title: Using the systems framework for postural control to analyze the components of balance evaluated in standardized balance measures: a scoping review.
abstract: OBJECTIVE
  To identify components of postural control included in standardized balance measures for adult populations.
  
  
  METHODS
  Electronic searches of MEDLINE, EMBASE, and CINAHL databases using keyword combinations of postural balance/equilibrium, psychometrics/reproducibility of results/predictive value of tests/validation studies, instrument construction/instrument validation, geriatric assessment/disability evaluation, gray literature, and hand searches.
  
  
  METHODS
  Inclusion criteria were measures with a stated objective to assess balance, adult populations (18y and older), at least 1 psychometric evaluation, 1 standing task, a standardized protocol and evaluation criteria, and published in English. Two reviewers independently identified studies for inclusion. Sixty-six measures were included.
  
  
  METHODS
  A research assistant extracted descriptive characteristics and 2 reviewers independently coded components of balance in each measure using the Systems Framework for Postural Control, a widely recognized model of balance.
  
  
  RESULTS
  Components of balance evaluated in these measures were underlying motor systems (100% of measures), anticipatory postural control (71%), dynamic stability (67%), static stability (64%), sensory integration (48%), functional stability limits (27%), reactive postural control (23%), cognitive influences (17%), and verticality (8%). Thirty-four measures evaluated 3 or fewer components of balance, and 1 measure-the Balance Evaluation Systems Test-evaluated all components of balance.
  
  
  CONCLUSIONS
  Several standardized balance measures provide only partial information on postural control and omit important components of balance related to avoiding falls. As such, the choice of measure(s) may limit the overall interpretation of an individual's balance ability. Continued work is necessary to increase the implementation of comprehensive balance assessment in research and practice.
authors: Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada; Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
authors: Kathryn M
authors: KM
authors: Sibley
authors: Department of Physical Medicine and Rehabilitation, Spaulding Outpatient Center, Harvard Medical School, Boston, MA.
authors: Marla K
authors: MK
authors: Beauchamp
authors: Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
authors: Karen
authors: K
authors: Van Ooteghem
authors: Li-Ka-Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors: Sharon E
authors: SE
authors: Straus
authors: Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada; Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada. Electronic address: susan.jaglal@utoronto.ca.
authors: Susan B
authors: SB
authors: Jaglal
mesh_terms: D001696:Biomechanical Phenomena; D004185:Disability Evaluation; D006801:Humans; D026741:Physical Therapy Modalities; D004856:Postural Balance / Q000502:physiology*; D011594:Psychometrics; D015203:Reproducibility of Results
keywords: Accidental falls; Aging; Chronic disease; Postural balance; Psychometrics; Rehabilitation