Basics – Balance Assessment



Activities specific Balance Confidence Scale (ABC) )(Powell, 1995) Activities specific Balance Confidence Scale (ABC) The ABC is an 11-point scale and ratings should consist of whole numbers (0-100) for each item.   Score Interpretation: 80% = high level of physical functioning 50-80% = moderate level of physical functioning < 50% = low level of physical functioning < 67% = older adults at risk for falling; predictive of future fall
One Legged Stance Test (OLST) The OLST measures an older adult’s balance abilities (non-institutionalized population). Stand, arms across the chest, eyes open. Lift one foot off the floor and time how long they can maintain balance. Stop the test at 30 seconds. See normative values below:
Tinetti Performance Oriented Mobility Assessment (POMA) Assesses both gait and balance activities by 9 balance tasks and 7 components of gait.   Each task is scored 0 (impaired), 1 or 2 (independent) Total Balance Score = 16; Total Gait Score = 12; Total Test Score = 28 Interpretation: 25-28 = low fall risk; 19-24 = medium fall risk; < 19 = high fall risk
Dynamic Gait Index This scale was designed to test eight facets of gait using a four-point ordinal scale, ranging from 0-3. (0 =lowest level of function; 3 =highest function; Total Score = 24)   Interpretation: < 19 = predictive of falls in the elderly > 22 = safe ambulators
Four Square Step Test (FSST) The FSST measures an older adult’s (65+) balance, incorporating quick change of directions which is predictive for risk of multiple falls Interpretation: >15 seconds considered a multiple faller
BESTest and Mini-BESTest Balance test to differentiate balance in six systems that may influence balance: biomechanical, stability limits, postural responses, anticipatory postural adjustments, sensory orientation, and dynamic balance during gait and cognitive effects.   Interpretation: <19 on Mini-BESTest predicts future falls (Parkinson’s Disease) (Myers, 1998) <16 on Mini- BESTest = history of falls (Lajoie, 2004) <82 on BESTest = history of falls (Briggs, 1989)   Reliability: (BESTest inter-rater reliability: 0.916, Mini-BESTest inter-rater reliability 0.72-0.996).

Normative Values

60-64 38 34
65-69 24 24
70-74 18 20
75-79 11 12
80-86 11 10
Age Group
BESTest 95.7 91.4 85.4 79.4
Mini-BESTest 26.3 24.7 21.0 19.6

Briggs, C.R., Gossman, M.R., Birch, R., Drews, J.E, Shaddea, S.A. (1989). Balance Performance Among Noninstitutionalized Adult Women. Physical Therapy, 69(9), 748-756.

Dite, W.,Temple, V. A. (2002) Clinical Test of Stepping and Change of Direction to Identify Multiple Falling Older Adults. Arch Phys Med Rehabil, 83.

Godi M, Franchignoni F, Caligari M, Giordano A, Turcato AM, Nardone A. Comparison of reliability, validity, and responsiveness of the mini-BESTest and Berg Balance Scale in patients with balance disorders. Phys Ther. 2013;93(2):158-167. doi:10.2522/ptj.20120171

Lajoie, Y. Gallagher, SP. (2004). Predicting falls within the elderly community: comparison of postural sway, reaction time, the Berg balance scale and ABC scale for comparing fallers and non-fallers. Arch Gerontol Geriatr, 38, 11-26.

Mak MKY, Auyeung MM. The mini-BESTest can predict parkinsonian recurrent fallers: a 6-month prospective study. J Rehabil Med. 2013;45(6):565-571. doi:10.2340/16501977-1144

Marques A, Almeida S, Carvalho J, Cruz J, Oliveira A, Jácome C. Reliability, Validity, and Ability to Identify Fall Status of the Balance Evaluation Systems Test, Mini-Balance Evaluation Systems Test, and Brief-Balance Evaluation Systems Test in Older People Living in the Community. Arch Phys Med Rehabil. 2016;97(12):2166-2173.e1. doi:10.1016/j.apmr.2016.07.011

Myers, A.M, Fletcher, P.C, Myers, A.N, Sherk, W. (1998). Discriminative and evaluative properties of the ABC Scale. J Gerontology A Biol Sci Med Sci, 53, M287-M294

Powell, LE & Myers AM. The Activities-specific Balance Confidence (ABC) Scale. J Gerontol Med Sci 1995; 50(1): M28-34

Shumway-Cook, A., Woollacott, M. (1995). Motor Control Theory and Applications, Williams and Wilkins Baltimore, 323-324

Yingyongyudha A, Saengsirisuwan V, Panichaporn W, Boonsinsukh R. The Mini-Balance Evaluation Systems Test (Mini-BESTest) Demonstrates Higher Accuracy in Identifying Older Adult Participants With History of Falls Than Do the BESTest, Berg Balance Scale, or Timed Up and Go Test. J Geriatr Phys Ther. 2016;39(2):64-70. doi:10.1519/JPT.0000000000000050