Understanding approaches to balance assessment in physical therapy practice for elderly inpatients of a rehabilitation hospital.

PURPOSE: Balance is a critical modifiable risk factor for falls in older adults. The purpose of this study was to identify the physiotherapy assessment tools used to evaluate balance in clinical practice and to determine the components of balance assessed through the use of standardized and/or other measures.
METHODS: A retrospective chart review was performed on 250 patients aged 65 and older undergoing in-patient rehabilitation with a clinical diagnosis associated with a balance impairment (stroke, musculoskeletal conditions, lower limb amputation, deconditioning, or cardiac surgery) at a rehabilitation hospital in Ontario.
RESULTS: All patients received at least one assessment that incorporated a balance component. Standardized balance measures were performed for 73% of patients; the timed up-and-go test (48%) and Berg Balance Scale (36%) were most commonly used for this assessment. Reactive movement strategies and cognitive processing were the least commonly assessed components of balance. Balance was assessed least often among people with cardiac surgery.
CONCLUSIONS: Considerable variation exists in the assessment of balance, and the data suggest that not all relevant components are equally considered. Future research should be conducted in other clinical settings and should include other health care practitioners' assessments to develop a more complete understanding of current balance assessment procedures.