Measures of balance and falls risk prediction in people with Parkinson's disease: a systematic review of psychometric properties.

The review found no responsiveness estimates for the Activities-specific Balance Confidence, Berg Balance Scale, and Falls Efficacy Scale-International, so these measures cannot yet be used confidently to track change over time. Many reliability estimates were rated poor quality, often because studies had small samples. All included studies recruited people with mild or moderate Parkinson's disease, so the findings may not apply to people with severe Parkinson's disease or later stages. The review excluded conference abstracts and non-English studies, so some published evidence may be missing. The review did not include randomized controlled trials, which can provide minimal clinically important differences. The review did not find enough psychometric evidence to recommend instrumented laboratory balance measures, the Postural Instability and Gait Difficulty subscale, or selected balance items of the Unified Parkinson's Disease Rating Scale motor exam.

The authors declared no potential conflicts of interest. Open access funding was supported by the Start-up fund for early careers at The Hong Kong Polytechnic University.

Do not read these measures as proof that a balance intervention worked. The review says responsiveness to change over time was not established for the Activities-specific Balance Confidence, Berg Balance Scale, and Falls Efficacy Scale-International, and the Timed Up and Go responsiveness was based on only an eight-week group physiotherapy comparison.