Rating scales to inform balance exercise difficulty during rehabilitation for individuals with neurological disorders.

The study included only 16 participants, so the agreement result is preliminary and could be affected by a few people's patterns. All training and clinician ratings came from a single physical therapist at a single site, so the result does not show whether different therapists would rate similarly. Participants had different balance diagnoses, but the sample was too small to analyze whether agreement differed by diagnosis. Eligibility required standing for 3 minutes, adequate ankle motion, and a cognitive screen score of at least 26, so people with more severe impairment or cognitive difficulty were not represented. The study did not measure balance outcomes, safety, or adherence, so it does not show whether using the ratings improves rehabilitation. The same ratings were used both to compare agreement and to guide progression, which may make the rating pattern less independent. The progression rules were conservative and may have kept exercises from reaching higher difficulty levels. Exercises were not matched to each participant's personal functional goals, which may affect how useful the program is in routine care.

The authors declared that financial support was received. The parent trial was supported by National Institute on Deafness and Other Communication Disorders grant R21DC12410, and author support included grants T32DC011499 and K23DC020215. No commercial sponsor is named in the supplied text.

Do not conclude that patient difficulty ratings improve balance rehabilitation. The study only compared patient and therapist ratings in 16 people and did not test balance outcomes, safety, or adherence.