table presented in this document.

● Functional Mobility Assessment Tool (FMA): Functional mobility assessment (FMA) instrument is a self-report

outcome tool designed to measure the effectiveness of wheeled mobility and seating, not a fall assessment; therefore, no

summary table presented in this document.

● Gait Abnormality Rating Scale: There is minimal research supporting the Gait Abnormality Rating Scale, however,

there is a modified version currently in the process of validation.

● Gait Efficacy Scale: There is minimal research supporting the Gait Efficacy Scale, however, there is a modified version

currently in the process of validation.

● Global Deterioration Scale: This scale is not a fall assessment, but a dementia/cognitive assessment tool.

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● Goal Attainment Scale: This is scale is for patient-centered goals attainment. The population and psychometric property

varied depending on the population and goals selected. In addition, it used a T-score; therefore, no summary table

presented in this document.

● Guralnik Test Battery: We were unable to find evidence to validate this performance-based test battery; therefore, no

summary table presented in this document.

● Health-Related Quality of Life: This is a quality of life assessment, not a balance and fall assessment; therefore, no

summary table presented in this document.

● International Physical Activity Questionnaire: This questionnaire with limited studies and varied validity is not a fall

assessment measure. It is used as an indication of activity level and has no established link to balance performance and

fall risk. See systematic review by Lee et al 2018 for more information

● L Test of Functional Mobility: This test is a modified version of the Timed Up and Go Test designed for people with

lower limb amputations. It is not a general fall assessment measure.

● Late Life Function and Disability Instrument: This instrument is not a fall assessment measure.

● Motor Fitness Scale: There is little evidence to support use of this scale in balance and falls management in the older

adult population.

● Norwegian General Motor Function Assessment: This assessment has very limited study. It is recommended to look at

the General Motor Function Assessment instead.

● Perceived Participation and Autonomy: There are many studies on vertigo and how it affects falls, but none on how

this assessment tool is used for identifying fall risk; therefore, no summary table presented in this document.

● Peter James Centre Fall Risk Assessment Tool: No studies found on this tool; therefore, no summary table presented in

this document.

● Physical Activity Questionnaire (CHAMPS): CHAMPS is a valid and reliable measure, however, no link to fall risk

prediction.

● Physical Mobility Scale: This is a scale of disability or functional mobility in residential older adults that is used to

determine physical assistance in care facilities. It is not applicable to balance or fall risk assessment.

● Physical Performance Scale: This scale is a test of physical function that has been updated in Multiple Sclerosis

literature. There is low evidence for use of it in fall prediction. In the past 10 years, it has been used primarily for stroke

and dementia diagnoses. In addition, there are no psychometrics for this scale.

● Rivermead Mobility Index: This index is a mobility test with limited supporting literature found

● Roger Modular Obstacle Course: There were no articles found; therefore, no summary table presented in this

document.

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● Self-Efficacy Scale (SES): This scale measures self-efficacy in strength, stamina, and memory. It is not related to

balance and falls.

● Short Health Form Survey (SF8, SF12, SF36): This survey is not a balance and fall risk assessment; therefore, no

summary table presented in this document

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Outcome Measures Related to Balance/Fall Risk Assessment but Warranting Additional

Research for Further Validation

● 21 Item Fall Risk Index: No further evidence reported aside from the original article.

● 25 Question Geriatric Locomotive Function Scale: This scale is not widely used and has limited evidence to support it.

● Activity-Based Balance and Gait: No further evidence reported aside from the original article.

● Activity Specific Fall Caution Scale: No further evidence reported aside from the original article.

● Alternate Step Test (Step Test): It is a component of Berg Balance Scale that is not widely studied.

● Balance Outcome Measure for Elder Rehabilitation (BOOMER): There are two articles supporting the measure from

2007 and 2011, but more is warranted.

● Balance Self Perception Test: There was only one study found to support this measure.

● Bed Rise Difficulty Scale: This scale assesses mobility with limited studies related to fall assessment.

● Brunel Balance Assessment: There were limited studies with insufficient information to support this assessment.

● Clinical Test of Sensory Integration & Balance (CTSIB): Most of research supporting the CTSIB were in other

populations. It has moderate construct validity. This measure warrants studies in older adult balance/fall assessment.

● Community Balance & Mobility Scale (CB&M): Strength, balance, and quality of life measure for young elders and

young adults. There is no evidence that it can predict fall risk.

● CONFbal Scale of Balance Confidence: It is a balance confidence scale with limited evidence related to fall

predictability.

● Conley Scale: There is limited evidence to support this measure.

● Demura’s Fall Risk Assessment Chart (DFRA): This chart is a 50 item list used in Japan in a large population study.

Further research is needed to decrease the number of items on the list if it will be used in other countries and general

practice.

● Downton Fall Risk Index: There are few studies to support this measure. The index uses an inpatient population and has

low specificity.

● Elderly Mobility Scale (EMS): EMS was developed for use with frail elderly adults for mobility status. It is not

validated for fall risks.

● Elderly Fall Screening Test: This measure is not well studied, however, early work shows fall risk predictability.

● Falls Behavioral Scale: Limited research supporting this scale with no cutoff score or stratification for fall risk. There

were two articles found about the scale, however, access was only available to the initial article (2003). We were unable

to access the other 2008 article published in the Journal of Disability and Rehabilitation. Review table completed with

the initial research article information on validity and reliability.

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● Fall Perception Questionnaire: This measure looks at adult perception about fall risk. It is not a fall risk predictor;

therefore, further studies needed to link to fall risk predictability.

● Fall Prevention Strategy Survey: This measured is studied on the Multiple Sclerosis population, however, only the

original article was found. It needs further study. No research on this outcome measure since 2009 which included a

Rasch Validation Analysis. This outcome measure was identified as a valid tool to examine the frequency of engaging in

protective behaviors related to fall risk among adults with Multiple Sclerosis and to track outcomes of behaviorally

oriented fall reduction interventions, but has not been identified as a tool for assessment of fall risk.

● Fall Risk for Older People in the Community Assessment: This measure has a moderate capacity to predict falls, but

needs further studies.

● Floor Rise Test: There is limited research supporting its use.

● Fullerton Advanced Balance Scale (FAB): One study in 2008 presented a cutoff. There is a Sn, Sp, and PPV for fall

predictability. This scale warrants more research.

● Functional Ambulation Category: Sn and Sp are established. It is used in post stroke population and can be used to

predict community ambulation post stroke. This scale warrants more studies in other populations.

● Geriatric Fear of Falling Measure: There is significant validity with FES. It has good reliability but is not studied very

well in populations outside of Northern Taiwan. It is touted as a screening tool for nursing.

● Gorningen Activity Restriction Scale: It is a mobility restriction assessment scale. More studies are needed to evaluate

the relationship to balance and fall risk.

● Hauser Ambulation Index: It has been validated against multiple other outcome measures for the Multiple Sclerosis

population, however, more studies are needed for other populations and for fall risk prediction.

● High Level Mobility Assessment Tool: There is one article for validity, reliability, and MDC in inpatient traumatic

brain injury population, however, there are no studies for other populations or to predict fall risk.

● Home Falls and Accidental Screening Tool: This is a reliable and valid home fall assessment survey/questionnaire.

This is one study with a large sample size with high sensitivity and low specificity that presented cutoff score as 9. It has

also been validated in foreign languages including Malaysia and Chinese. However, no report found in US population.

● Push and Release Test: There was one study in 2006. No other evidence to support the test.

● LASA Fall Risk Profile: There are limited studies, but nothing since 2010.

● Melbourne Fall Risk Assessment Tool (MFRAT): This is a novel assessment tool targeting residential population

(nursing home and long-term care facilities), but no other validation except the original article. More research warranted

in this population.

● Minimal Chair Height Standing Ability: This is a novel assessment tool from 2015. The original article validated it

with a large sample (n = 156), however, more validation is warranted.

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● Mobility Interaction Fall Chart: This is a functional assessment for residential care population. Only the original article

provided some validation.

● Multiple Sclerosis Walking Scale-12: This scale has good psychometrics but limited to use in Multiple Sclerosis

population. Data is limited to younger population due to the progressive and debilitating nature of Multiple Sclerosis.

● Multiple Lunge Test: This test has an established Sn and Sp, but limited research in last five years.

● Peninsula Health Fall Risk Assessment Tool (PHRAT): This tool needs more research to support it.

● Queensland Fall Risk Assessment Tool (QFRAT): There is very limited evidence on this tool after 2014. Most of the

research was conducted more than five years ago.

● Short Physical Performance Battery (SPPB): This is a fitness/activity capacity test with no established link to balance

performance and fall risk.

● Stroop Stepping Test: This is a low cost test capable of distinguishing fallers from non-fallers, however, it has limited

research in the last five years. A computer program with a specialized mat sensor is required to track response time and

accuracy.

● Shuttle Walk: Shuttle Walk is a reliable aerobic capacity test, however, more research is needed to establish a link to

balance and fall risks.

● Stroke Assessment Fall Risk: While this measure has promising fall risk predictability in stroke population, there is no

reliability evidence found. More studies are needed for other populations/diagnoses.

● Subjective Risk Rating of Specific Tasks: One original article in 2011 validated the measure, but it needs more study.

● Survey of Activities and Fear of Falling in the Elderly: This measures activity and fear of falling (not efficacy or

confidence), however, only the original article validated this tool.

● The Falls Behavior Scale: It has the potential to be a useful tool but is not widely used and has not been well researched

to identify fall risk predictability.

● University of Illinois at Chicago Fear of Falling Measure (UIC FFM): This tool measures the construct of fear of

falling (not efficacy or confidence), however, only the original article validated it. Many

presentations/abstracts/proceedings found at various conferences (ISPRM, IAAG, CSM), but are not published yet.

19

Outcome Measures Widely Used, but with Limited Recent Evidence Related to Fall Risks

● 2 Minute Walk Test and other similar timed tests e.g., 6 Minute Walk: This outcome measure was designed to

measure aerobic capacity/endurance, however, its predictability of fall risk is yet to be established.

● 30 Second Sit to Stand: There is significant amount of evidence for fall risk prediction, however, there are no cutoff

scores, just comparisons to age norms. There is minimal cross validation to different diagnoses.

● 360 Degree Turn: Incorporated into many tests, but as a stand-alone it has significant variability in the cutoff time/steps.

Despite inconsistent cutoff, it still has high sensitivity and specificity.

● 4 Stage Balance Test (Also known as “Frailty and Injuries: Cooperative Studies of Intervention Techniques” -

FICSIT-4): There is no study that looked at the FICSIT alone. Some studies looked at tandem, single limb, or the

STEADI but nothing at FICSIT alone.

● Dynamic Gait Index: There is limited recent evidence to support the DGI. The DGI is primarily studied with the

vestibular population. It has moderate to high construct validity.

● Falls Efficacy Scale (FES): It is supported for falls, but not well studied for predictive capability. There is no recent

literature on this scale.

● Fear Avoidance Beliefs Questionnaire (FABQ): It is validated against other outcome measures (i.e., FES, BBS, etc.),

however, it does not have evidence in cutoff scores to support use in predicting fall risk. No summary table in this

document.

● Functional Independence Measure (FIM): No strong evidence in the literature to support the use of FIM to identify fall

risk. Petitoierre et al 2010 identified poor Sn, Sp for using FIM to identify fall risk at two different cutoff scores. Much of

the literature on the FIM discusses its use in determining rehab potential, overall functional prognosis, and to monitor

progress in rehab settings. Forest et al 2016 identified that FIM scores at admission are inversely related to fall risk but

without cutoff scores.

● Missouri Alliance for Home Care (MAHC-10): This is used at home health setting in all Epic and other EMR systems.

Information only found in the original article. More evidence is warranted.

● Physiological Profile Assessment (PPA): The shortened version has been studied in the past four years with slightly

higher reliability than the long form. There are multifactorial clinical tests with evidence for individual test reliability.

● Romberg Test (Tandem Stance): This is a reliable and valid test; however, it is seldom used alone. It is usually part of a

larger assessment (BESTest, STEADI).

● Single Leg Stance: This is a reliable and valid test; however, it is seldom used alone. It is usually part of a larger

assessment (BESTest, STEADI).

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● Sickness Impact Profile (SIP): This profile looks at physical dimension. It has been researched and used for many

diagnoses, but unsure if it corresponds to fall/balance assessment. There is no direct evidence regarding fall risk.

● Stopping Elderly Accidents, Deaths, and Injuries (STEADI): It is used by PT as a screening tool, but needs continued

refinement and field validation of its use in primary care.

● St. Thomas Risk Assessment Tool (STRATIFY): Used as a hospital fall screening tool to identify patient’s fall risk,

however, literature reports inconsistent predictive accuracy. This raises questions about operational usefulness. More

studies are warranted for fall predictability.

● Timed Up and Go - Dual Task: Incorporated into other tests, however, there are many varieties clinically. More studies

are needed for cutoff scores linked to fall predictability.

● Western Ontario and McMaster Osteoarthritis Index (WOMAC): A patient reported outcome measure (PROM) that

is widely used to evaluate the pain, stiffness, and physical function of patients with osteoarthritis of the hip and knee. It is

not a balance and fall assessment. Studies are needed to link to balance and fall risks; therefore, no summary table

presented in this document.

● World Health Organization Quality of Life (WHOQoL): This has not been cross validated with other balance and

falls measures. This measure is not a direct assessment of balance or falls and should not be included in the final

recommendation since its primary purpose is not related. No summary table presented in this document.

21

Outcome Measures Divided by Setting

Outcome Measures Studied in Community Setting

● 21 Item Fall Risk Index

● 25 Question Geriatric Locomotive Scale

● 30 Second Chair Stand Test

● 360 Degree Turn Time

● 4 Step Square Test

● Five Times Sit to Stand Test

● Activities Specific Balance Confidence Scale

● Activity-Based Balance and Gait

● Balance Self-Perceptions Test

● Berg Balance Scale

● Brunel Balance Assessment

● Clinical Test of Sensory Interaction and Balance

(CTSIB)

● Community Balance and Mobility Scale

● CONFal Scale of Balance Confidence

● Demura’s Fall Risk Assessment Chart (DFRA)

● Downton Fall Risk Index

● Dynamic Gait Index

● Fall Risk for Older People in the Community

Assessment

● Falls Efficacy Scale (FES)

● Fear Avoidance Beliefs Questionnaire (FABQ)

● Floor Rise Test

● Fullerton Advanced Balance Scale (FAB)

● Functional Gait Assessment (FGA)

● Functional Reach Test (FRA)

● Gait Efficacy Scale

● Gait Speed

● Geriatric Fear of Falling Assessment

● Grip Strength

● LASA Fall Risk Profile

● Minimal Chair Height Standing Ability

● Multiple Lunge Test

● Physical Activity Questionnaire (CHAMPS)

● Physical Performance Scale

● Physiological Profile Assessment

● Push and Release Test

● Romberg Test

● Single Let Stance

● Stopping Elderly Accidents, Deaths, & Injuries

(STEADI)

● Stroop Stepping Test

● Tandem Test

● The Obstacle Course

● Timed Up and Go Test

● Timed Up and Go - Dual Task

● Tinetti Performance-Oriented Mobility Assessment

● University of Illinois at Chicago Fear of Falling

Measure (UICFFM)

22

Outcome Measures Studied in Acute Hospital Setting

● Balance Evaluation System Test (BESTest; BESTmini; BESTbrief)

● Berg Balance Scale

● Community Balance and Mobility Scale

● Conley Scale

● Downton Fall Risk Index

● Dynamic Gait Index

● Figure 8 Walking Test

● Fullerton Advanced Balance Scale (FAB)

● Functional Reach Test

● Gait Speed

● Gorningen Activity Restriction Scale

● Grip Strength

● Hendrich II Fall Risk Model

● High Level Mobility Assessment Tool

● Melbourne Fall Risk Assessment Tool (MFRAT)

● Morse Fall Scale

● Single Leg Stance (Single Limb Standing)

● St. Thomas Risk Assessment Tool (STRATIFY)

● Stroke Assessment Fall Risk

● Tinetti Performance-Oriented Mobility Assessment (POMA)

● World Health Organization Quality of Life (WHOQoL)

23

Outcome Measures Studied in Inpatient Rehab (Rehab Hospital or SNF) Setting

● Balance Evaluation System Test (BESTest; BESTmini; BESTbrief)

● Berg Balance Scale

● Downton Fall Risk Index

● Dynamic Gait Index

● Figure 8 Walking Test

● Fullerton Advanced Balance Scale (FAB)

● Functional Reach Test

● Gait Speed

● Grip Strength

● Hendrich II Fall Risk Model

● High Level Mobility Assessment Tool

● Melbourne Fall Risk Assessment Tool (MFRAT)

● Morse Fall Scale

● Peninsula Health Fall Risk Assessment Tool (PHRAT)

● Shuttle Walk

● Single Leg Stance (Single Limb Standing)

● St. Thomas Risk Assessment Tool (STRATIFY)

● Tinetti Performance-Oriented Mobility Assessment (POMA)

● World Health Organization Quality of Life (WHOQoL)

24

Outcome Measures Studied in Outpatient Setting

● Balance Evaluation System Test (BESTest; BESTmini; BESTbrief)

● Berg Balance Scale

● Community Balance and Mobility Scale

● CONFbal Scale of Balance Confidence

● Dynamic Gait Index

● Fall Perception Questionnaire

● Figure 8 Walking Test

● Fullerton Advanced Balance Scale (FAB)

● Functional Reach Test

● Gait Speed

● Grip Strength

● Hauser Ambulation Index

● Shuttle Walk

● Sickness Impact Profile Physical Dimension

● Single Leg Stance (Single Limb Standing)

● World Health Organization Quality of Life (WHOQoL)

25

Outcome Measures Studied in Home Health Setting

● Balance Evaluation System Test (BESTest; BESTmini; BESTbrief)

● Berg Balance Scale

● Figure 8 Walking Test

● Home Falls and Accidents Screening Tool (HomeFast)

● Missouri Alliance for Home Care (MAHC-10)

● Single Leg Stance (Single Limb Standing)

26

Outcome Measures Studied in Long Term Care Facility Setting

• Activities Specific Balance Confidence Scale

• Bed Rise Difficulty (BRD) Scale

• Berg Balance Scale

• Gait Speed

• Hauser Ambulation Index

• Melbourne Fall Risk Assessment Tool (MFRAT)

• Mobility Interaction Fall Chart

• Morse Fall Scale

• Peninsula Health Fall Risk Assessment Tool (PHRAT)

• Physiological Profile Assessment

• Queensland Fall Risk Assessment Tool (QFRAT)

• Sickness Impact Profile Physical Dimension

• Single Leg Stance (Single Limb Standing)

• St. Thomas Risk Assessment Tool (STRATIFY)

• Subjective Risk Rating of Specific Tasks

• Survey of Activities and Fear of Falling in the Elderly

27

Summary Tables of Each Individual Outcome Measure

(alphabetic order; 92 tables)

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

2 Minute

Walk Test

Pin et al.,

2014

Systematic

Review, 25 studies

were all adults

with one exception

NA

Moderate to strong evidence

to support the 2MWT as a

reliable, valid, and responsive

outcome measure for adults

with lower limb amputation

and for frail elderly patients.

Important psychometric

information on the 2MWT

such as minimal clinically

important changes and

normative data is still

missing. At present, any

changes in the 2MWT should

be interpreted with caution.

NA

Bohannon et

al.,

2015

Community-

dwelling adults

(age 18-85 y/o,

n=1137)

NA

ICC 0.82

42.5m

NA

Legend:

NA = Not assessed

MDC = Minimum Detectable Change

y/o = years old

s/p = after

Sn = Sensitivity

Sp = Specificity

PPV = Positive Predictive Value

NPV = Negative Predictive

28

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

21 Item Fall

Risk Index

Ishimoto et

al., 2012

Community-

dwelling adults

(age >65, n=518)

NA

≥ 10 items

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

25 Question

Geriatric

Locomotive

Function Scale

Seichi et

al.,

2012

Community-

dwelling adults

(age >65, n=711)

NA

Test-retest ICC

(range 0.712–

0.924).

NA

16 for

identifying

locomotive

syndrome

NA

Seichi et

al.,

2014

Community-

dwelling adults

(age >65, n=880)

NA

16

NA

Tavares et

al., 2017

Community-

dwelling adults

(age >60, n=100)

NA

Interobserver and

intra-rater ICC of

97.6% and

98.4%,

respectively

NA

Kimura et

al., 2018

Older adults with

cervical

myelopathy

(mean age 67.2 ±

11.7 y/o, n=360)

NA

GLFS-25 and lower

extremity motor function

score of the JOA score

yielded the areas under the

receiver operating

characteristic curves of

0.674 and 0.607,

respectively, to differentiate

recurrent fallers from non-

recurrent fallers.

NA

29

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

30 Sec Sit to

Stand

Rikli et al., 1999

Community-

dwelling older

adults

Criterion validity

of the chair stand

compared to

weight adjusted

leg press

performance for

all participants: r

= 0.77, 95% CI =

0.64-0.85

Test-retest: r

= 0.89 (95%

CI 0.79-

0.93)

interrater

reliability r

= 0.95 (95%

CI 0.84-

0.97)

NA

.

NA

Yamada et al., 2015

157 Japanese

community-

dwelling older

adults (76±6 y/o)

NA

OR to fall

prediction =

1.03

NA

30

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

360 Degree

Turn Time

Dite & Temple,

2002

Community-

dwelling

NA

Inter-rater reliability:

Kappa=096

Intra-rater reliability:

Kappa=0.92

Re-test reliability:

Kappa=0.91

Inter-rater reliability:

kappa=0.97

Intra-rater reliability:

kappa=0.99

Re-test reliability:

Kappa=0.90

NA

4 steps

2.1 SEC

92

81

70

89

NA

Schenkman et al.,

2011

Parkinson’s

Disease

NA

Test-retest reliability:

seconds: ICC = 0.77

steps: ICC = 0.80

NA

Shiu et al., 2016

Stroke survivors

(55 y/o or older)

NA

Excellent intra-rater,

interrater, and test-

retest reliability

(ICC=.824–.993)

-NA

Affected

side:0.76

seconds

Unaffected

side: 1.22

seconds

84

91

89

NA

31

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

4 Square

Step Test

Dite et al., 2002

Community-

dwelling

Strong correlations with the

TUG and Step Test.

The lower correlations found

between the FSST and FRT

Interrater:

ICC=0.99

Re-test:

ICC=0.98

NA

> 15sec

85

100

86

Dite et al., 2007

s/p Unilateral

Transtibial

Amputation

NA

24 seconds

92

93

NA

Whitney et al.,

2007

Patients with

vestibular

symptoms

who were

rolled into PT

Good correlations with the other

gait measures (correlation

coefficients for the TUG, .69;

gait speed, .65; DGI, −.51) and

poor correlations with the DHI

and the ABC (DHI, −.13; ABC,

−.12)

IC=9.93; 95CI

0.86–0.96

NA

12 sec

80

92

NA

Blennerhassett et

al., 2008

Older adults

who could

walk at least

50m with

minimal

assistance

Strong inverse relationship with

step test: spearman ρ=−0.73 to

−0.86

Inter-rater

reliability:

0.94–0.99

NA

15 seconds

NA

Duncan et al.,

2013

Individuals

with idiopathic

Parkinson’s

Disease

NA

Interrater ICC =

0.99

Test-retest

reliability ICC

= 0.78

NA

9.68 sec

73

57

31%

from

21%

NA

Goh et al., 2013

Community-

dwelling older

adults with

chronic stroke

Correlation with TUG scores

r=.59; P=.02

Intra-rater

reliability:0.82-

0.83

Interrater

reliability >.99

NA

11

73.3

93.3

NA

32

Wagner et al.,

2013

Relapsing-

remitting,

secondary

progressive,

and primary

progressive

Multiple

Sclerosis

Excellent correlations between

the FSST and BBS (rs = -0.84,

P<0.001), DGI (rs = -0.81, P

<0.001), and ABC (rs = -0.78, P

<0.001). The FSST was also

moderately correlated with

EDSS scores (rs=0.73, P<0.001).

Test–retest,

reliability:0.922

(0.831–0.965)

4.6

sec

NA

33

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

5 Times Sit

to Stand

(10 Times Sit

to Stand)

Tiedemann et

al.,

2008

Community-

dwelling adults

(age 74-98 y/o, n

= 362)

NA

ICC 0.89 (95% CI =

0.79-0.95)

NA

Buatois et al.,

2008

Community-

dwelling older

adults (>65 y/o,

mean age 70±4)

NA

12 s

Risk Ratio 1.74,

CI=1.24-2.45,

P<.001

55%

65%

NA

Bohannon et

al., 2011

(Systematic

Review)

Community-

dwelling older

adults

NA

ICCs ranged from 0.64

to 0.96. The adjusted

mean ICC calculated

from the reported ICCs

was 0.81

NA

Wallmann, et

al.,

2012

Community-

dwelling older

adults (mean age

65 y/o)

NA

Excellent interrater

reliability among all

three researchers: ICC =

1.000.

NA

Fang Zhang,

et al.,

2013

Community-

dwelling older

adults

NA

Those who

require > 16.6 s to

finish 5TSTS

have significantly

higher likelihood

of developing

IADL-related

disability at 3

year follow-up

NA

Lusardi et al.,

2017

(Systemic

Review)

Community-

dwelling older

adults (age >65

y/o)

n > 30

NA

>12 s

49%

63%

+LR 1.6;

Posttest

Probability if

+ 41

-20

34

Medina-

Mirapeix, et

al.,

2018

Community-

dwelling older

adults s/p

unilateral Total

Knee

Replacement

NA

ICC for inter-observer

reliability of the 5STS

were 0.998 for men and

women combined. For

test-retest 0.982

NA

10 Time Sit

to Stands

Bohannon

2006

(Meta-

analysis)

Healthy older

adults (60+ y/o)

NA

60-69 11.4s

70-79 12.6s

80-89 12.7s

NA

Segura-Ortí,

et al.,

2011

39 adults

undergoing

hemodialysis

(mean age 60

y/o)

NA

Test-retest ICC 0.88

8.4

sec;

STS

10

NA

35

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Activity-Based

Balance and Gait

Topper et al.,

1993

17 men and 83 women

volunteers (aged 62-96

y/o) who ADL

independently

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Activities

Specific Balance

Confidence Scale

(ABC)

Lajoie Y and

Gallagher S P,

2004

Community-dwelling

older adults

NA

<67

89

96

NA

Steffen T and

Seney M, 2008

Parkinson’s Disease (mean

age=71 y/o)

NA

Test-retest

reliability 0.90

13

NA

Mak M K and

Pang M Y,

2009

NA

<67

93

69

NA

Sakakibara et

al., 2011

Unilateral lower limb

amputation for at least 6

months (age ≥50 y/o)

NA

ICC=0.93

Test-re-test r=

0.84–0.95

NA

36

An et al., 2017

Chronic stroke survivors,

who have ability to

ambulate > 10m without

walking aides, with

absence of lower motor

neuron diseases or

musculoskeletal problems,

and with score of >24 on

the Mini-Mental State

Examination (MMSE).

NA

81

71%

72%

NA

37

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Activities

Specific Fall

Caution Scale

Blanchard et

al., 2007

Seniors residing in

nursing homes or

assistive living facility

Convergent

validity: with

functional

measures

(TUG, Berg,

etc.);

Discriminant

validity (with

or without

walking aid):

p<0.05

Test-retest: ICC

(2,1)

=.87; 95% CI, .78−.93

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Alternate Step

Test

Tiedemann

et al., 2008

Community-dwelling

adults (age 74-98 y/o, n

= 362)

NA

ICC 0.78 (95% CI =

0.59, 0.89)

NA

> 10sec

69%

56%

NA

Chung et

al., 2014

S/p stroke

NA

Inter-rater (ICC=

0.991– 0.999), intra-

rater (ICC= 0.946–

0.955) and test-retest

reliability (ICC=

0.909–0.952) of the

AST times for the

participants with

stroke

3.26sec

NA

38

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Balance

Outcome

Measure for

Elder

Rehabilitation

(BOOMER)

Haines et al.,

2007

Australian adults in 2

states received PT

services (inpatient,

outpatient and

homecare)

Construct

validity with

Modified Elderly

Mobility Scale

(MEMS), (ρ

=.88)

Cronbach

α: .87-.89

NA

Kuys et al.,

2011

Australian rehab

inpatient geriatric

unit patients

Concurrent

validity with

Berg (ρ=.91;

P<.01)

with gait speed

(ρ=.67; P<.01)

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Balance Self-

Perception Test

Shumway-

Cook et

al.1997

Community-dwelling

older adults

NA

<50

73

82

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Bed Rise

Difficulty Scale

Alexander, et

al., 1992

Women 3 groups:

Young n=17, (24 y/o),

Community-dwelling

n=12, (71 y/o),

Assisted living n=15.

(86 y/o)

NA

0-10 Min

difficulty, 11-

20 Mod

difficulty, 21

30 severe

difficulty

NA

.

39

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Berg

Balance

Scale

Godi et al.,

2013

93

individuals

with balance

deficits

(mean age 66

y/o)

With scores of Mini-BESTest

at baseline and follow-up:

r= 0.85

Test-retest reliability:

ICC= 0.92 (95%

CI.87-.97)

Inter-rater reliability:

ICC= 0.97 (95%

CI .96-.99)

MDC=

6.2

(SEM=

2.18)

NA

77%

97%

NA

Major et al.,

2013

n = 30, with

lower

extremity

amputation

(mean age 54

y/o)

NA

Inter-rater reliability:

ICC= 0.94

NA

Wong 2014

5 individuals

with lower

limb

amputations

NA

Inter-rater reliability:

ICC= 0.99 (95%

CI .99-1.00)

Intra-rater reliability:

ICC= 0.99 (95%

CI .96-1.00)

NA

Pickenbrock

et al.,

2015

53 patients

with acute

stroke

With Static Balance test: r =

0.91

Inter-rater reliability:

ICC= 0.87

NA

40

Chan et al.,

2015

92 patients

with total

knee

arthroplasty

At 2 weeks post-op:

With FGA: r= 0.67

With BESTest: r= 0.78

With Mini-BESTest: r= 0.72

With BriefBESTest: r= 0.74

At 12 weeks post-op:

With FGA: r= 0.51

With BESTest: r= 0.68

With Mini-BESTest: r= 0.58

With BESTest Brief: r= 0.64

At 24 weeks post-op:

With FGA: r= 0.43

With BESTest: r= 0.64

With Mini-BESTest: r= 0.55

With BESTest Brief: r= 0.71

Inter-rater reliability:

ICC= 0.98 (95% CI

0.97-0.99)

MDC=

2.00

(SEM=

0.72)

NA

Telenius et

al., 2015

33 nursing

home

patients with

mild to

moderate

dementia (82

y/o)

NA

Inter-rater reliability:

ICC= 0.99

MDC=

1.92

(SEM=

0.97)

NA

Schlenstedt

et al., 2016

85 patients

with

idiopathic

Parkinson’s

Disease

Construct validity:

r= 0.94

NA

To predict

future falls:

Cutoff score

of <52/56

0.64

(95%

CI:

0.47-

0.78)

0.67

(95%

CI:

0.50-

0.80)

NA

Jacome et

al., 2016

46 patients

with COPD

(mean age 75

y/o)

With ABC scale:

rho= 0.75

Inter-rater reliability:

ICC= 0.94 (95%

CI .88-.97)

Intra-rater reliability:

ICC= 0.52 (95%

CI .19-.74)

MDC=

5.9

(SEM=

2.1)

With and

without

history of

falls: Cutoff

score of

52.5/56

0.73

0.77

3.20

0.35

41

Lee at al.,

2016

75

hemiparetic

stroke

patients

(mean age of

58 y/o)

NA

To predict

level of

community

ambulation

(defined as

gait speed >

0.8

meters/sec):

> 46.5/56

79%

76%

72%

82%

Marques et

al., 2016

122

community-

dwelling

older adults

(mean age of

76 y/o)

With ABC scale:

rho= 0.58

Inter-rater reliability:

ICC= 0.88 (95% CI

0.77-0.94)

Test-retest reliability:

ICC= 0.50 (95% CI

0.15-0.73

MDC=

4.6

(SEM=

1.4)

To identify

participant

with or

without

history of

falls:

Cutoff score

of 48.5/56

74%

72%

2.59

0.37

Park et al.,

2017

9,743

individuals

(aged > 60

y/o)

NA

0.73

(95%

CI:

0.65-

0.79)

0.90

(95%

CI:

0.86-

0.93

NA

Jorgensen et

al., 2017

46

individuals

with chronic

spinal cord

injury

With mini-BESTest:

r= .889

With TUG test:

r= -.75

With SCIM:

r= 0.88

With 10 m walk time:

r= -.88

With WISCI II:

r= 0.63

With FES-1:

r= -0.62

NA

Between

walkers

without

walking aids

and those

with walking

aids:

Cutoff score

of >47/56

Between

participant

with

low/high

concerns of

falling:

≤46/56

NA

42

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

BESTest

Horak et

al., 2009

Adults with

neurological

disorders

With

Activities

Specific

Balance

Confidence

Scale (ABC)

r=.69

Interrater:

BESTest (ICC

= .91)

Components

(.79-.96); n =

22

NA

Leddy et

al., 2011

Adults with

Parkinson’s

Disease (>40

y/o; no

description)

With Berg

Balance Scale

(BBS); r=.87

Interrater:

BESTest [ICC

(2, 1)

= .96];

component

(.79-.96); n =

15;

Test-retest:

BESTest [ICC

(2, 1) = .88];

component

(.63-.87); n =

24

NA

Padgett et

al., 2012

13 adults with

and 13 adults

without

Multiple

Sclerosis

NA

Interrater:

BESTest:

ICC =.99; No

component

reported

NA

77

86%

95%

NA

Duncan et

al., 2013

80 participants

with

Parkinson’s

Disease,

(68.2±9.3 y/o);

Retrospective 6

month;

Prospective 6

month: Prospec

tive 12 month

NA

69%

Retrospective

6 month:

84%;

Prospective 6

month: 93%;

Prospective

12 month:

46%

Retrospective

6 month:

76%;

Prospective 6

month: 84%;

Prospective

12 month:

74%

NA

43

Rodrigues

et al., 2014

Adults with

hemiparesis

(61.1 ±7.5 y/o;

no range)

Against ABC

r=.59 and

BBS r=.78

Interrater:

BESTest

[ICC

(?)

= .93];

component

(.85-.96); n =

16

Test-retest:

BESTest [ICC

= .98];

component

(.71-.94); n =

16

NA

Chinsongkr

am et al.,

2014

12 adults with

subacute stroke

(58.2; 24-90

y/o)

With BBS

(r=.96)

Interrater:

BESTest [ICC

(3, 1)

= .99]; No

component

results

reported; n =

12

Test-retest:

BESTest [ICC

(2, 1) = .96];

No

component

results

reported; n =

12

NA

Chinsongkr

am et al.,

2014

49 adults with

subacute stroke

(58.2 y/o; 24-

90)

NA

10% of

balance

improvement

80.8%

87.5%

NA

Chan and

Pang, 2015

Patients after

total knee

arthroplasty

(65+ y/o)

(n = 46)

Internal

consistency

α=0.98;

validated

against BBS,

Functional

Gait

Interrater:

BESTest [ICC

(2, 1)

= .99];

Component

(.98-1.00); n =

25

Test-retest:

BESTest

MDC =

6.2%

Component

: 22.71%; n

= 46

NA

44

Assessment

(FGA), and

ABC Scale

BESTest [ICC

(2, 1)

= .96];

Component

(.76-.96); n =

45

Huang et

al., 2016

28 community-

dwelling cancer

survivors

(68.4±8.1y/o)

ABC (r=.73)

Interrater:

BESTest [ICC

(2, 1)

= .96]; No

component

results

reported;

Test-retest:

BESTest [ICC

(2, 1) = .92];

No

component

results

reported

BESTest

MDC =

6.9%; No

component

results

reported

NA

Jacome et

al., 2016

46 participants

with COPD

(75.9±7.1 y/o)

Against ABC

(rho = 0.61)

Interrater:

BESTest [ICC

(2, 1)

= .85]; No

component

results

reported;

Intrarater:

BESTest [ICC

(2, 1)

= .87]; No

component

results

reported

6.3%

76.9%

64%

77%

NA

Yingyongy

udha et al.,

2016

200 healthy

adults with or

without fall hx,

(70.2±7.0 y/o)

NA

66%

76%

50%

NA

45

Anson et

al., 2017

58 adults with

fall history and

self-reported

balance

problem,

(78.1±7.0 y/o)

NA

Test-retest:

0.86

8.9

NA

Margues et

al., 2017

66 adults with

Type II Diabetes

Mellitus

(75±7.6 y/o)

Against ABC

(rho = 0.70)

NA

81 points

68%

71%

NA

Wang-Hsu

et al., 2018

Community-

dwelling older

adults (85/5.5

y/o; 70-94)

NA

Interrater:

BESTest [ICC

(2, 1)

= .97];

Component

(.85-.94); N =

32

Test-retest:

BESTest [ICC

(2, 1) = .93];

Component

(.72-.89); N =

70

BESTest

MDC =

8.2-point

(95%CI)

Component

: 2.1-3.4

point

(95%CI);

N = 70

NA

46

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

BESTest-

Brief

Padgett et

al., 2012

13 adults with and 13

adults without

Multiple Sclerosis

NA

Interrater:

ICC = .99

NA

100%

NA

Duncan et

al., 2013

80 participants with

Parkinson’s Disease,

(68.2±9.3 y/o); also

reported

Retrospective 6

month; Prospective 6

month: and

Prospective 12-

month LR+, LR-,

pretest probability of

falling, 6 month

posttest probability,

and 12 month

posttest probability

of falling

NA

11/24

(45.8%)

Retrospective

6 month:

76%;

Prospective 6

month: 71%;

Prospective

12 month:

53%

Retrospective

6 month:

84%;

Prospective 6

month: 87%;

Prospective

12 month:

93%

NA

Chan and

Pang, 2015

Patients after Total

Knee Arthroplasty

(65+ y/o)

(n = 46) Internal

consistency

α=0.97; validated

against Berg

Balance Scale,

Functional Gait

Assessment

(FGA), and

Activities-

speciﬁc Balance

Conﬁdence

(ABC) Scale

Interrater:

[ICC

(2, 1)

= .97]; n =

25

Test-retest:

[ICC

(2, 1)

= .94]; n =

45

MDC

= 3.2

point;

n = 46

NA

Jacobs et

al., 2015

42 adults with

Parkinson’s Disease

(67, range 64-70 y/o)

NA

14

70.6%

76.9%

NA

47

Bravini et

al., 2016

244 adults with

balance disorders

(65.3±14.9 y/o)

Internal construct

validity using

Rasch analysis

demonstrated un-

fit model,

recommend item

1 not fit

Cronbach

α=0.89;

Interrater:

ICC

(2, 1)

= .90;

Test-retest:

ICC

(2, 1)

= .94

4.3

NA

Huang et

al., 2016

28 community-

dwelling cancer

survivors

(68.4±8.1y/o)

ABC (r=.81)

Interrater:

[ICC

(2, 1)

= .92];

Test-retest:

[ICC

(2, 1)

= .94];

MDC

= 2.55

point

NA

Jacome et

al., 2016

46 participants with

COPD (75.9±7.1 y/o)

Against ABC

(rho = 0.53)

Interrater:

[ICC

(2, 1)

= .97];

Intra-rater:

[ICC

(2, 1)

= .82];

MDC

= 4.9

16.5

81%

73%

NA

Margues et

al., 2017

66 adults with Type

II Diabetes Mellitus,

(75±7.6 y/o)

Against ABC

(rho = 0.62)

NA

15.5

67%

71%

NA

48

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

BESTest-

mini

Horak et al.,

2011

115 adults with

neurological disorders

Using Rasch

analysis to

select 14

items

NA

Padgett et al.,

2012

13 adults with and 13

adults with balance

deficits

NA

Interrater:

ICC = .99

NA

71%

100%

NA

Tsang et al.,

2013

106 post stroke and

48 control adults

participated (55+ y/o)

With BBS

(rho = 0.83)

Interrater:

ICC

(2, 1)

= .97

Test-retest:

ICC

(3, 1)

= .96; n =

22

3 point

17.5

64.0%

64.2%

NA

Duncan et al.,

2013

80 participants with

Parkinson’s Disease,

(68.2±9.3 y/o); also

reported

Retrospective 6

month; Prospective 6

month: and

Prospective 12 month

LR+, LR-, pretest

probability of falling,

6 month posttest

probability, and 12

month posttest

probability of falling

NA

20/32

Retrospective

6 month:

88%;

Prospective 6

month: 86%;

Prospective

12 month:

62%

Retrospective

6 month:

78%;

Prospective 6

month: 78%;

Prospective

12 month:

74%

NA

Godi et al.,

2013

93 participants with

various neurological

disorders (66.2±13.2

y/o)

Correlated to

BBS

Cronback

α=0.90;

Interrater:

ICC

(2, 1)

= .98;

Test-retest:

ICC

(2, 1)

= .96

3.5

NA

94%

81%

NA

49

Chinsongkram

et al., 2014

49 adults with

subacute stroke (58.2

y/o; 24-90);

responsiveness of the

test

NA

3 points

21

84.6%

87.5%

NA

Chan and Pang,

2015

Patients after Total

Knee Arthroplasty

(65+ y/o)

(n = 46)

Internal

consistency

α=0.96;

validated

against BBS,

Functional

Gait

Assessment

(FGA), and

ABC Scale

Interrater:

[ICC

(2, 1)

= .96]

Test-retest:

[ICC

(2, 1)

= .92]; n =

45

MDC =

3.71

point; n

= 46

NA

Jacobs et al.,

2015

42 adults with

Parkinson’s Disease

(67 y/o, 64-70)

NA

21

82.4%

65.4%

NA

Wallen et al.,

2016

112 adults with

Parkinson’s Disease

(72.8±5.5 y/o)

Structure

validity with

exploratory

factor

analysis

(EFA) and

Rasch

analysis;

recommend

omit item 7

NA

Ross et al.,

2016

52 adults with

Multiple Sclerosis

(45.7±5.7 y/o)

With BBS

(r=.79)

None

reported

None

reported

22.5 cutoff

for falls;

AUC = 0.77,

Positive

likelihood

ratio 2.86,

negative

NA

50

likelihood

ratio 0.19

Huang et al.,

2016

28 community-

dwelling cancer

survivors 68.4±8.1y/o

ABC (r=.52)

Interrater:

[ICC

(2, 1)

= .86];

Test-retest:

[ICC

(2, 1)

= .90];

MDC =

2.39

point

NA

Jacome et al.,

2016

46 participants with

COPD

(75.9±7.1 y/o)

Against

ABC (rho =

0.55)

Interrater:

[ICC

(2, 1)

= .85];

Intrarater:

[ICC

(2, 1)

= .88];

MDC =

3.3

21.5

68%

65%

NA

Schlenstedt et

al., 2016

66 adults with

Parkinson’s Disease

NA

19

0.52%

0.70%

NA

Yingyongyudha

et al., 2016

200 healthy adults

with or without fall

history

(70.2±7.0 y/o)

NA

16

85%

75%

NA

Anson et al.,

2017

58 adults with fall

history and self-

reported balance

problem, (78.1±7.0

y/o)

NA

Test-retest:

0.84

4.0

NA

Jorgensen et al.,

2017

46 ambulatory adults

with chronic spinal

cord injury (55±17

y/o)

Correlates to

BBS

(r=0.90)

NA

19

55-82%

54-75%

NA

Margues et al.,

2017

66 adults with Type II

Diabetes Mellitus

(75±7.6 y/o)

Against

ABC (rho =

0.63)

NA

20.5

60%

71%

NA

51

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Brunel Balance

Assessment

Tyson &

DeSouza,

2004

Reliability testing (n

= 37, mean age 66)

Validity testing (n =

55, mean age 68 y/o)

Correlation

coefficients 0.83

for Motor

Assessment Scale,

0.97 with Berg

Balance Test and

0.95 with

Rivermead

Mobility Index

100%

agreement (K=

1) for both test

retest reliability

and inter-tester

reliability.

1(stroke)

Score ranges

from 0/12

(lowest) to

12/12

(highest)

NA

Tyson, et al.

2007

Post CVA, n=75,

(mean age 70 y/o)

Findings of this

study confirm the

predictive validity

of the BBA

NA

52

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Canadian

Occupational

Performance

Measure

(COPM)

McColl et

al., 2000

Disabled

adults (18-75

y/o);

n = 61

Construct validity with

Satisfaction with Performance

Scaled Questionnaire (SPSQ),

Reintegration to Normal

Living Index (RNL), Life

Satisfaction Scale (LSS) at

p<.0005, correlations .37 - .46

Criterion validity with

Perceived Problem Check List

(PPCL): Frequency of reported

problems: PPCL COPM

Selfcare 60% 46%

Productiv22% 23%

Leisure 9% 31%

NA

Sewell &

Singh,

2001

COPD,

pulmonary

rehabilitation

outpatient

(53-79 y/o)

n = 15

NA

Mean differences:

Performance =.14,

Satisfaction = 42,

CI 95%

Intraclass

correlation

coefficients:

Performance r =

0.92; Satisfaction

r = 0.90, p<.0001

NA

Cup et al.,

2003

Stroke, s/p 2

month, (26-83,

mean 68 y/o)

n = 26

Discriminant validity with: BI,

FAI, SA-SIP30, EQ-5D,

Rankin Scale r = -0.225, -

0.115, 0.102, 0.143, 0.209

respectively

Test-retest

reliability rho =

Performance .89

&

Satisfaction .88 at

p<0.001

NA

Dedding et

al., 2004

Neurological

and orthopedic

adults

n = 99

Divergent validity with SIP68

Performance r = -0.20, p =

0.05; Satisfaction r = -0.19, p

= 0.07; Convergent validity

with Disability & Impact

NA

53

Profile (DIP) 63%

corresponding items

Eyssen et

al., 2011

Various

diagnoses in

adult

outpatient

clinics

n = 138

(51±13 y/o)

Construct validity with SIP68,

DIP & Impact on Participation

and Autonomy (IPA) p =

<0.01

NA

AUC

0.79

to

0.85

NA

54

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Clinical

Test of

Sensory

Interaction

& Balance

(CTSIB);

Di Fabio &

Badke,

1990

Stroke

patients,

university

hospital

(29-70 y/o),

n = 10

Construct validity

with Fugl-Meyer

Sensorimotor

Assessment (FMSA)

Sensory rho = .55,

P< .05

Balance rho = .77,

p<.01

Total LE rho = .69,

p<.05

Interrater

reliability

Kappa .95,

P<.05

NA

(also called

SOT in ‘90s

but with

same

protocol on

level

ground)

Anacker &

Di Fabio,

1992

Community-

dwelling

elders; Fallers

& non-fallers

(65-96 y/o)

n = 47

Construct validity

with Get Up and Go

Test (GUGT)

Spearman Rho =

-.67 fallers; -.44

non-fallers

Test retest

reliability r

= .75, p<.05

NA

Cohen et

al., 1993

Healthy adults

3 age groups

vestibular

dysfunction

adults - 4

th

group

Healthy n =

15; (25-85

y/o)

Vestibular n =

17; (30-87

y/o)

Predictive validity

of scores between

the 2 groups.

Condition 5 t = 4.17,

P<.001

Condition 6: t

=5.58, P<.001

Test-retest

reliability &

interrater

reliability r

= .99, p<.01

NA

Di Fabio &

Anacker,

1996

Community-

dwelling

elders

(65 -96 y/o).

16 Fallers, 31

No-Fallers

Construct validity:

Discriminant

functions classified:

Non-fallers: 77%

Fallers: 63%

NA

< 250 sec

Identifying

fallers

44%

90%

NA

55

El-Kashlan

et al., 1998

Two Groups:

Healthy adults

& Vestibular

Dysfunction

Normal: (20-

79 y/o)

N =69

Vestibular:

(20-70 y/o); N

= 35

Construct validity

with Dynamic

Posturography

(SOT) on Balance

Master

Baseline: r = 0.41,

P≤0.018

1 month: r = .74,

P≤0.000

2 months: r = 0.89,

P≤ 0.000

3 months: r = .41,

P≤0.034

NA

Sensitivity

of 60% in

identifying

vestibular

dysfunctio

n

NA

Normal

CTSIB: 89

%

Abnormal

CTSIB:

55%

NA

Bernhardt

et al., 1998

Stroke, acute

IP

(71.8± 10.5

y/o)

N =29

Correlations

( Pearson’s r) with

Locomotion

Measures (Step

Test, gait velocity,

Motor Assessment

Scale ) >.40,

p<0.0036

NA

Freeman

DL, 2018

Parkinson’s

Disease,

Idiopathic

Parkinson’s

Disease

(62.7±13.5

y/o)

N = 26

Concurrent validity

with Instrumented

mCTSIB & SOT

Composite Score =

r=-.43, p=0.03 to

0.64, p=<.001

Condition 1=

r=0.43, p.0.03

Condition 2=

r=0.16, p=0.43

Condition 3 r= -.60,

p=<.001

Condition 4 r= 0.54,

p=<.001

Differentiation

between fallers/non-

fallers mean score

P=0.04

NA

56

Cohen HS,

2019

Community-

dwelling

outpatient

screen for

vestibular

disorders

n=292 healthy

controls

n=90

vestibular

patients

NA

Individual

Test: ROC

values

0.67-0.84

yaw &

pitch head

movements

NA

57

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Community

Balance &

Mobility Scale

(CB&M)

Howe et

al, 2006

TBI, undergoing

inpatient and

outpatient

neurorehabilitation

N = 36

Phase 1 (31±9 y/o)

Phase 2 (34±12

y/o)

Content validity with

Therapist Global Rating

Scale r = 0.62, P<0.001

Construct validity with

self-paced gait & max

gait velocity; r =0.53

and r =0.64 at P<0.001

respectively

Inter, inter, test-

retest reliability

& internal

consistency

ICCs of 0.977,

0.977, 0.975 &

Cronbach’s

alpha 0.96

respectively

9.6 (SEM &

Cronbach’s a

NA

Knorr et

al., 2010

Stroke community-

dwelling &

ambulatory

(62.6±12 y/o)

N = 44

Convergent validity

with BBS, TUG,

Chedoke McMaster

Stroke Assessment

(CMSA)

TUG &BBS P<.01, p

= .70 -.83

CMSA, p= .67 at

P<.001

NA

Sensitivity to

change,

SRM = .83

(ratio of mean

change in

scores divided

by SD of

change

scores), P =

<.001

NA

Inness et

al., 2011

Traumatic brain

injury inpatient and

outpatient private

clinic undergoing

neurorehabilitation,

ambulatory

(18-60 y/o)

N = 35

Construct validity with

Spatiotemporal Gait

measures, ABC and

Community integration

Questionnaire (CIQ)

CIQ r = 0.54, p<0.001

ABC r = 0.60, p 0.011

Spatiotemporal Gait

Measures p < 0.05;

moderate to excellent

correlation with

velocity, step length,

step width, step time;

correlation with

dynamic instability, step

time & step with

variability, p<0.001

NA

58

Weber et

al., 2018

adults (60-70 y/o)

participants

correlated with multiple

other outcome measures

including TUG;

Internal consistency

alpha = 0.88

Interrater ICC2,

k = 0.97; Intra-

rater ICC3, k =

1.00

NA

59

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

CONFbal

Simpson et al

2009

Older people (mean 81 y/o)

in day centers

Cronbachs alpha

0.91

ICC 0.95

3 points

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Conley Scale

Palese et al., 2016

Acute Medical Unit (>65

y/o)

Cronbachs alpha

0.465

ICC 0.95

3 points

NA

60.0

55.9

NA

98.5

60

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Demura’s

Fall Risk

Assessment

Chart

(DFRA)

Demura et

al., 2010

Healthy

community-

dwelling

adults (≥ 60

y/o)

With Tokyo

Metropolitan

Institute of

Gerontology

(TMIG)

NA

≥ 1 point of

each of 5 risk

factor scores;

14.4% (total

score); 39.7%

(independent

risk factor

scores)

NA

Odds ratios

calculated for

each risk factor

score & total

score; ≥

3 points = odds

ratio of ≥ 5

NA

Demura et

al., 2012

Healthy

community-

dwelling

adults (≥60

y/o)

With TMIG

NA

Overall score

22 pts

PF-3 score 1

point

Pf-4 score 2

pts

.306;

AUC .68(CI

95%)

.869; AUC .797

(CI 95%)

.869; AUC .946

(CI 95%)

.072

.657

.906

NA

Demura et

al., 2011

Healthy

community-

dwelling

adults (≥ 60

y/o)

NA

Total score =

Test –retest

ICC .956, N

= 172

NA

Total Score >2

pts

NA

Total Score OR

5

NA

Demura et

al., 2013

Healthy

community-

dwelling

adults (≥ 60

y/o)

NA

Potential for

falling 1 point

Physical

function 10 pts

Diseases &

Physical 5 pts

Behavior &

character 3 pts

Environment 1

point

.87; AUC .80

(CI 95%)

.40; AUC .63

(CI 95%)

.30; AUC .63

(CI 95%)

.53; AUC .67

(CI 95%)

.78; AUC .54

(CI 95%)

.66

.81

.87

.75

.27

NA

61

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Downton

Fall Risk

Index

Nyberg et

al., 1996

Geriatric stroke

rehabilitation unit

≥ 3 high fall risk

91%

27%

44.4%;

Odds ratio

3.5

81.5%

Rosendahl

et al., 2003

Residential care

facility (81± 6 y/o);

47% dementia 45%

depression 32%

stroke

≥ 3 high fall risk

91%

39%

36% fall

risk high

risk group;

5% low

risk group

Vassallo et

al., 2008

Geriatric general

rehabilitation ward

Predictive validity

with STRATIFY

no significant

difference

≥ 3 high fall risk

92.2%

CI

95%;

35/8%

CI

95%

33.1% CI

95%

92.9%

CI

95%

Bueno-

Garcia et

al., 2017

Public hospital; all

diagnoses

Poor external

validity in this

population

58%

62%

1%; odds

ratio 2.31

99%

Mojtaba et

al., 2018

6650 hospitalized

patients

Among individual

modules, only

previous falls (IRR

2.58, 95% CI 2.22

to 3.01) and

unsafe gait (IRR

1.79, 95% CI 1.53

to 2.09) were

associated with

fall-related injuries.

The cutoff

3 points

significantly

associated with

fall-related injury

(IRR 1.94,

95% CI 1.60 to

2.38).

Majtaba et

al., 2019

Australian hospital,

(>65 y/o)

n= 6650

Stratified analysis

by gender

Concurrent validity

with fall-related

injuries & high fall

risk at 6 months

IRR 1.94, 95% CI

1.60-2.38

≥3 pts

62

Stratified Analysis

higher risk for men

95% CI

63

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Dynamic

Gait Index

(DGI)

Shumway-

Cook et al.,

1997

Community-

dwelling adults (≥

65 y/o)

Balance Self-

Perceptions Test,

Berg Balance Test r

= .76

Interrater r = .96; Test-

retest r = .98; N = 44

NA

≤ 19 pts

59%

64%

NA

Whitney et

al., 2000

Adults (mean age

62.5 y/o) with

vestibular disorder

NA

≤ 19 pts

Odd

ratio

2.58

at

95%

NA

Whitney et

al., 2003

Outpatient

vestibular and

balance dysfunction

(Ages 14-88 y/o)

With Berg Balance

Scale; r = .71; p < .01

NA

Wrisley et

al., 2003

Outpatient

vestibular disorders

(Ages 27-88 y/o)

NA

Interrater k = .68;

Spearman Rho r = .95,

P < .0001; N = 30

NA

Whitney et

al 2004

Outpatient

vestibular disorders

(Ages 14-90 y/o)

NA

≤ 18 pts for

previous 6

month fall

70%

51%

NA

Hall et al.,

2004

Outpatient

unilateral vestibular

hypofunction (Ages

28-86 y/o)

NA

77%

90%

NA

Legters et

al., 2005

Outpatient,

peripheral

vestibular disorder;

(Ages 24-87 y/o)

With Activities-

specific Balance

Confidence Scale

(ABC); Total Sample:

r = .58 (p < .0001);

Mild-Mod vestibular

weakness: r = .72 (p

< .0001;

NA

64

Severe-Total

vestibular weakness: r

= .48 (p < .0001)

McConvey

et al., 2005

Individuals with

Multiple Sclerosis

With 6.1 m Timed

Walk; -.801, P<.01

Interrater .983 (P<.05);

Intra-rater

reliability .910-.976 (p

= .05); N =10

NA

Dibble &

Lange, 2006

Individuals with

Idiopathic

Parkinson’s

Disease; (Ages 39-

90 y/o)

NA

Current

research: 22

.75

.89

.30

.48

NA

Hall &

Herdman,

2006

Adults with

peripheral

vestibular disorders

NA

Test-retest ICC 3,1

= .86

NA

Marchetti &

Whitney,

2006

Individuals with

and without

vestibular and

balance dysfunction

(Ages 14-91 y/o)

4-Item Test

Cronbach’s alpha .89

8-Item Test

Cronbach’s alpha .92

Interrater Kappa .54

- .80

NA

4-Item test

<12

8-Item Test <

19

85%

86%

75%

86%

NA

Cattaneo et

al., 2006

Individuals with

Multiple Sclerosis;

(mean age = 45 y/o)

Berg Balance

Scale .78 TUG.72

Hauser De-

ambulation Index .8

Dizziness Handicap

Inventory

-.39; ABC .54

NA

Jonsdottir et

al., 2007

Individuals with

stroke,

rehabilitation

outpatient

With Berg Balance

Scale r = .83

ABC r = .68

Timed Walking Test r

= -.73

TUG r =-.77

Test-retest ICC .96

Interrater reliability

ICC .96

N = 25

NA

65

Cakit et al.,

2007

Individuals with

Idiopathic

Parkinson’s Disease

With UPDRS motor

subscale

r = -.643, p < .01

Fall history

R = .643, p < .01

NA

Landers et

al., 2008

Individuals with

Idiopathic

Parkinson’s Disease

Discriminant: fallers

16.1 SD = 3.4

Non-fallers 19.6 SD =

2.6, p < .01

NA

Lin et al.,

2010

Individuals with

stroke, outpatient

rehabilitation

With DGI-4 &

Functional Gait

Assessment r > .91

Test-Retest ICC .94

(CI 95%)

4.0

NA

Jonsson et

al., 2011

Hospital and

outpatient

rehabilitation center

with fall hx (≥ 65

y/o)

NA

Hospital: Intra-rater

ICC .90

Interrater ICC .92; N

=24

Rehabilitation Center:

Intra-rater ICC .89

Interrater ICC .82: N =

24

NA

Huang et al.,

2011

Outpatient

individuals with

movement disorders

(mean age 67.5 y/o)

NA

Test-Retest ICC .84

(CI 95%)

2.9

(13.3)

NA

Romero et

al., 2011

Community-

dwelling, fall or

near fall history (>

65 y/o)

NA

2.9

(95%)

NA

66

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Elderly

Fall

Screening

Test

Cwikel et

al. 1998

Community-

dwelling

adults (> 60

y/o)

Concurrent with

physician examination

Predictive with f/u

interview

NA

2+

83%

physician

69%

physician

66.7%

(physician);

RR > 3.0 for

fall related

parameters

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Elderly

Mobility

Scale

Smith et

al., 1994

Frail elderly

(70-93 y/o)

With Barthel Index

(BI) (Spearman’s

Rho .962);

Functional

Independence

Measure (FIM)

(Spearman’s

Rho .948)

NA

Prosser et

al., 1997

Hospitalized

elders; N = 66

With Barthel Index (r

= .79, p < .0001)

Interrater .88,

p < .0001

NA

Spilg et al.,

2003

Community-

dwelling and

residential

care elderly

with mobility

problems

(≥ 60 y/o)

EMS, Functional

Reach and Barthel

Index at discharge,

significantly

associated with the

risk of having two or

more falls (p = 0.008,

0.017 and 0.031)

NA

Low risk ≥

20

for recurrent

falls s/p DC

from

geriatric Day

Program

NA

Yu et al.,

2007

Elders,

residential

homes

NA

Functional

Mobility

13/14

93.3%/CI

95%

93.3%

CI 95%

NA

Nolan et

al., 2008

Acute

hospitalized

(≥ 55 y/o)

Modified Rivermead

Mobility Index

(MRMI)p= .887, p

< .05, CI 95%

Intra-

reliability 0.72

NA

67

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Euroqual (EQ-

5D

Brazier J et

al., 1993

General practice

patients; (16-70

y/o); n=1980

Concurrent

validity with SF-

36

Construct validity:

no statistics

presented

Spearman Rank

correlation coefficient

range 0.48-0.60

(p<0.01)

NA

Poor

sensitivity at

the high

ceiling

NA

Van Agt HM

et al., 1994

General population

n=208

NA

Test-retest analysis

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Fall Perception

Questionnaire (F

RAQ)

Goncalves et

al., 2017

Community-

dwelling older

adults (> 60 y/o); 3

focus groups of 3-5

participants

Methodological

quantitative study

with VC to evaluate

item content,

representativeness

of the measure

based on analysis of

3 judges

Content validity

coefficient

(VC): .71-.80 for

the 3 categories

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Falls Handicap

Inventory

Rai et al.,

1995

28 hospital patients

with fall history (78

± 5.6 y/o)

validated with fall

efficacy scale (r =

-7.5, p< 0.0001)

NA

68

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Falls

Prevention

Strategy

Survey

Finlayson ML,

Peterson EW,

Fujimoto KA,

Plow MA,

2009

Adults with

Multiple

Sclerosis

Rasch Validation:

Analysis indicated that the

rating scale structure (i.e.,

response options) was valid. Of

the original 19 items, 8 of them

misfit and needed to be

dropped to obtain a valid

instrument under the Rasch

model. With the final 11 items,

the instrument was able to

distinguish participants of

different ability levels across a

range of 11.58 logits.

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Fall Risk for

Older People

in the

Community

(FROP-COM)

Russell, M et

al., 2008

Community-

dwelling

older adults

(> 60 y/o)

27 days post

ED

n = 20

(reliability)

n = 34

(predictive)

n = 20 concurrent study with;

Functional Reach: r = .50 95%

CI

TUG: r =.62 95% CI

Inter-

reliability .8

1 & intra-

reliability.9

3, 95% CI

NA

18/19

71.3

%

95%

CI

56.1

95%

CI

NA

69

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Fall

Behavior

Scale

Clemson et

al., 2003

Community-dwelling older

adults. nursing home and

hospital-based residents

excluded

Content validity index

28/30 items, CVI=93;

Construct validity: scores

positively associated with

increasing age (rs = .46,

p <.01);

negatively associated

with physical mobility

(rs = .68, p <.01)

Test-retest

reliability ICC

=.94 (p<.01)

NA

no cutoff

scores

established

NA

70

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Falls

Efficacy

Scale - Int

Yardley et

al., 2005

Community-

dwelling

older adults

NA

Excellent

internal and test-

retest reliability

Cronbach’s

alpha .96

(ICC .86)

NA

Delbaere et

al., 2010

Community-

dwelling

older adults

(mean age

77.4 y/o)

Content Validity: .93

Positive associated with associated with

increase in age

(r

s

=46, p<.01)

Neg association with greater physical

mobility (r

s=

-.68, p<.01)

and leaving the home more often in the

past week (r

s=

-.51, p<.01)

ICC=.79

NA

Fall concern:

16-19 low

concern

20-

27=moderate

concern

28-64 high

concern

NA

Hauer et al.,

2010

Cognitively

impaired

older adults

(mean age

82.5 y/o)

NA

Test-retest

ICC .96

NA

Hauer et al.,

2011

Older adults

without

cognitive

impairment

(mean age

81.6 y/o)

NA

Test-retest

ICC .58 to .92

Excellent

internal

consistency

(Cronbach’s

alpha=.92)

NA

Morgan et

al., 2013

Vestibular –

(mean age 54

y/o)

Criterion validity:

excellent correlations with Activities

Balance Confidence Scale (ABC)

(scores: -.84

Dizziness Handicap Inventory (DHI)

r=.75

Vestibular Activities and Participation

(VAP) (r=.78)

Adequate correlations: gait speed

(r=-.55)

Dynamic Gait Index (DGI) (r=-.55)

Test-retest

ICC .94

8.2

NA

71

Dewan and

MacDermid,

2014

Community-

dwelling

older adults

NA

Test-retest

ICC .96

NA

Visschedijk

et al., 2015

Older adults

s/p hip

fracture

(mean age

83.1 y/o)

Internal consistency 3rd or 4th week

after SNF admission = (Cronbach’s

alpha = .94)

Inter-rater

reliability

ICC.72

17.7

NA

FES-I

short

Kempen et

al., 2008

Community-

dwelling

older adults

(> 60 y/o)

Correlation with FES-I = .97

Internal and test-

retest reliability

excellent with

Cronbach’s

alpha .92

(ICC .83)

NA

72

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Fear

Avoidance

Beliefs

Questionnaire

Chugh EJ et

al., 2013

55 patients

with LBP

(mean age =

46 y/o, range

19-76)

Construct Validity

FABQ-P

-with FABQ-W significant

correlation (r=0.496 p=0.00)

-with VAS significant

correlation (r=0.0320

p=0.017)

-with FABQ total significant

correlation (r=0.794 p=0.00

-with RMDQ Roland Morris

Disability Questionnaire

significant correlation

(r=0.372 p=0.005)

-with Osteresky Disability

Questionnaire

no significant correlation

(r=0.199 p=0.146)

NA

Dedering &.

Börjesson,

2013

46 patients

with cervical

radiculopathy

(Age-49± 9.8

y/o); 41

healthy

participants

(Age-44±6.6

y/o)

FABQ has concurrent validity

for patients with cervical

radiculopathy

Good correlation (spearman

correlation coefficient >0.50)

between FABQ-PA with TSK

(0.62)

Poor correlation between TSK

with FABQ-W (0.32) and

FABQ-SUM (0.47)

Test retest

reliability:

Good to moderate

for FABQ

Weighted kappa

values (k-value is

good if >0.60)

FABQ-PA -0.50

FABQ-W-0.67

(good)

FABQ SUM-0.68

ICC of FAQB SUM

-0.93

Internal consistency

Cronbach’s Alpha =

0.89

NA

73

Merrill et al.,

2016

64

participants

with or

without

pathology

ROC Curves & area under

curve:

Fallers at 1yr after assessment,

95%CI 0.62-0.91;

frequent fallers at 1 year after

assessment, 95%CI 0.70-0.95

Predictor variables used:

Physical -BBS, TUGT, SSGS,

DGI, SOT

: Psychological -ABC, FABQ,

FES

ABC and FABQ were the best

at predicting future falls both

independently and when

compared against other

predictor variables.

NA

74

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Figure 8

Walk

Test

Hess et al.,

2010

51

community-

dwelling older

adults

(Mean

age=76.8±5.5

y/o)

NA

Interrater reliability

ICC (95% CI)

For time: 0.90

For number of steps: 0.92

For smoothness: 0.85

Test retest reliability

ICC values (95%CI)

For time: 0.84

For number of steps: 0.82

For smoothness: 0.64

NA

Wong et

al., 2013

64 subjects

(35 with

chronic stroke

and 29 healthy

elderly)

NA

Excellent intra-rater, inter-

rater and test–retest

reliabilities (CC range

0.944–0.999)

NA

8.2 seconds

100

%

89.2

%

NA

Welch et

al., 2016

428 primary

care patients

(>65 y/o,

Median age =

76.5 y/o)

NA

poorer

performance

of F8WT by

1 second was

associated

with 8%

greater rate

of falls

(RR=1.08,

CI: 1.03–

1.14)

NA

Barker et

al., 2019

74 older adults

(> 55 y/o) one

year s/p Total

Knee

Arthroplasty

in both home

care and

outpatient

setting

F8W and TUG were

correlated for the overall

sample (r = 0.921) and

subgroups: Home (r = 0.945)

and Clinic (r = 0.911). F8W

and Timed walk test were

correlated for the overall

sample (r = 0.834) and

subgroups, Home (r = 0.864)

and Clinic (r = 0.793)

Intra-rater reliability at

95% - 1.8 sec.

Inter-rater reliability at

95%, 1.2 sec.

NA

75

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Floor Rise

Test (Supine

to stand

test)

Klima et al

2016

Community-

dwelling adults

NA

gait speed (r =

−.61; p < .001)

grip strength (r =

−.30; p < .05)

Timed Up and Go

(TUG) performance

(r = .71; p < .001)

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Fullerton

Advanced

Balance

Scale (FAB)

Rose et al.,

2006

46 community-

dwellers

31 with known

balance issues

and 15 without

balance issues

NA

Test re-test

0.96

Inter-rater

0.94-0.97

Intra-rater

0.97-1.00

NA

Hernandez

& Rose,

2008

Independently

functioning older

adults

NA

25/40 points

74.6%

52.6%

8% increase

in chance of

falls with

each 1 point

decrease in

score

NA

Schlenstedt

et al., 2015

Idiopathic

Parkinson’s

Disease

(>40 y/o)

Spearman 0.87

Inter and intra 0.99

NA

Chauhan &

Padnani,

2019

Post-stroke,

independent

ambulatory

Concurrent

validity with

BBS Spearman

correlation

coefficient (r)

0.86 p < 0.01

Spearman correlation

coefficient (r) for intra

rater reliability is 0.96;

p <0.01; inter rater

reliability Spearman

correlation coefficient

(r) is 0.972, p < 0.01.

NA

76

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Functional

Ambulation

Category

Mehrholz et

al., 2007

Acute stoke,

inpatient

rehabilitation

setting

NA

Test re-test

Kappa .950

Inter-rater

Kappa .905

NA

FAC score ≥4

predicted community

ambulation following

4 weeks of rehab at 6

months

100% for

community

ambulation

78%

for

community

ambulation

NA

77

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Functional

Gait

Assessment

Wrisely et

al 2004

Vestibular

(mean age

58.7 y/o)

Criterion Validity:

Excellent concurrent validity

with: Perception Dizziness

Symptoms: (r=-.70);

Dizziness Handicap

Inventory (r=-.64)

ABC (r=.64); number of falls

in previous 4 weeks (r=-.66),

DGI (r=.80); adequate with

TUG (r=-.50)

Excellent

interrater

reliability

(ICC.84)

8 points

from

admissio

n to

follow up

NA

Walker et

al., 2007

Community-

dwelling

adults

healthy (aged

40-89 y/o)

NA

Excellent

Interrater

reliability

(ICC=.93;

p<.001)

NA

Thieme et

al., 2009

Adults (mean

age 69.9 y/o)

max 6 month

s/p CVA

Construct validity:

excellent correlation (p<.001)

with Functional Ambulatory

Category (.83), gait speed

(.82), Berg Balance Scale

(.93), Rivermead Mobility

Index (.85), Barthel Index

(.71).

Excellent

Interrater

reliability

(ICC=.94)

NANA

NA

Wrisley &

Kumar,

2010

Community-

dwelling

older adults

Concurrent Validity and

statistical significance

excellent with BBS r=.84

(P<.000); TUG r=.84

(P<.000); with ABC scale

r=.53 (P<.001).

Predictive validity: correctly

identified 6/7 unexplained

falls in the 6 months s/p the

test

NA

<22/30

predicting falls

<20/30 predict

falls in next 6

months

85%

100

%

86%

76%

(+) LR

3.6

PPV:

58%

(+) LR

5.8

PPV:

43%

(-) LR

0

(-) LR

NPV

100%

78

Lin et al.,

2010

Adults (mean

age 54.9 y/o)

acute and

chronic CVA

Convergent validity:

Excellent statistical

association at 1st week, 2

months and 5 months post

therapy with 10MWT

(r=.61-.87) and PASS

(r=.74-.85)

Excellent test-

retest

reliability

(ICC=.95,

95% CI)

4.2 (5

point)

14.4%

change

NA

Leddy et

al., 2011

Community-

dwelling

older adults

with

Parkinson’s

Disease

NA

Test-retest

reliability

administered

by student:

excellent (ICC

=.80; 95%

CI=.58-.91)

administered

by a PT

excellent

(ICC=.9; 95%

CI=.80-.96

Interrater

reliability

(ICC=.93;

95% CI

=.84-.98)

NA

<15/30

predictive of

fall

72%

78%

(+) LR

3.24

PPV

59.6%

(-) LR

.36

NPV

14.1%

Ellis et al.,

2011

Adults with

Parkinson’s

Disease

Concurrent validity and

statistical sig Excellent with:

Berg Balance Scale (r=.77),

PDQ-39 mobility subsection

(r=. -66), postural instability

score (r=-.68)

Adequate with PDQ39 total

score (r=-.57), age (r=-.44),

bradykinesia composite score

(r=-.55), freezing of gait

score (r=-.54), functional

reach (r=.52), 9 hole peg test

(r=-.52)

NA

79

Duncan et

al., 2012

Adults with

Parkinson’s

Disease

NA

<15/30

6-month

prospective

falls

12 months

prospective

falls

64%

46%

81%

(+) LR

3.37

PPV

56%

(+) LR

2.42

PPV

54%

(-) LR

.44

NPV

15%

(-) LR

.67

NPV

24%

80

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Functional

Independence

Measure (FIM)

Hobart JC

et al., 2001

Inpatient Neuro

rehabilitation; n =

149 (age 16-77 y/o,

mean 46.2 y/o)

Item Validity:

Disability- 0.82,

Cronbach’s alpha;

Handicap, physical

health status, mental

health status

psychological distress,

global cognitive

function,

responsiveness ranged

0.10-0.48

Internal Consistency:

0.53-0.87, Alpha

coefficient 0.95

Concurrent Validity

with Barthel Index, 18-

item FIM, 30-item

FIM+FAM: Pearson’s

r=0.96-0.996, ICC

=0.95-0.995

Intra-rater

reproducibility:

0.98, ICC

NA

81

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Functional

Reach Test

Katz-

Leurer, et

al.,

2009

Older adults s/p

acute CVA

Reliability n=10,

(mean age 63 y/o)

Validity n=35,

mean age 60 y

Responsiveness to

paretic side (effect

size 0.80) forward

and nonparetic side

(effect size 0.57 –

0.60)

test-retest ICC

range 0. 90 –

0.95

NA

Merchán-

Baeza, et

al.,

2014

Older adults s/p

acute CVA

n=5

(mean age 76.7 y/o)

NA

Inter-rater 0.987

intra-rater 0.983

NA

Bohannon,

et al.,

2017

Hypertensive

adults, n=199

(mean age 80.6 y/o)

Consolidated data

from 20 studies,

n=7535

NA

Hypertensive

grp 27.5 cm

(SD 7.2cm)

Consolidated

data 27.2 cm

(SD 0.9cm)

NA

Modified

Functional

Reach Test

Thomas &

Lane, 2005

Frail elderly

(>65y/o); n=30;

fallers (79.7 y/o)

non-fallers (81.4

y/o)

NA

Intra-rater

reliability: .087,

ICC

NA

18.5 cm; OR

5.28, CI 95%,

P=.076

75%

at CI

95%

67%

at CI

95%

Fallers vs.

non-fallers:

t=2.024,

P=.053,

Power=.46

NA

82

Outcome Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Modified

Gait Abnormality

Rating Scale

VanSwearingen

et al., 1996

Community-

dwelling

Concurrent

validity: gait

speed r = -

0.679

Intra-rater

reliability: Kappa

0.493-0.676

ICC 0.95-0.984

Interrater

Reliability:

Kappa 0.789-0.886

ICC 0.968-0.975

NA

Outcome Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Gait Efficacy Scale

(modified)

Newell et al.,

2012

Community-

dwelling

older adults

FES r 0.80

ABC Scale

0.88, and

Late Life

FDI Overall

functional

Subscale r =

0.88

Test-retest

reliability: ICC 0.

93 (95% CI 0.85-

0.97)

SEM 5.23

NA

83

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Gait

Speed

Verghese J

et al., 2009

Community-

dwelling older

adults (mean

age 80 ±5.4

y/o). n=597

NA

Risk ratio (RR) for

falls per 10 cm/s

decrease gait speed

<70 cm/s = slow gait,

RR 1.540, 95% CI

1.095-2.150

70-100 cm/s, RR

1.276, 95% CI 0.906-

1.768

NA

Peel et al.,

2012

Community-

dwelling adults,

hospital

inpatient,

outpatient

settings

NA

Community-dwellers

0.58 m/s usual pace

and 0.89 m/s maximal

pace; acute inpatient

0.46 m/s; outpatient

settings 0.74 m/s

NA

Kon et al.,

2012

Community-

dwelling older

adults with

COPD (Gold

Stage II-IV)

NA

Inter-rater:

ICC 0.99

Test-

retest: ICC

0.97

Slow:

<0.8m/s

Normal:

>0.8m/s

NA

Hiengkaew

et al., 2012

Individuals with

chronic stroke

+6 months from

initial event

(63.5±10.0 y/o)

NA

Comfortab

le speed:

0.96

Fast

speed:

0.98

(MDC 95%)

Comfortable

speed:

0.18m/s

Fast speed:

0.13 m/s

NA

Peters et al.,

2013

Healthy older

adults

0.99-1.00

between

stopwatch

and

automatic

timer

Test re-

test ICC

10 m

walk: 0.98

4 m walk:

0.97

4m: 0.02

m/s

10m: 0.01

m/s

NA

84

Elbers et al.,

2013

Community

ambulators with

Parkinson’s

Disease

(67±7.54 y/o)

NA

0.88m/s to predict

community

ambulation (70%

accurate)

NA

Blankevoort

et al., 2013

Older adults

with dementia

from nursing

homes/day care

centers (82.57

±5.31 y/o)

NA

6 m walk

test ICC

0.86

6 m walk

test = 0.27

m/s

NA

Bijleveld-

Uitman et

al., 2013

Community

ambulatory with

history of stroke

who completed

both an inpatient

and outpatient

program

NA

0.89

(CI

95%;0.

85–

0.91)

0.70

(CI

95%;0.

58–

0.80)

0.92 (CI

95%; 0.89-

0.95)

0.61

(CI

(95%;

(0.51–

0.70)

Bohannon et

al., 2013

Stroke patients

in inpatient

rehab

(62.0±13.7 y/o)

NA

MDIC 0.13

m/s

NA

0.810

0.714

NA

Bongers et

al., 2015

Community-

dwelling older

adults; (mean

age 76.2 y/o)

n=352

NA

Gait speed

for falls:

AUC 0.53

Gait speed

for recurrent

falls: AUC

0.59

Gait speed

with age,

gender & fall

hx for falls:

AUC 0.64

and for

recurrent

falls:

AUC0.69

NA

85

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Geriatric Fear of

Falling Measure

Huang et al.,

2006

Summary of 2

descriptive cross-

sectional studies in

Taiwanese

community dwelling

older adults (pilot

study n=100 and

follow up validation

n=354)

R=0.29

p=0.002

with FES

Test-retest 0.88

(p<0.0001), paired T-

tests determined no

significant difference in

mean scores

Inter-rater 0.91 for Risk

prevention, 0.94 for

psychosomatic

symptoms, and 0.89 for

modifying behavior

subscales at p<0.001 for

all

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Global

Deterioration

Scale (dementia

assessment

instrument)

Reisberg et al.,

1982

Elderly (65 y/o or

older) with stages of

dementia

Stage

progression

correlated

with CT

scan:

p<0.05

NA

Reisberg et al.,

1988

38 dementia patients

NA

Test-retest: Pearson’s

correlation

coefficient:0.92

NA

Gottlieb et al.,

1988

43 possible

Alzheimer’s

Disease patients

NA

Inter-rater: ICC = 0.82

NA

86

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Gorningen

Activity

Restriction Scale

Kempen et al.,

1996

4789

community-

based

participants

(age 57-85 y/o)

Concurrent

validity against

SF-20 (0.79)

0.91

NA

Metzelthin et al

2011

Older adults

(over 70 y/o)

With GFI:

r = 0.57

With TFI:

r = 0.61

With SPQ:

R = 0.46

NA

Wales et al.

2017

Hospitalized

older adults

NA

MDC: 7.04

NA

87

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Grip

Strength

Sayer et al.,

2006

2148 participants

from UK (59-73

y/o); falls had

significantly

lower grip

strength

NA

Pijappels et

al., 2008

17 healthy older

adults (70±4.5

y/o)

NA

Discriminative

model fallers vs

non-fallers, no

value reported

86%

80%

NA

Xue et al.,

2011

352 women (74

y/o) declined grip

strength inversely

correlated with

rate of falls

NA

Silva et al.,

2015

24 with

Parkinson’s (65.5

± 6.2 y/o) and 26

healthy subjects

(63.4 ± 7.2 y/o)

NA

Inter-rater

reliability

ICC

(2, 1)

=

0.79-0.89

6.34-

7.4mmHg

NA

Bertrand et

al., 2015

34 adults with

acute stroke (18-

80 y/o)

NA

Test-retest

reliability

ICC = 0.95-

0.99

2.73-

4.68Kg

NA

Agular et al.,

2016

12 adults with

subacute stroke

Concurrent

validity with

Berg (ρ=.91;

P<.01)

with gait

speed (ρ=.67;

P<.01)

Intra-rater

reliability

ICC

(2, 1)

=

0.64-0.99

Inter-rater

reliability

ICC

(2, 1)

=

0.66-0.99

95% CI

0.96-

6.12Kg

NA

88

Vasconcelos

et al., 2016

1374 community-

dwelling frail

older adults in

Brazil

NA

Predict mobility

limitation

Men= 25.8Kg

Women=17.4Kg

Men

69%

Women

60%

Men

73%

Women

66%

NA

Jenkins et

al., 2017

257 older adults

with sarcopenia

(98 men, 159

women)

NA

Test-retest

reliability

ICC = 0.93-

0.97

2.67-5.5

Kg

NA

Sampaio et

al., 2017

578 older adults

from community

centers of south

Brazil (70±6.7

y/o)

NA

Predict fear of

falling

Men=30Kgf;

Women= 21.7 Kg

Men

39%

Women

29%

Men

94%

Women

73%

Men

0.81

Women

0.67

Men

0.71

Women

0.36

Ikegami et

al., 2019

415 community

older adults

(Japan)

NA

Shift of one

Standard deviation

increased fall risk

by 39%

NA

89

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Hauser

Ambulation

Index

Syndulko et

al., 1996

Patients with

chronic

progressive

Multiple

Sclerosis

NA

Test-retest:

ICC= 0.91

NA

Sharrack et

al., 1999

64 individuals

with Multiple

Sclerosis

NA

Intra-rater:

ICC= 0.93

Interrater:

ICC= 0.96

NA

Cattaneo et

al., 2006

51 patients

with Multiple

Sclerosis

With Berg

Balance Scale: r=

0.74

With Dynamic

Gait Index:

r=0.80

With TUG: r=

0.74

With ABC scale:

r=0.45

With Dizziness

Handicap

Inventory: r=0.32

With

Functional

Independence

Measure:

r=0.73

With Barthel

Index = r-0.72

With SF-36

physical

functioning:

r=0.87

NA

90

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric Property

Fall Predictability

Validity

Reliability

MDC

Cutoff Score

Sn

Sp

PPV

NPV

Hendrich II

Fall Risk

Model

Ivziku et al.

2011

Older adults

(65+ y/o) in

geriatric

unit of

hospital

NA

Inter-rater

reliability: 0.87

(CI 95%: 0.71-

1.00)

NA

Score of >

or equal to

5 = at risk

for falling

0.86

(CI

95%:

0.67-

1.04)

0.43

(CI

95%:

0.34-

0.51)

0.11

(CI

95%:

0.051-

0.17)

0.97

(CI

95%:

0.94-

1.01)

Aranda-

Gallardo et

al

2013

Acutely

hospitalized

adults

(n=13,284

included in

analysis)

NA

0.628

(CI

95%:

0.549-

0.702)

0.640

(CI

95%:

0.630-

0.651)

NA

Nassar et al.

2013

Adult patients

on the

medical,

surgical,

oncology, and

critical care

units at a

medical center

NA

55.2%

89.3%

16.5%

98.3%

Jung and

Park

2018

Acutely

hospitalized

adults (15,480

total included

in analysis)

NA

0.80

(maximum

point)

0.59

(maximum

point)

NA

91

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Home Falls and

Accidents

Screening Tool

Mackenzie et

al., 2002

40 home visits, in

urban and rural

settings, by pairs

of raters, one of

whom was an

expert rater.

NA

Inter-rater

reliability: 0.62

NA

Vu et al.,

2012

Community-

dwelling older

adults (over 65

y/o)

NA

Inter-rater: 0.82

(95% CI, 0.66-

0.91)

Test-retest: 0.77

(95% CI, 0.57-

0.88)

NA

Mackenzie et

al., 2018

567 older women

(mean 77.5 y/o)

survey

NA

9

73.9%

37.9%

30.6%

79.7%

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

High Level

Mobility

Assessment Tool

Kleffelgaard

et al. 2013

Patients with

mild TBI at Oslo

University

Hospital

NA

Inter-rater

reliability: 0.99

(95% CI = .98-

1.00)

Intra-rater

reliability: 0.95

(95% CI

= .89-.98)

+/- 3.25

points

NA

92

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

International

Physical

Activity

Questionnaire

Kurtze, et

al., 2008

108 men (aged 20–39

y/o)

Vigorous PA, hours

per week and days

were most strongly

correlated

(respectively 0.41,

0.40 and 0.36, r= p ≤

0.01) with VO2max

ICC 0.30 for

moderate

activity hours,

0.80 for sitting

hours

NA

Short version

Lee et al.,

2018

(systematic

review)

23 studies from USA,

Japan, Hong Kong,

Switzerland, Canada,

etc.

Populations include

military, chronic fatigue

syndrome,

schizophrenia,

fibromyalgia, school

students

Small effect size

when validated

against other fitness

measurements

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

L Test of

Functional

Mobility

Barry, et

al., 2005

93 people with unilateral

amputations (74%

transtibial, 26%

transfemoral; 78% male,

22% female; mean

age=55.9 y/o) from

outpatient clinic

NA

ICC .96 for

interrater

reliability

and .97 for

intra-rater

reliability

NA

N

A

NA

Rushton, et

al., 2015

33 adults with LE

amputation (mean age

60 ± 13.0 y/o)

NA

MCID

4.5 s

NA

N

A

NA

93

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

LASA

Fall Risk

Profile

Pluijm et

al., 2006

1365 community

-dwelling 65

years and older

(mean age

75.3±6.4 y/o)

NA

cutoff point of

5 (range 0–30)

cutoff point of

10

59%

31%

71%

92%

NA

Peeters, et

al., 2010

408 adults (mean

age 77.9 ±

7.1y/o) 73.3%

female

Area under

the receiver

operating

(AUC)

characteristic

curve was

0.65(95% CI:

0.58, 0.72)

NA

8

56.6%

(CI: 51.8,

61.4),

71.4%

(CI: 67.0,

75.8),

34.1%

(CI: 29.5,

38.7),

85.6%

(CI: 82.2,

89.0)

94

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Late-Life

Function

and

Disability

Instrument

Jette et al.,

2002

150

community-

dwelling

older adults,

(mean age

75.9±8.5 y/o)

NA

Test-retest

ICC (.68–.82)

NA

Haley et

al., 2002

150

community-

dwelling

older adults,

(mean age

75.9±8.5 y/o)

NA

Test-retest

ICC (.91

to .98).

NA

Sayers et

al., 2004

101 men and

women (aged

80.8 + 0.4

y/o)

Moderately associated with the

SPPB (r 5 0.65, Po.001), 400-m

W gait speed (r 5 0.69, Po.001)

NA

Beaucham

p, et al.,

2014

17,301 adults

There is extensive evidence to

support the construct validity and

sensitivity to change of the

LLFDI among various clinical

populations of community-

dwelling older adults. Further

work is needed on predictive

validity and values for clinically

important change.

NA

Pandya et

al., 2016

181 African

American

breast cancer

survivors

(59.7 ± 7.2

y/o)

Cronbach alpha 0.91

NA

95

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Missouri

Alliance for

Home Care

(MAHC-10)

Calys et al.,

2012*

Homecare

retrospective

analysis (n = 2247)

Correlated

with CT

scan:

p<0.05

NA

None

reported

≥ 4

96.9

%

13.3%

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Melbourne

Fall Risk

Assessment

Tool (MFRAT)

Barker et al.,

2009*

87 hospital and

nursing home

residents,

(81.6±10.7 y/o)

NA

Kappa k =

0.21

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Minimal Chair

Height

Standing

Ability

Reider et al.,

2015

167 community-

dwelling older

adults (83.6±1.3

y/o)

NA

34 cm Fallers vs Non-

Fallers

75%

62%

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Mobility

Interaction Fall

Chart

Lundin-Olsson

et al., 2000

78 residential care

facility residents 82

y/o (66-99) in

Sweden

NA

80%

agreement

(Kappa k =

0.6)

NA

Classified as high risk of

falling, i.e., stopped

walking at turns

(log rank test 39.1;

p<0.001; hazard ratio

12.1; 95% CI 4.6–31.8).

NA

78%

(CI

67-

87%)

88%

(CI =

79-

95%)

96

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Morse Fall

Scale

Baek et al.,

2013

Retrospective

inpatient (hospital

data)

51 (AUC = 0.77)

0.72

0.91

0.63

0.94

Nassar et al.,

2013

1815

inpatient/hospital

data

Cronbach’s

alpha r = 0.64

Inter-rater

reliability ICC =

0.9

51

0.37

0.54

0.124

0.98

McKechnie et

al., 2016

Systematic review

Reliability

established prior

to 2015

< 25 pts low fall risk

25-44 points; moderate

fall risk;

> 45 high fall risk

78%

83%

10%

99%

Sardo et al.,

2016

8356 hospital

patients

45 correlated with

diagnosis and length of

say

Bórikova et

al., 2018

Long term care

residents

44 correlated with fall

history

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Motor

Fitness

Scale

Kinugasa et

al., 1998

Community

dwellers n=62

NA

0.92

NA

Aoyama et al.,

2015

Community

dwellers n=99

NA

No associate with

fallers or non-

fallers

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Multiple

Lunge Test

Wagenaar et

al., 2012

n=130 community

dwellers

NA

0.79-0.88

NA

73

%

63

%

NA

97

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Multiple

Sclerosis

Walking Scale-

12

Nilsagard et

al., 2009

Community-

dwellers with

Multiple Sclerosis

n=82

NA

≥ 75 pts

52

82

83

50

Motl et al.,

2010

Community-

dwellers with

Multiple Sclerosis

Comfortable

walking speed

0.64;

Fast walking

speed 0.62

NA

Cavanagh et

al., 2011

Community-

dwellers with

Multiple Sclerosis

n=21

BBS -0.78

NA

Motl et al.,

2011

Community-

dwellers with

Multiple Sclerosis;

N = 260

NA

6 month

0.86; 12

month 0.87

NA

Learmonth et

al., 2014

Community-

dwellers with

Multiple Sclerosis

n=82

NA

22 points for

functional

mobility

NA

Motl et al.,

2014

Community-

dwellers with

Multiple Sclerosis

n=82

NA

4-6 points

with changes

in walking

ability

NA

Goldman et al.,

2017

159 people with

Multiple Sclerosis

Benchmark scores

reflect to levels of

function

NA

98

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Norwegian

General Motor

Function

(NGMF)

assessment

scale

Linghammer et al.,

2016

Community-dwelling

older adults

Falls were not

correlated to

NGMF

NA

dependence

2.8 points,

pain 4.9

points and

insecurity 6.1

points→ but

none for falls

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Peninsula

Health Fall

Risk

Assessment

Tool (PHRAT)

Stapleton et al., 2009

Multi-campus

setting of an Aged Care

and Rehabilitation

Peninsula includes

inpatient rehabilitation,

hospital, nursing home,

and psychogeriatric

beds (mean age 78.8

y/o)

NA

high

reliability

(ICC =

0.79)

NA

99

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Physical Activity

Questionnaire

(CHAMPS

Physical Activity

Questionnaire)

Stewart et al.,

2001

Underactive

community-

dwelling older

adults, (65-90 y/o)

n = 249

Construct validity

with 6 Min Walk

Test, Self-Reported

Physical

Functioning, 0.22-

0.30, P < .001

Test-retest

reliability 6 month

N = 91:

Caloric expenditure

ICCs 0.67 - 0.66;

Frequency

measures ICCs

0.58 -0.62

NA

Harada et al.,

2001

Older community-

dwelling and

retirement home

adults, (64+ y/o)

n = 87

Construct validity

with Physical

Activity Survey for

the Elderly (PASE)

&Yale Physical

Activity Survey

(YPAS) 0.58- 0.68,

P < 0.0001

Test-retest

reliability 2 weeks:

All physical

measures ICCs =

0.59-0.69

Moderate-intensity

measures ICCs =

0.72-0.79

NA

Hekler et al.,

2012

Older community-

dwelling adults

(65+ y/o)

n = 870

Concurrent validity

with accelerometer,

n = 850; Spearman

rank-order p = 0.06

-0.40, P < .001

Test-retest

reliability, N = 748

ICCs = 0.56-.70

NA

100

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Physical

Mobility

Scale

Nitz et al.,

2006

Adults,

residential care

(35-90 y/o)

n = 9

Physical

Therapists n =

19

Concurrent validity

Rivermead Mobility

Index (RMI) &

Clinical Outcomes

Variable Scale

(COVS)

ICC .69-.90, P <

0.001

Inter-rater

reliability ICC

0.68-0.88

NA

Barker et

al., 2008

Older adults,

residential care

facilities

Cohort 1 –

(85.22±5.1

y/o); Cohort 2

(dementia

>50%)

(81.59±10.69

y/o) n = 189

Internal construct

validity

Rasch analysis:

residual mean value

both cohorts = 0,

SD=1.21 & 1.52

respectively, P>.05

Inter-rater

reliability (28

participants)

k ≥.60 all

items except;

sitting, stand to

sit, mobility

with k

= .46-.59

CI 95%

4.39 pts,

90%

confidence

NA

Pike et al.,

2010

Older adults,

long term care

(81.4 ± 6.3 y/o)

n = 70

NA

Intra-rater

reliability ICC

= 0.982

MDC 3.98

pts, 95%

confidence

MCID 5 pts

(n = 60)

NA

Barker et

al., 2012

Older adults,

long term care

n = 87

NA

High fall risk:

PMS score 28-

36; Hazard

Ration 1.98,

95%, CI 1.30-

3.03

Low fall

risk: PMS

score 0-9;

hazard Ratio =

0.05 95% CI

0.01- 0.32

NA

101

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Physical

Performance

Test (PPT)

7 & 9 item

tests

Reuben et

al., 1990

Community

and

retirement

home

dwelling

older adults;

one cohort of

Parkinson’s

Disease;

(mean age

79, range 46-

94 y/o)

N = 183; 106

9-item, 179

7-item test

Concurrent validity 9

& 7-item tests:

Roscow Breslau r =

0.80 & 0.69

Tinetti Gait score r =

0 .78 & 0.69

KATZ Activities of

Daily Living r = 0.65

& 0.50

Reliability 9

& 7-item

tests:

Cronbach’s

alpha = 0.99

& 0.93

Inter-rater

reliability: p =

0.99 & 0.93

NA

Brown et

al., 2000

Community-

dwelling

older adults,

(83 ± 4 y/o)

N = 107

Concurrent validity

9-item test:

Balance – obstacle

course, Berg Test,

Full Tandem,

Functional Reach r =

-.793, .710, .600, .51

1 with P =

<.005, .005, .001, .00

5 respectively

Gait –

Preferred gait speed,

Fast gait speed,

cadence, stride

length, % gait cycle

spent in stance,

double stance time r

= .528, .518, .427, .4

43, .487, .375 with

P =

< .05, .05, .005, .05, .

05, .001 respectively

NA

Frailty Cutoff Scores:

Not frail 32-36

Mild frailty 25-31

Moderate frailty 17-24

NA

102

Lusardi et

al., 2003

Community-

dwelling

older adults

(82.7 ± 7.9

y/o)

n = 76

NA

Cutoff Frailty Scores:

9-item test –

32-36 not frail

25-32 mild frailty

17-24 moderate frailty

< 17 unlikely to function in

community

7-item test –

< 19.4 moderate frailty

19.4-24.8 mild frailty

NA

Delbaere

et al.,

2006

Community-

dwelling

older adults,

(60+ y/o)

n= 257

NA

OR

4.16,

95%

CI

2.22-

7.79, P

<0.001

NA

Paschal et

al., 2006

Community-

dwelling

older adults

with

Parkinson’s

disease,

(62.4 ±6.3

y/o)

n = 14

Test-retest reliability

ICC 7-item test

0.818; 9-item test

o.895, 95% CI

NA

2.5 pts

NA

Farrell et

al., 2011

Community-

dwelling

older adults

with mild to

moderate

dementia,

(76/6±9.5

y/o)

n= 34

7-Item Test:

Intra-tester ICC .99,

95% CI

Test-retest reliability

ICC .90, 95%CI

NA

Cutoff score with best

sensitivity & specificity 19

pts

83%

41%

1.41,

95%

CI

.41

95%

CI

103

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Physiological

Profile

Assessment

(PPA)

Lord et

al., 2003

Community

and

institutional

older adults

(59-99 y/o)

Individual item

validation

performed from

1989-1996

Individual item

reliability performed

from 1989-1996

NA

75%

accuracy in

determining

elders at fall

risk

NA

Lorbach et

al., 2007

Community-

dwelling

older adults

with mild to

moderate

Alzheimer’s

Disease (63-

91 y/o)

n = 21

Long version

PPA

NA

Test-retest reliability

for visual acuity,

contrast sensitivity,

knee extension

strength, stability and

max balance

range ICC = 0.78-

0.90

ICCs for tactile

sensitivity, ankle

dorsiflexion strength,

hand reaction time,

sway/foam/EC,

overall fall risk score

0.43-0.75

ICCs for

proprioception, foot

reaction time,

sway/floor EO & EC,

sway/foam/EO 0.18-

0.39

NA

Liston et

al., 2012

Older adult

fallers

referred to

fall risk

clinics (60-

90+ y/o)

n = 865

Short version

PAA

Sig difference

between all age

groups for

contrast

sensitivity, knee

extensor

strength,

Sway/foam, fall

risk score

P<0.01

NA

Sway Test of

under 2500

mm

2

had

significantly

better contrast

sensitivity,

proprioception

, grip strength

and lower fall

risk scores

NA

104

Sampaio

et al.,

2014

Brazilian

community

dwelling

older adults

(75.2±5.17

y/o)

n = 10

Short version

PPA

NA

Intra-rater reliability

-

composite score .55

contrast

sensitivity .94

proprioception .74

strength .93

reaction time .25

sway .24

Inter-rater reliability

–

composite score .69

contrast

sensitivity .93

proprioception .92

strength .95

reaction time .54

sway .62

ICC composite PPA

& test components

p<.005

NA

Gunn et

al., 2018

Outpatient PT

clinics with

Multiple

Sclerosis n =

416

(51±12.0 y/o)

NA

Independent

prediction

of fallers

odds ratio

1.30, 95%

CI 1.17-1.46

NA

105

Outcome Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Push and Release Test

Jacobs et al.,

2006

Community-

dwellers with

Parkinson’s

Disease

NA

ICC: 0.84-

0.83

NA

Trial 1:

100%

Trial

3:91%

NA

Outcome Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Queensland Fall Risk

Assessment Tool

(QFRAT)

Barker et al.,

2009

87 long term

care residents

(81.59 ± 10.59

y/o)

NA

Test-retest

agreement

k=0.88; Inter-

rater

agreement

k=0.51

7.34

NA

61%

49%

NA

Outcome Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Rivermead Mobility

Index

Cho et al.,

2015

(modified

version)

Post-stroke

patients;

389±236 days

Correlation of

0.545 to FES

and 0.703 to

BBS

NA

106

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Romberg

Test

Olsson

Moller et

al., 2012

152 Sweden

community

older adults

(81.5±6.3

y/o)

NA

15 s

Sensitivity

=22%

Specificity

= 91%

NA

Grass et

al., 2017

n = 100

Mean Age:

71.8±7.8

y/o)

Convergent

validity:

SR EO:

correlation with

BBS (Pearson’s

Correlation

coefficient with

95% CI=0.635)

and TUG (-

0.647); correlated

with SR EC

(0.496) and 10

MWT (0.447),

p<0.01

Inter-rater reliability

Eyes open–

ICC =1.0

Eyes Closed-

ICC=0.999

Intra-rater Reliability

Eyes open-

ICC=0.786

Eyes closed test

ICC=0.701

Test retest reliability

Eyes Open-ICC

=0.589

Eyes Closed-

ICC=0.670

NA

cutoff:>/=15

s (Only 8%

of

individuals

could

perform

TRT)

Sensitivity

=94%

Specificity

=12%

NA

107

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Self-

Efficacy

Scale (SES)

Doba et al.,

2016

257 elderly

people

(82.3±3.8

y/o)

Correlation between self-efficacy and

score on clinical frailty scale

Significant relationships between

self-efficacy and non-parametric

variables like Beck depression

inventory score(p<0.001), physical

strength or stamina and cognition or

memory(p<0.001)

Cronbach’s

alpha = 0.79

NA

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Short

Physical

Performan

ce Battery

Stookey et

al., 2014

43 patients

with stroke

(61.5 +/-9.8

y/o)

Significant correlation between SPPB

and 6 MWT(0.76; P < .001) and

between SPPB and peak O2

consumption during a graded exercise

test(r = 0.52; P < .001)

NA

Bernabeu-

Mora et al.,

2015

137 patients

with COPD

Mean Age:

(66.9 y/o,

46-80)

Convergent Validity:

Positive Moderate co-relation with

Quadriceps strength

Correlation Coeff-0.49

Divergent Validity:

Positive but weak correlation with

hand grip strength

(Correlation Coeff-0.28)

NA

10

77%

70%

NA

Lauretani et

al., 2018

451 frail

older adults

(82.1 ± 6.8

y/o) in a

geriatric

outpatient

clinic

Association with POMA; association

with fallers OR 0.83; AUC = 0.676

NA

108

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Shuttle

Walk

Bloemendaal et

al., 2012

75 rehab center after

stroke patients (58.8

± 9.8 y/o);

Netherland

correlated to 6-

min walk test

Test-retest: ICC

2, 1

= 0.961 (0.936-

0.977)

SEM = 6%

NA

Houchen-

Wolloff et al.,

2015

220 outpatient

cardiac rehab patients

(65 ± 10.5 y/o); UK

NA

70.0 meters or

25%

NA

Costa et al.,

2018

45 outpatient patients

with difficult to

control asthma (47 ±

13.8 y/o); Brazil

NA

Test-retest: ICC

2, 1

= 0.98 (0.96-0.98)

NA

109

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Sickness

Impact

Profile

Physical

Dimension

(SIP)

Carter et

al., 1976

25 health

professionals –

n = 1973

108 care

providers &

1975 patients;

(18-74 y/o)

Validation of scaled

values by two different

judgement groups,

correlation r = 0.092;

p≤0.00001

Reliability &

consistency of judges of

scaled items via deviate

score was good for 284

items with 28 dropped

or revised

NA

Bergner et

al., 1976

278 adults in 4

outpatient

settings

(18 - 75 y/o)

Criterion validity

Category scores

discriminated among

subsamples ANOVA F

= 57.48, p < 0.001

Categories ambulation,

mobility and

confinement and leisure

pastimes high

correlation to sickness &

dysfunction r = .54, p,

0.001

Concurrent validity with

Activities of Daily

Living Index r = .46,

P< 0.001

Concurrent validity with

National Health

Interview Survey Data

(NHIS) r = .61, p <

0.001

NA

Bergner et

al., 1981

1976 field test

of adults

enrolled in

prepaid group

practice n =

696; family

practice

outpatient n =

199

Concurrent validity

with:

Self-assessment &

dysfunction r = 0.63 &

0.69

National Health

Interview Survey Data

(NHIS) r = .55 p < 0.001

53 subjects used for test-

retest reliability 0.92;

internal consistency

Cronbach’s alpha 0.94

NA

110

Gerety et

al., 1994

Older adults

residents in

nursing homes

(≥ 60 y/o, mean

age 78.2 y/o), n

= 231

NA

Convergent validity of

SIP-NH Physical

Dimension with: SIP

Physical Dimension r

= 0.97, p < .001

Katz Activities of Daily

Living r = .28, p≤ .0002

Physical Index r = -.35,

p≤ .0001

Geriatric Depression

Scale r = .21, p ≤ .0002

Folstein Mini-Mental

State Exam r = -.08

NA

Morishita

et al., 1995

Older adults

outpatient of

geriatric clinic,

(mean age 77.3;

range 60-94

y/o), n = 31

NA

Concurrent validity of

SIP:Physical

Functioning Dimension

(PFD) with Geriatric

Depression Scale by

Telephone r = .90, p

< .001

NA

111

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Single Leg

Stance

Adkin et al.,

2003

Parkinson’s

Disease

UPDRS posture

and gait score

explained a

significant

amount of

variation in

stance duration

for the 1 leg

stance test

(r20.50; P 0.01

NA

Jacobs et al.,

2006

Parkinson’s

Disease

NA

10 seconds

75%

74%

NA

Springer et

al., 2007

NA

Inter-rater reliability ICC-

0.994 (95% CI 0.989 to

0.996) for eyes open best

of 3 trials, ICC=0.998

(95% CI 0.996-0.999) for

eyes closed best of 3 trials,

ICC=0.951 (95% CI 0.926

to 0.969) for eyes open

mean of 3 trials, and ICC=

0.832 (95% CI 0.748 to

0.895) for eyes closed

mean of 3 trials

NA

Goldberg et

al., 2011

Adults (60-

89 y/o)

NA

MDC at

95%

confiden

ce level

was

24.1

seconds

NA

Chomiak et

al., 2015

Parkinson’s

Disease

NA

test retest reliability ICC

0.82 (95% CI: 0.64-0.91, P

<0.01) and an ICC 0.83

(95% CI: 0.66-0.92,

P<0.01) for right and left

legs respectively

NA

112

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

St. Thomas

Risk

Assessment

Tool

(STRATIFY)

Oliver et al., 1997

Elderly hospital

inpatients (aged >65

y/o):

116 cases and 116

controls in phase 1,

217 patients in

phase 2, and 331 in

phase 3.

NA

>2 points

>3points

93%

92%

88%

68%

NA

Smith et al., 2005

620 patients (over

the age of 65 y/o)

admitted to acute

care center/teaching

hospital

during a 6 month

period.

acute stroke,

baseline at rehab

at DC

NA

>/= 2 points

>/=2 points

11.3

16.3

89.5

86.4

25.0

38.2

76.6

66.5

Aranda-Gallardo

2018

647 nursing home

residence in Spain,

(411 fallers); (mean

age 81.8 y/o)

NA

1 point or

more

47.6%

85%

NA

113

Outcome

Measure

Reference

Population/

Diagnosis

Psychometric property

Fall Predictability

Validity

Reliability

MDC

Cutoff score

Sn

Sp

PPV

NPV

Stopping

Elderly

Accidents,

Deaths, &

Injuries

(STEADI)

Shumway-

Cook A et

al., 2000

Community-

dwelling older

adults

n = 15 non

fallers, (mean

age 78, range

65-85 y/o)

n = 15 ≥2 falls,

(mean age

86.2, range 76-

95 y/o)

NA

≥ 13.5 sec

(only uses

TUG

portion)

Fallers 87%

Nonfallers

87%

.77

NA

Rubenstein

LZ et al.,

2011

Community-

dwelling older

adults (≥ 65

y/o), n = 40

Concurrent validity

of the Fall Risk

Questionnaire

(FRQ) with an

independent

geriatrician clinical

fall risk

examination items:

fall past 6 month

= Kappa 0.800 p

<.0001

Fall concern =

Kappa 0.700

p<.001

Feel unsteady =

Kappa 0.500

p<0.001

Medication use =

Kappa0.832

p<.0001

Depressed = Kappa

0.694 p<.001

Assistive device =

Kappa 0.698

p<.0001

Overall FRQ

items alpha

=.795

NA

Indicated fall

risk ≥ 4

96-100% for

original &

Revision 2

66.7-

83.3% for

original &

Revision

2

NA

114

Rest of items =

Kappa 0.139 = .466

Panzer VP

et al., 2011

Community-

dwelling older

adults (64-94

y/o), n = 74

Full Clinical

Measures Set

Concurrent validity

with: Tinetti

Performance

Oriented Mobility

Assessment

(POMA) 0.5 – 1.0,

Sensory

Organization Test

(SOT).41 - .79

Mobility

Battery; 5

clinical

variables

ICC >0.6

NA

AUC .80

.74

NA

Stevens et

al., 2013

Health care

providers n =

18

6 geriatricians,

6 PCPs, 4 RNs,

2 NPs

NA

Quantitative

approach

using focus

groups to

identify

STEADI

components

NA

Lohman

MC et al.,

2017

Older US

adults (≥ 65

y/o), n = 7,392

NA

Discriminate

between

fallers AUC

= 0.641

NA

Moderate

Fall Risk

OR =

2.62,

High Fall

Risk OR

= 4.76,

Moderate

Multiple

Fall Risk