Premium
M easurement instruments to assess posture, gait, and balance in P arkinson's disease: Critique and recommendations
Author(s) -
Bloem Bastiaan R.,
Marinus Johan,
Almeida Quincy,
Dibble Lee,
Nieuwboer Alice,
Post Bart,
Ruzicka Evzen,
Goetz Christopher,
Stebbins Glenn,
MartinezMartin Pablo,
Schrag Anette
Publication year - 2016
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.26572
Subject(s) - tinetti test , gait , balance (ability) , berg balance scale , physical medicine and rehabilitation , rating scale , fear of falling , physical therapy , parkinson's disease , gait analysis , dynamic balance , psychology , medicine , poison control , disease , injury prevention , developmental psychology , physics , environmental health , pathology , quantum mechanics
ABSTRACT Background Disorders of posture, gait, and balance in Parkinson's disease (PD) are common and debilitating. This MDS‐commissioned task force assessed clinimetric properties of existing rating scales, questionnaires, and timed tests that assess these features in PD. Methods A literature review was conducted. Identified instruments were evaluated systematically and classified as “recommended,” “suggested,” or “listed.” Inclusion of rating scales was restricted to those that could be used readily in clinical research and practice. Results One rating scale was classified as “recommended” (UPDRS‐derived Postural Instability and Gait Difficulty score) and 2 as “suggested” (Tinetti Balance Scale, Rating Scale for Gait Evaluation). Three scales requiring equipment (Berg Balance Scale, Mini‐BESTest, Dynamic Gait Index) also fulfilled criteria for “recommended” and 2 for “suggested” (FOG score, Gait and Balance Scale). Four questionnaires were “recommended” (Freezing of Gait Questionnaire, Activities‐specific Balance Confidence Scale, Falls Efficacy Scale, Survey of Activities, and Fear of Falling in the Elderly–Modified). Four tests were classified as “recommended” (6‐minute and 10‐m walk tests, Timed Up‐and‐Go, Functional Reach). Conclusion We identified several questionnaires that adequately assess freezing of gait and balance confidence in PD and a number of useful clinical tests. However, most clinical rating scales for gait, balance, and posture perform suboptimally or have been evaluated insufficiently. No instrument comprehensively and separately evaluates all relevant PD‐specific gait characteristics with good clinimetric properties, and none provides separate balance and gait scores with adequate content validity for PD. We therefore recommend the development of such a PD‐specific, easily administered, comprehensive gait and balance scale that separately assesses all relevant constructs. © 2016 International Parkinson and Movement Disorder Society