Difficulties encountered in testing, scoring, and interpreting balance performance in older adults using clinical evaluation tools: a cross-sectional study

Abstract

Abstract Background: Balance impairment is one of the primary intrinsic risk factors contributing to falls in older adults. Prior research has consolidated the prevalent clinical tools for detecting balance issues in this demographic. Nevertheless, only a few studies have recognized the constraints associated with current balance assessment methods. Materials and Methods: The current research was initiated due to a shortage of comprehensive knowledge concerning the hurdles clinicians faced when interpreting balance test results and the obstacles older adults encountered while undertaking these assessments. The methodology involved assessing the static and dynamic balance capabilities of 661 older individuals through tests including the four stage balance test (FSBT), star excursion balance test (SEBT), Four Square step test (FSST), timed up and go (TUG) test, and Tinetti performance-oriented mobility assessment (TPOMA). Results: All older adults were able to complete the TUG and TPOMA tests. . Fifteen percent encountered difficulty completing the entire FSBT; however, they managed to execute the initial two stages of this test. Additionally, 5% of older adults who utilized walking aids could not complete the FSST. Thirty four percent of young-old individuals and 56.3% of old-old individuals were unable to execute the SEBT in posterior directions. Moreover, 1% of 60-64-year-old and 2% of >/75-year-old individuals were unable to perform SET in all 8 directions. Conclusion: TPOMA and TUG emerged as the most suitable clinical assessment tool for older adults. Within the FSBT, maintaining tandem and one-leg stance positions posed challenges, whereas the SEBT proved to be the most demanding dynamic balance test for older adults. These current findings will aid clinicians in selecting the most suitable balance assessment tool for routine clinical evaluations of older adults.