Balance Assessment Practices and Use of Standardized Balance Measures Among Ontario Physical Therapists

Background. Balance impairment is a significant problem for older adults, as it can influence daily functioning. Treating balance impairment in this population is a major focus of physical therapist practice. Objective. The purpose of this study was to document current practices in clinical balance assessment and compare components of balance assessed and measures used across practice areas among physical therapists. Design. This was a cross-sectional study. Methods. A survey questionnaire was mailed to 1,000 practicing physical therapists in Ontario, Canada. Results. Three hundred sixty-nine individuals completed the survey questionnaire. More than 80% of respondents reported that they regularly (more than 60% of the time) assessed postural alignment, static and dynamic stability, functional balance, and underlying motor systems. Underlying sensory systems, cognitive contributions to balance, and reactive control were regularly assessed by 59.6%, 55.0%, and 41.2% of the respondents, respectively. The standardized measures regularly used by the most respondents were the single-leg stance test (79.1%), the Berg Balance Scale (45.0%), and the Timed Up & Go Test (27.6%). There was considerable variation in the components of balance assessed and measures used by respondents treating individuals in the orthopedic, neurologic, geriatric, and general rehabilitation populations. Limitations. The survey provides quantitative data about what is done to assess balance, but does not explain the factors influencing current practice. Conclusions. Many important components of balance and standardized measures are regularly used by physical therapists to assess balance. Further research, however, is needed to understand the factors contributing to the relatively lower rates of assessing reactive control, the component of balance most directly responsible for avoiding a fall.