Balance
(also see subset of tests under Vestibular Tool Kit)


Fall Sreening tool: STEADI is a combination of :

  1. Performance tests: TUG, Static Balance, and 30 sec Sit to Stand
  2. Fall History
  3. Questionnaire results

Developed by the CDC, based on the 2011 AGS/BGS Guidelines for Fall Prevention*

* Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society. (2011). Summary of the Updated American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons. J Am Geriatr Soc. 59(1):148-57

STEADI is also available as an app for mobile devices by Evidence in Motion


Static Balance tests

1. Battery of Static Balance Tests:
EO/EC, and Firm/Compliant surfaces

-- Single Limb Stance: normative values by decade:
Springer BA, Marin R, Cyhan T, Roberts H, Gill NW. (2007). Normative Values for the Unipedal Stance Test with Eyes Open and Closed. Journal of Geriatric Physical Therapy. Vol. 30:1, 8-15.    Mean values.

Bohannon RW. (2006). Single Limb Stance Times: A Descriptive Meta-Analysis of Data From Individuals at Least 60 Years of Age. Topics in Geriatric Rehabilitation 22(1), 70-77.

-- Tandem Stance norms (Sharpened Romberg), eyes open, eyes closed
Briggs RC, Gossman MR, Birch R, Drews JE, Shaddeau SA. (1989). Balance Performance Among Noninstitutionalized Elderly Women. Physical Therapy. 69(9) 748-756.

Romberg: EC on compliant surface (vestibular): norms
Agrawal Y, Carey JP, Hoffman HJ, Sklare DA, Schubert MC. (2011). The modified Romberg Balance Test: normative data in U.S. adults. Otol Neurotol. 32(8):1309-11.

2. CTSIB - Clinical Test of Sensory Integration on Balance, "Foam & Dome"

3. FICSIT-4

4. Functional Reach


Static + Dynamic Balance tests

5. Berg Balance Scale (BBS)

6. BESTest: Balance Evaluation Sytems Test (and 2 modified versions)

7. Fullerton Advanced Balance Scale (FAB)

8. Physical Performance Test - Modified (m-PPT)

9. Short Physical Performance Battery (SPPB)

10. Tinetti: Performance Oriented Mobility Assessment --POMA

11. O Sullivan functional balance scale (not validated)


Dynamic Balance tests (gait activities)

12. DGI: Dynamic Gait Index

13. FGA: Functional Gait Assessment

14. Four Square Step Test (FSST)


Balance Questionnaires:

15. Activities-specific Balance Confidence - ABC

16. Modified Falls Efficacy Scale (MFES)


Research reports on balance measures:

For community dwelling older adults, "important limitations, including ceiling effects and relatively low sensitivity to change and responsiveness, were noted (BBS, POMA, DGI), highlighting their limited utility across the full spectrum of the community-dwelling elderly population."

Pardasaney PK, Latham NK, Jette AM, Wagenaar RC, Ni P, Slavin MD, Bean JF. (2012). Sensitivity to change and responsiveness of four balance measures for community-dwelling older adults. Phys Ther. 92(3):388-97.


Should we offer support to get into tandem position? (Hile, 2012)


Missouri Alliance for Home Care Fall Risk Assessment Tool
Calys M, Gagnon K, Jernigan S. (2012). A Validation Study of the Missouri Alliance for Home Care Fall Risk Assessment Tool. Home Health Care Management Practice published online 6 September 2012. Retrieved Oct. 10, 2012 at http://www.homecaremissouri.org/projects/falls/documents/Oct2012FINALValidatedFallriskassessmenttool.pdf


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Creative Commons license

Prost, E. (2013). Examination Tool Kit. University of Missouri,
School of Health Professions, Department of Physical Therapy

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Updated: September 24, 2013