Outcome Measure Toolkit

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Outcome Measure Toolkit for Geriatric Fall/Balance Assessment Table of Contents Introduction ------2 Background of the Outcome Measure Toolkit Project ------3 Taskforce Members ------5 Outcome Measure Toolkit Project Searching Key Words and Database ------6 Outcome Measure Toolkit Project Search/Review Flow Chart ------8 Master List of Outcome Measures Assessing Balance/Fall Risk Being Reviewed ------9 Outcome Measures with Evidence of Psychometric Properties and Fall Risk Predictability ------12 Outcome Measures Not Supported in Relation to Balance/Fall Assessment in the Older Adult Population and Rationales ----- 13 Outcome Measures Related to Balance/Fall Risk Assessment but Warranting Additional Research for Further Validation ---- 15 Outcome Measures Widely Used, but With Limited Recent Evidence Related to Fall Risks ------18 Outcome Measures Divided by Setting ------20 Summary Tables of Each Individual Outcome Measure (in alphabetic order) ------26 Discussion ------121 Appendix a. Compiled List of Outcome Measures Found During Phase 1 Search ------122 b. Outcome Measure Toolkit Project Article Review Instructions ------126 c. Outcome Measure Summary Table Template ------127

Introduction November 2019 Dear fellow therapists:

Welcome to the Outcome Measure Toolkit. I am excited to present this document to you. The Outcome Measure Toolkit project is a product of the Balance & Falls Special Interest Group (BFSIG) of APTA Geriatrics, an Academy of the American Physical Therapy Association (APTA).

Falls are the most common cause of injuries and hospital admissions in older adults, and balance is a potentially modifiable factor known to contribute to falls—choosing proper tests and measures is a critical component of balance and fall risk assessment. Evidence-based interventions can then be implemented to improve participation, activity limitations, and impairments of body structure and function for people with balance deficits and risks of falling. In recent decades, an enormous amount of outcome measures have been developed to evaluate balance and to predict fall risk. As fall risks and balance assessments are multidimensional and multifaceted, selecting the optimal outcome measure is challenging.

The BFSIG decided to take on the challenge to create the Outcome Measures Toolkit, providing our members with an updated summary of current outcome measures related to balance and fall risk assessment. As the BFSIG Research Liaison, I am humbled and honored to lead the project.

The Outcome Measure Toolkit took over two years to ready itself; fourteen taskforce members volunteered their time, effort, and knowledge to make this project possible. We started using keywords to search related outcome measures. The original compiled list had over 245 outcome measures! After multiple conferences, discussions, and endless hours of hard working, we now present you with the final list of 107 outcome measures. We hope you find this Toolkit helpful, clinically and academically. For this Toolkit to remain current, the list needs to be updated every three to five years. We hope to see more volunteers devote themselves to updating this project in the future. Your participation and contribution help the BFSIG grow and expand!

Sincerely, Elizabeth Wang-Hsu, PT, PhD Elizabeth Wang-Hsu, PT, PhD Chair, the Outcome Measure Toolkit Project Research Liaison, Balance and Fall Special Interest Group University of Pennsylvania Health System 2

Background of the Outcome Measure Toolkit Project

• Purposes: 1. Create an updated summary in the form of an Outcome Measure Toolkit for balance and fall assessment, including the psychometric properties, fall predictability, population validated, and references of each outcome measure in a simple, easy to understand table format. 2. Provide all APTA Geriatrics members a toolkit to easily access current and existing BF outcome measures, with their psychometric properties and fall predictability in the geriatric population at various settings or with different diagnosis.

• Process and Phases of the Project: The project was initiated immediately after CSM 2017. Originally, 8 members from BFSIG volunteered to form the taskforce for this project. A few members withdrew from the project due to various personal reasons, but new members joined the project. The taskforce members in various stages are acknowledged in the following page.

The project was conducted in five phases: . Phase 1 was finding combinations of key words used to thoroughly search for any existing outcome measures that are appropriate for balance and fall assessment. From this search, 260 outcome measures were identified. The results were then streamlined to make a consensus master list of 107 outcome measures. . Phase 2 was the literature review process. The master list of outcome measures was assigned to taskforce members to review. Each member in each timeline was assigned 3 to 5 outcome measures. Phone conferences were held between each timeline to discuss issues and concerns from taskforce members. . Phase 3 was cross-validation and recommendations. . Phase 4 was updating of literature from 2018-2019. . Phase 5 was formatting of the BFSIG Outcome Measure Toolkit and dissemination.

• The Outcome Measure Toolkit is a toolkit based on consensus opinion of experts from the BFSIG. It is a resource/toolkit for members but should not be confused or mistaken for peer-reviewed evidence-based document. The BFSIG Outcome Measure Toolkit seeks to offer a quick summary with generalizability, as well as various practice settings, in addition to community-dwelling. Furthermore, the emphasis of this project was placed on current literature in the past 5 or so years. This allows us to make recommendations on outcome measures which may no longer be valid with the changing features of the human population including the prevalence rate of medical comorbidities, life expectancy, and medical advances.

Taskforce Members The APTA Geriatrics Balance & Fall Special Interest Group would like to recognize and extend its gratitude to the taskforce members, who volunteered their time, effort, and knowledge to this project.

Elizabeth Wang-Hsu, PT, PhD (Chair) Research Liaison for APTA Geriatrics Balance and Falls SIG 2016-2019

Heidi Moyer*†, PT, DPT (Co-Chair for the initial phases) Secretary, APTA Geriatrics Balance and Falls SIG Eastern Regional Coordinator, APTA Geriatrics State Advocate Program

Carmen Casanova Abbott, PT, PhD (Co-Chair for the final phases)

Core Taskforce Members Anne Reilley*, PT, DPT, MS Susan Glenney*†, PT, DPT Mariana Wingood*†, PT, DPT

Adjunct Taskforce Members Ryan Allison, PT, DPT Harsha Dhingra†, PT, MS Emma Phillips, PT, DPT Haim Nesser†, PT, DPT Paula Graul*†, PT, MS Shweta Subramani†, PT, MHS Ashley Bell, PTA Jennifer Vincenzo*, PT, MPH, PhD (Chair, BFSIG) * Board Certified Clinical Specialist in Geriatric Physical Therapy (GCS) † Certified Exercise Expert for Aging Adults (CEEAA) 5

Outcome Measure Toolkit Project Searching Key Words and Database Combination of Words: Falls, Fall Risk, Balance, Functional Mobility, Strength, Older Adults, Aged, Geriatric, Elderly, Frail, Community-Dwelling, Independent Living, Nursing Home, Institutionalized, Skilled Nursing Facility, Residential Care, Long Term Care, Outcome Measure, Assessment.

Database Searched: PubMed, CINAHL, Google Scholar, PsychInfo

Falls

Word Definition

Falls Any event that leads to an unplanned, unexpected contact with a supporting surface. This does NOT include falls that are the result of an outside force such as a push or shove or falls that are the result of a medical event such as a MI, syncope or fainting.

Population Examined

Word Definition

Older Adults According to Medicare, a person over the age of 65 years.

Elderly Older adults or aged individuals.

Aged A person 65 through 79 years of age. For a person older than 79 years, AGED, 80 and over is available

Aged, 80 and over A person 80 years of age and older.

Frail elderly (Elderly, Frail) Older adults or aged individuals who are lacking in general strength and are unusually susceptible to disease or to other infirmity.

Frail Older Adults A person 65 or older who are lacking in general strength and are unusually susceptible to disease or to other infirmity.

Community-Dwelling Adults According to SoG CPG Committee: a person over age of 65 residing in the community or assisted living without distinction about health/frailty status.

Independent Living A housing and community arrangement that maximizes independence and self-determination. Item Examined

Word Definition

Outcome Assessment Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).

Outcome Measure Evaluations of the efficacy/effectiveness of an intervention on the premise of gauges taken prior to, during, and following the intervention.

Outcome Measure Toolkit Project Search/Review Flow Chart

December 2016 Presentation of the Purpose/Mission of Outcome Measure Project to BFSIG executives; Recruit Taskforce Members via BFSIG emails

First Conference Call; February 2017 Discuss Search Strategies, Keywords, Database, etc.

March 2017 Initial Delegation; Key Words Search Balance/Fall-Related Outcome Measure

Compile List From All Members : 245 Outcome Measures Identified April 2017 (By Heidi Moyer & Elizabeth Wang-Hsu) Excluded Not Related to Balance, Falls, Functional Mobility, or Stength (i.e., MiniCog, MMSE)

May 2017 Master List of Outcome Measures: 107 Outcome Measures (By Taskforce Consensus)

Outcome measures critically reviewed Outcome measure tables developed June 2017 First recommendations made (By Taskforce Members)

Cross validation of outcome measures December 2018 Outcome measure recommendation finalized

May 2019 Update outcome measures literature review

Format BFSIG Outcome Measure Toolkit (By Carmen Abbott & Elizabeth Wang-Hsu) October 2019 BFSIF Executives Internal Review AGPT review of Outcome Measure Toolkit

Dissemination

Master List of Outcome Measures Assessing Balance/Fall Risk Being Reviewed

1. 2 Minute Walk Test & other similar timed 21. Canadian Occupational Performance walks such e.g., 6 Minute Walk Measure 2. 21 Item Fall Risk Index 22. Clinical Test of Sensory Interaction and 3. 25 Question Geriatric Locomotive Function Balance (CTSIB) Scale 23. Community Balance and Mobility Scale 4. 30 Second Chair Stand Test 24. Scale of Balance Confidence (CONFbal) 5. 360 Degree Turn Time 25. Conley Scale 6. 4 Step Square Test 26. Demura's Fall Risk Assessment Chart 7. 4 Stage Test, or Frailty and Injuries: (DFRA) Cooperative Studies of Intervention 27. Downton Fall Risk Index Techniques (FICSIT-4) 28. Dynamic Gait Index 8. 5 Times Sit to Stand &10 Times Sit to Stand 29. Elderly Fall Screening Test 9. Activities Specific Balance Confidence Scale 30. Elderly Mobility Scale (ABC) 31. Euroqual 10. Activities Specific Fall Caution Scale 32. Fall Handicap Inventory 11. Activity-Based Balance and Gait 33. Fall Perception Questionnaire 12. Alternate Step Test 34. Fall Prevention Strategy Survey 13. Attitudes to Falls-Related Interventions 35. Fall Risk for Older People in the Community Scales Assessment 14. Balance Evaluation Systems Test (BESTest; 36. Falls Behavioral Scale BESTmini; BESTbrief) 37. Falls Efficacy Scale (FES) 15. Balance Outcome Measure for Elder 38. Fear Avoidance Beliefs Questionnaire Rehabilitation (BOOMER) (FABQ) 16. Balance Self-Efficacy Test 39. Figure 8 Walking Test 17. Balance Self-Perceptions Test 40. Floor Rise Test 18. Bed Rise Difficulty (BRD) Scale 41. Frenchay Activity Index 19. Berg Balance Scale 42. Fugl-Meyer Motor Assessment 20. Brunel Balance Assessment 43. Fullerton Advanced Balance Scale (FAB) 44. Functional Ambulation Category 9

45. Functional Fitness Test 76. Norwegian General Motor Function 46. Functional Gait Assessment Assessment 47. Functional Independence Measure (FIM) 77. Penisual Health Fall Risk Assessment Tool 48. Functional Mobility Assessment Tools (FMA) (PHRAT) 49. Functional Reach Test 78. Perceived Participation and Autonomy 50. Gait Abnormality Rating Scale 79. Peter James Centre Fall Risk Assessment 51. Gait Efficacy Scale Tool 52. Gait Speed (m/s) 80. Physical Activity Questionnaire 53. Geriatric Fear of Falling Assessment 81. Physical Mobility Scale 54. Global Deterioration Scale 82. Physical Performance Scale 55. Goal Attainment Scale 83. Physiological Profile Assessment 56. Gorningen Activity Restriction Scale 84. Push and Release Test 57. Grip Strength 85. Queensland Fall Risk Assessment Tool 58. Guralnik Test Battery (QFRAT) 59. Hauser Ambulation Index 86. Rivermead Mobility Index 60. Health-Related Quality of Life 87. Rogers Modular Obstacle Course 61. Hendrich II Fall Risk Model 88. Romberg Test (Tandem) 62. High Level Mobility Assessment Tool 89. Self-Efficacy Scale (SES) 63. Home Falls and Accidental Screening Tool 90. Short Health Form Survey (SF8, SF12, SF36) 64. International Physical Activity Questionnaire 91. Short Physical Performance Battery (SPPB) 65. L Test of Functional Mobility 92. Shuttle Walk 66. LASA Fall Risk Profile 93. Sickness Impact Profile Physical Dimension 67. Late-Life Function and Disability Instrument 94. Single Leg Stance 68. Missouri Alliance for Home Care 95. St. Thomas Risk Assessment Tool (MAHC-10) (STRATIFY) 69. Melbourne Fall Risk Assessment Tool 96. Stopping Elderly Accidents, Deaths, & (MFRAT) Injuries (STEADI) 70. Minimal Chair Height Standing Ability 97. Stroke Assessment Fall Risk 71. Mobility Interaction Fall Chart 98. Stroop Stepping Test 72. Morse Fall Scale 99. Subjective Risk Rating of Specific Tasks 73. Motor Fitness Scale 100. Survey of Activities and Fear of Falling in the 74. Multiple Lunge Test Elderly 75. Multiple Sclerosis Walking Scale-12 101. The Obstacle Course 10

102. Timed Up and Go 106. Western Ontario and McMaster 103. Timed Up and Go: Dual Task Osteoarthritis Index (WOMAC) 104. Tinetti Performance-Oriented Mobility 107. World Health Organization Quality of Life Assessment (POMA) (WHOQoL ) 105. University of Illinois at Chicago Fear of Falling Measure (UIC FFM)

Outcome Measures with Evidence of Psychometric Properties and Fall Risk Predictability

• 4 Step Square Test • Activities Specific Balance Confidence Scale • Balance Evaluation Systems Test (BESTest; BESTmini; BESTbrief) • Berg Balance Scale • Figure 8 Walking Test • 5 Times Sit to Stand (more commonly used/researched than 10 Times Sit to Stand) • Functional Gait Assessment • Functional Reach Test • Gait Speed (m/s) • Grip Strength • Hendrich II Fall Risk Model (inpatient population only) • Morse Fall Scale • The Obstacle Course • Tinetti Performance-Oriented Mobility Assessment (POMA)

Outcome Measures Not Supported in Relation to Balance/Fall Assessment in the Older Adult Population and Rationales

● Attitudes to Falls-Related Interventions Scales: From Prevention of Falls Network Europe [ProFaNE] (2006). This is a questionnaire to assess attitudes related to balance and fall interventions. The web link no longer works; therefore, no summary table presented in this document. ● Balance Self-Efficacy Test: Studies on this test only looked at activity participation, not falls. In addition, there are no studies that validate this test; therefore, no summary table presented in this document. ● Canadian Occupational Performance Measure (COPM): The COPM is used as a measure of life satisfaction and reintegration into normal living. It has no evidence in fall risk. ● Euroqual: Euroqual is a descriptive profile and index of health status measure from the early 1990s. It is not recommended for fall risk assessment due to minimal evidence and no recent literature. ● Fall Handicap Inventory: There is no further study since the original report. In addition, the report was a letter to the editor, not an article. ● Frenchay: It was validated in 1993, but there is little evidence following this validation. Therefore, no summary table is presented in this document. ● Fugl-Meyer Motor Assessment: This measure is great for assessing motor recovery post stroke, but it is not correlated with falls or balance. It is used mainly in studies to classify subjects and can be used to assess intervention efficacy with other balance measures. There is no evidence on psychometric properties; therefore, no summary table presented in this document. ● Functional Fitness Test – Senior Fitness Test: The test was developed in 1999 to measure the key components to fitness. Age group and gender norms for fitness have been established and updated in 2013 along with some criterion norms for loss of independence and mobility decline. This test battery as a whole has not been researched for fall risk screening or assessment; therefore, no summary table presented in this document. ● Functional Mobility Assessment Tool (FMA): Functional mobility assessment (FMA) instrument is a self-report outcome tool designed to measure the effectiveness of wheeled mobility and seating, not a fall assessment; therefore, no summary table presented in this document. ● Gait Abnormality Rating Scale: There is minimal research supporting the Gait Abnormality Rating Scale, however, there is a modified version currently in the process of validation. ● Gait Efficacy Scale: There is minimal research supporting the Gait Efficacy Scale, however, there is a modified version currently in the process of validation. ● Global Deterioration Scale: This scale is not a fall assessment, but a dementia/cognitive assessment tool. 13

● Goal Attainment Scale: This is scale is for patient-centered goals attainment. The population and psychometric property varied depending on the population and goals selected. In addition, it used a T-score; therefore, no summary table presented in this document. ● Guralnik Test Battery: We were unable to find evidence to validate this performance-based test battery; therefore, no summary table presented in this document. ● Health-Related Quality of Life: This is a quality of life assessment, not a balance and fall assessment; therefore, no summary table presented in this document. ● International Physical Activity Questionnaire: This questionnaire with limited studies and varied validity is not a fall assessment measure. It is used as an indication of activity level and has no established link to balance performance and fall risk. See systematic review by Lee et al 2018 for more information ● L Test of Functional Mobility: This test is a modified version of the Timed Up and Go Test designed for people with lower limb amputations. It is not a general fall assessment measure. ● Late Life Function and Disability Instrument: This instrument is not a fall assessment measure. ● Motor Fitness Scale: There is little evidence to support use of this scale in balance and falls management in the older adult population. ● Norwegian General Motor Function Assessment: This assessment has very limited study. It is recommended to look at the General Motor Function Assessment instead. ● Perceived Participation and Autonomy: There are many studies on vertigo and how it affects falls, but none on how this assessment tool is used for identifying fall risk; therefore, no summary table presented in this document. ● Peter James Centre Fall Risk Assessment Tool: No studies found on this tool; therefore, no summary table presented in this document. ● Physical Activity Questionnaire (CHAMPS): CHAMPS is a valid and reliable measure, however, no link to fall risk prediction. ● Physical Mobility Scale: This is a scale of disability or functional mobility in residential older adults that is used to determine physical assistance in care facilities. It is not applicable to balance or fall risk assessment. ● Physical Performance Scale: This scale is a test of physical function that has been updated in Multiple Sclerosis literature. There is low evidence for use of it in fall prediction. In the past 10 years, it has been used primarily for stroke and dementia diagnoses. In addition, there are no psychometrics for this scale. ● Rivermead Mobility Index: This index is a mobility test with limited supporting literature found ● Roger Modular Obstacle Course: There were no articles found; therefore, no summary table presented in this document.

● Self-Efficacy Scale (SES): This scale measures self-efficacy in strength, stamina, and memory. It is not related to balance and falls. ● Short Health Form Survey (SF8, SF12, SF36): This survey is not a balance and fall risk assessment; therefore, no summary table presented in this document

Outcome Measures Related to Balance/Fall Risk Assessment but Warranting Additional Research for Further Validation

● 21 Item Fall Risk Index: No further evidence reported aside from the original article. ● 25 Question Geriatric Locomotive Function Scale: This scale is not widely used and has limited evidence to support it. ● Activity-Based Balance and Gait: No further evidence reported aside from the original article. ● Activity Specific Fall Caution Scale: No further evidence reported aside from the original article. ● Alternate Step Test (Step Test): It is a component of Berg Balance Scale that is not widely studied. ● Balance Outcome Measure for Elder Rehabilitation (BOOMER): There are two articles supporting the measure from 2007 and 2011, but more is warranted. ● Balance Self Perception Test: There was only one study found to support this measure. ● Bed Rise Difficulty Scale: This scale assesses mobility with limited studies related to fall assessment. ● Brunel Balance Assessment: There were limited studies with insufficient information to support this assessment. ● Clinical Test of Sensory Integration & Balance (CTSIB): Most of research supporting the CTSIB were in other populations. It has moderate construct validity. This measure warrants studies in older adult balance/fall assessment. ● Community Balance & Mobility Scale (CB&M): Strength, balance, and quality of life measure for young elders and young adults. There is no evidence that it can predict fall risk. ● CONFbal Scale of Balance Confidence: It is a balance confidence scale with limited evidence related to fall predictability. ● Conley Scale: There is limited evidence to support this measure. ● Demura’s Fall Risk Assessment Chart (DFRA): This chart is a 50 item list used in Japan in a large population study. Further research is needed to decrease the number of items on the list if it will be used in other countries and general practice. ● Downton Fall Risk Index: There are few studies to support this measure. The index uses an inpatient population and has low specificity. ● Elderly Mobility Scale (EMS): EMS was developed for use with frail elderly adults for mobility status. It is not validated for fall risks. ● Elderly Fall Screening Test: This measure is not well studied, however, early work shows fall risk predictability. ● Falls Behavioral Scale: Limited research supporting this scale with no cutoff score or stratification for fall risk. There were two articles found about the scale, however, access was only available to the initial article (2003). We were unable to access the other 2008 article published in the Journal of Disability and Rehabilitation. Review table completed with the initial research article information on validity and reliability. 16

● Fall Perception Questionnaire: This measure looks at adult perception about fall risk. It is not a fall risk predictor; therefore, further studies needed to link to fall risk predictability. ● Fall Prevention Strategy Survey: This measured is studied on the Multiple Sclerosis population, however, only the original article was found. It needs further study. No research on this outcome measure since 2009 which included a Rasch Validation Analysis. This outcome measure was identified as a valid tool to examine the frequency of engaging in protective behaviors related to fall risk among adults with Multiple Sclerosis and to track outcomes of behaviorally oriented fall reduction interventions, but has not been identified as a tool for assessment of fall risk. ● Fall Risk for Older People in the Community Assessment: This measure has a moderate capacity to predict falls, but needs further studies. ● Floor Rise Test: There is limited research supporting its use. ● Fullerton Advanced Balance Scale (FAB): One study in 2008 presented a cutoff. There is a Sn, Sp, and PPV for fall predictability. This scale warrants more research. ● Functional Ambulation Category: Sn and Sp are established. It is used in post stroke population and can be used to predict community ambulation post stroke. This scale warrants more studies in other populations. ● Geriatric Fear of Falling Measure: There is significant validity with FES. It has good reliability but is not studied very well in populations outside of Northern Taiwan. It is touted as a screening tool for nursing. ● Gorningen Activity Restriction Scale: It is a mobility restriction assessment scale. More studies are needed to evaluate the relationship to balance and fall risk. ● Hauser Ambulation Index: It has been validated against multiple other outcome measures for the Multiple Sclerosis population, however, more studies are needed for other populations and for fall risk prediction. ● High Level Mobility Assessment Tool: There is one article for validity, reliability, and MDC in inpatient traumatic brain injury population, however, there are no studies for other populations or to predict fall risk. ● Home Falls and Accidental Screening Tool: This is a reliable and valid home fall assessment survey/questionnaire. This is one study with a large sample size with high sensitivity and low specificity that presented cutoff score as 9. It has also been validated in foreign languages including Malaysia and Chinese. However, no report found in US population. ● Push and Release Test: There was one study in 2006. No other evidence to support the test. ● LASA Fall Risk Profile: There are limited studies, but nothing since 2010. ● Melbourne Fall Risk Assessment Tool (MFRAT): This is a novel assessment tool targeting residential population (nursing home and long-term care facilities), but no other validation except the original article. More research warranted in this population. ● Minimal Chair Height Standing Ability: This is a novel assessment tool from 2015. The original article validated it with a large sample (n = 156), however, more validation is warranted.

● Mobility Interaction Fall Chart: This is a functional assessment for residential care population. Only the original article provided some validation. ● Multiple Sclerosis Walking Scale-12: This scale has good psychometrics but limited to use in Multiple Sclerosis population. Data is limited to younger population due to the progressive and debilitating nature of Multiple Sclerosis. ● Multiple Lunge Test: This test has an established Sn and Sp, but limited research in last five years. ● Peninsula Health Fall Risk Assessment Tool (PHRAT): This tool needs more research to support it. ● Queensland Fall Risk Assessment Tool (QFRAT): There is very limited evidence on this tool after 2014. Most of the research was conducted more than five years ago. ● Short Physical Performance Battery (SPPB): This is a fitness/activity capacity test with no established link to balance performance and fall risk. ● Stroop Stepping Test: This is a low cost test capable of distinguishing fallers from non-fallers, however, it has limited research in the last five years. A computer program with a specialized mat sensor is required to track response time and accuracy. ● Shuttle Walk: Shuttle Walk is a reliable aerobic capacity test, however, more research is needed to establish a link to balance and fall risks. ● Stroke Assessment Fall Risk: While this measure has promising fall risk predictability in stroke population, there is no reliability evidence found. More studies are needed for other populations/diagnoses. ● Subjective Risk Rating of Specific Tasks: One original article in 2011 validated the measure, but it needs more study. ● Survey of Activities and Fear of Falling in the Elderly: This measures activity and fear of falling (not efficacy or confidence), however, only the original article validated this tool. ● The Falls Behavior Scale: It has the potential to be a useful tool but is not widely used and has not been well researched to identify fall risk predictability. ● University of Illinois at Chicago Fear of Falling Measure (UIC FFM): This tool measures the construct of fear of falling (not efficacy or confidence), however, only the original article validated it. Many presentations/abstracts/proceedings found at various conferences (ISPRM, IAAG, CSM), but are not published yet.

Outcome Measures Widely Used, but with Limited Recent Evidence Related to Fall Risks

● 2 Minute Walk Test and other similar timed tests e.g., 6 Minute Walk: This outcome measure was designed to measure aerobic capacity/endurance, however, its predictability of fall risk is yet to be established. ● 30 Second Sit to Stand: There is significant amount of evidence for fall risk prediction, however, there are no cutoff scores, just comparisons to age norms. There is minimal cross validation to different diagnoses. ● 360 Degree Turn: Incorporated into many tests, but as a stand-alone it has significant variability in the cutoff time/steps. Despite inconsistent cutoff, it still has high sensitivity and specificity. ● 4 Stage Balance Test (Also known as “Frailty and Injuries: Cooperative Studies of Intervention Techniques” - FICSIT-4): There is no study that looked at the FICSIT alone. Some studies looked at tandem, single limb, or the STEADI but nothing at FICSIT alone. ● Dynamic Gait Index: There is limited recent evidence to support the DGI. The DGI is primarily studied with the vestibular population. It has moderate to high construct validity. ● Falls Efficacy Scale (FES): It is supported for falls, but not well studied for predictive capability. There is no recent literature on this scale. ● Fear Avoidance Beliefs Questionnaire (FABQ): It is validated against other outcome measures (i.e., FES, BBS, etc.), however, it does not have evidence in cutoff scores to support use in predicting fall risk. No summary table in this document. ● Functional Independence Measure (FIM): No strong evidence in the literature to support the use of FIM to identify fall risk. Petitoierre et al 2010 identified poor Sn, Sp for using FIM to identify fall risk at two different cutoff scores. Much of the literature on the FIM discusses its use in determining rehab potential, overall functional prognosis, and to monitor progress in rehab settings. Forest et al 2016 identified that FIM scores at admission are inversely related to fall risk but without cutoff scores. ● Missouri Alliance for Home Care (MAHC-10): This is used at home health setting in all Epic and other EMR systems. Information only found in the original article. More evidence is warranted. ● Physiological Profile Assessment (PPA): The shortened version has been studied in the past four years with slightly higher reliability than the long form. There are multifactorial clinical tests with evidence for individual test reliability. ● Romberg Test (Tandem Stance): This is a reliable and valid test; however, it is seldom used alone. It is usually part of a larger assessment (BESTest, STEADI). ● Single Leg Stance: This is a reliable and valid test; however, it is seldom used alone. It is usually part of a larger assessment (BESTest, STEADI).

● Sickness Impact Profile (SIP): This profile looks at physical dimension. It has been researched and used for many diagnoses, but unsure if it corresponds to fall/balance assessment. There is no direct evidence regarding fall risk. ● Stopping Elderly Accidents, Deaths, and Injuries (STEADI): It is used by PT as a screening tool, but needs continued refinement and field validation of its use in primary care. ● St. Thomas Risk Assessment Tool (STRATIFY): Used as a hospital fall screening tool to identify patient’s fall risk, however, literature reports inconsistent predictive accuracy. This raises questions about operational usefulness. More studies are warranted for fall predictability. ● Timed Up and Go - Dual Task: Incorporated into other tests, however, there are many varieties clinically. More studies are needed for cutoff scores linked to fall predictability. ● Western Ontario and McMaster Osteoarthritis Index (WOMAC): A patient reported outcome measure (PROM) that is widely used to evaluate the pain, stiffness, and physical function of patients with osteoarthritis of the hip and knee. It is not a balance and fall assessment. Studies are needed to link to balance and fall risks; therefore, no summary table presented in this document. ● World Health Organization Quality of Life (WHOQoL): This has not been cross validated with other balance and falls measures. This measure is not a direct assessment of balance or falls and should not be included in the final recommendation since its primary purpose is not related. No summary table presented in this document.

Outcome Measures Divided by Setting

Outcome Measures Studied in Community Setting

● 21 Item Fall Risk Index ● Functional Reach Test (FRA) ● 25 Question Geriatric Locomotive Scale ● Gait Efficacy Scale ● 30 Second Chair Stand Test ● Gait Speed ● 360 Degree Turn Time ● Geriatric Fear of Falling Assessment ● 4 Step Square Test ● Grip Strength ● Five Times Sit to Stand Test ● LASA Fall Risk Profile ● Activities Specific Balance Confidence Scale ● Minimal Chair Height Standing Ability ● Activity-Based Balance and Gait ● Multiple Lunge Test ● Balance Self-Perceptions Test ● Physical Activity Questionnaire (CHAMPS) ● Berg Balance Scale ● Physical Performance Scale ● Brunel Balance Assessment ● Physiological Profile Assessment ● Clinical Test of Sensory Interaction and Balance ● Push and Release Test (CTSIB) ● Romberg Test ● Community Balance and Mobility Scale ● Single Let Stance ● CONFal Scale of Balance Confidence ● Stopping Elderly Accidents, Deaths, & Injuries ● Demura’s Fall Risk Assessment Chart (DFRA) (STEADI) ● Downton Fall Risk Index ● Stroop Stepping Test ● Dynamic Gait Index ● Tandem Test ● Fall Risk for Older People in the Community ● The Obstacle Course Assessment ● Timed Up and Go Test ● Falls Efficacy Scale (FES) ● Timed Up and Go - Dual Task ● Fear Avoidance Beliefs Questionnaire (FABQ) ● Tinetti Performance-Oriented Mobility Assessment ● Floor Rise Test ● University of Illinois at Chicago Fear of Falling ● Fullerton Advanced Balance Scale (FAB) Measure (UICFFM) ● Functional Gait Assessment (FGA)

Outcome Measures Studied in Acute Hospital Setting

● Balance Evaluation System Test (BESTest; BESTmini; BESTbrief) ● Berg Balance Scale ● Community Balance and Mobility Scale ● Conley Scale ● Downton Fall Risk Index ● Dynamic Gait Index ● Figure 8 Walking Test ● Fullerton Advanced Balance Scale (FAB) ● Functional Reach Test ● Gait Speed ● Gorningen Activity Restriction Scale ● Grip Strength ● Hendrich II Fall Risk Model ● High Level Mobility Assessment Tool ● Melbourne Fall Risk Assessment Tool (MFRAT) ● Morse Fall Scale ● Single Leg Stance (Single Limb Standing) ● St. Thomas Risk Assessment Tool (STRATIFY) ● Stroke Assessment Fall Risk ● Tinetti Performance-Oriented Mobility Assessment (POMA) ● World Health Organization Quality of Life (WHOQoL)

Outcome Measures Studied in Inpatient Rehab (Rehab Hospital or SNF) Setting

● Balance Evaluation System Test (BESTest; BESTmini; BESTbrief) ● Berg Balance Scale ● Downton Fall Risk Index ● Dynamic Gait Index ● Figure 8 Walking Test ● Fullerton Advanced Balance Scale (FAB) ● Functional Reach Test ● Gait Speed ● Grip Strength ● Hendrich II Fall Risk Model ● High Level Mobility Assessment Tool ● Melbourne Fall Risk Assessment Tool (MFRAT) ● Morse Fall Scale ● Peninsula Health Fall Risk Assessment Tool (PHRAT) ● Shuttle Walk ● Single Leg Stance (Single Limb Standing) ● St. Thomas Risk Assessment Tool (STRATIFY) ● Tinetti Performance-Oriented Mobility Assessment (POMA) ● World Health Organization Quality of Life (WHOQoL)

Outcome Measures Studied in Outpatient Setting

● Balance Evaluation System Test (BESTest; BESTmini; BESTbrief) ● Berg Balance Scale ● Community Balance and Mobility Scale ● CONFbal Scale of Balance Confidence ● Dynamic Gait Index ● Fall Perception Questionnaire ● Figure 8 Walking Test ● Fullerton Advanced Balance Scale (FAB) ● Functional Reach Test ● Gait Speed ● Grip Strength ● Hauser Ambulation Index ● Shuttle Walk ● Sickness Impact Profile Physical Dimension ● Single Leg Stance (Single Limb Standing) ● World Health Organization Quality of Life (WHOQoL)

Outcome Measures Studied in Home Health Setting

● Balance Evaluation System Test (BESTest; BESTmini; BESTbrief) ● Berg Balance Scale ● Figure 8 Walking Test ● Home Falls and Accidents Screening Tool (HomeFast) ● Missouri Alliance for Home Care (MAHC-10) ● Single Leg Stance (Single Limb Standing)

Outcome Measures Studied in Long Term Care Facility Setting

• Activities Specific Balance Confidence Scale • Bed Rise Difficulty (BRD) Scale • Berg Balance Scale • Gait Speed • Hauser Ambulation Index • Melbourne Fall Risk Assessment Tool (MFRAT) • Mobility Interaction Fall Chart • Morse Fall Scale • Peninsula Health Fall Risk Assessment Tool (PHRAT) • Physiological Profile Assessment • Queensland Fall Risk Assessment Tool (QFRAT) • Sickness Impact Profile Physical Dimension • Single Leg Stance (Single Limb Standing) • St. Thomas Risk Assessment Tool (STRATIFY) • Subjective Risk Rating of Specific Tasks • Survey of Activities and Fear of Falling in the Elderly

Summary Tables of Each Individual Outcome Measure (alphabetic order; 92 tables)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV 2 Minute Pin et al., Systematic NA Moderate to strong evidence NA NA NA NA NA NA Walk Test 2014 Review, 25 studies to support the 2MWT as a were all adults reliable, valid, and responsive with one exception outcome measure for adults with lower limb amputation and for frail elderly patients. Important psychometric information on the 2MWT such as minimal clinically important changes and normative data is still missing. At present, any changes in the 2MWT should be interpreted with caution. Bohannon et Community- NA ICC 0.82 42.5m NA NA NA NA NA al., dwelling adults 2015 (age 18-85 y/o, n=1137)

Legend: Sn = Sensitivity NA = Not assessed Sp = Specificity MDC = Minimum Detectable Change PPV = Positive Predictive Value y/o = years old NPV = Negative Predictive s/p = after

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV 21 Item Fall Ishimoto et Community- NA NA NA ≥ 10 items NA NA NA NA Risk Index al., 2012 dwelling adults (age >65, n=518)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV 25 Question Seichi et Community- NA Test-retest ICC NA 16 for NA NA NA NA Geriatric al., dwelling adults (range 0.712– identifying Locomotive 2012 (age >65, n=711) 0.924). locomotive Function Scale syndrome

Seichi et Community- NA NA NA 16 NA NA NA NA al., dwelling adults 2014 (age >65, n=880)

Tavares et Community- NA Interobserver and NA NA NA NA NA NA al., 2017 dwelling adults intra-rater ICC of (age >60, n=100) 97.6% and 98.4%, respectively

Kimura et Older adults with NA NA NA NA NA NA GLFS-25 and lower NA al., 2018 cervical extremity motor function myelopathy score of the JOA score (mean age 67.2 ± yielded the areas under the 11.7 y/o, n=360) receiver operating characteristic curves of 0.674 and 0.607, respectively, to differentiate recurrent fallers from non- recurrent fallers.

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV 30 Sec Sit to Rikli et al., 1999 Community- Criterion validity Test-retest: r NA . NA NA NA NA Stand dwelling older of the chair stand = 0.89 (95% adults compared to CI 0.79- weight adjusted 0.93) leg press interrater performance for reliability r all participants: r = 0.95 (95% = 0.77, 95% CI = CI 0.84- 0.64-0.85 0.97) Yamada et al., 2015 157 Japanese NA NA NA OR to fall NA NA NA NA community- prediction = dwelling older 1.03 adults (76±6 y/o)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV 360 Degree Dite & Temple, Community- NA Inter-rater reliability: NA 4 steps 92 70 NA NA Turn Time 2002 dwelling Kappa=096 Intra-rater reliability: Kappa=0.92 Re-test reliability: Kappa=0.91

Inter-rater reliability: kappa=0.97 Intra-rater reliability: 2.1 SEC 81 89 kappa=0.99 Re-test reliability: Kappa=0.90 Schenkman et al., Parkinson’s NA Test-retest reliability: NA NA NA NA NA NA 2011 Disease seconds: ICC = 0.77 steps: ICC = 0.80 Shiu et al., 2016 Stroke survivors NA Excellent intra-rater, -NA Affected 84 91 NA NA (55 y/o or older) interrater, and test- side:0.76 retest reliability seconds (ICC=.824–.993) Unaffected 84 89 side: 1.22 seconds

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV

4 Square Dite et al., 2002 Community- Strong correlations with the Interrater: NA > 15sec 85 100 100 86 Step Test dwelling TUG and Step Test. ICC=0.99 The lower correlations found Re-test: between the FSST and FRT ICC=0.98

Dite et al., 2007 s/p Unilateral NA NA NA 24 seconds 92 93 NA NA Transtibial Amputation

Whitney et al., Patients with Good correlations with the other IC=9.93; 95CI NA 12 sec 80 92 NA NA 2007 vestibular gait measures (correlation 0.86–0.96 symptoms coefficients for the TUG, .69; who were gait speed, .65; DGI, −.51) and rolled into PT poor correlations with the DHI and the ABC (DHI, −.13; ABC, −.12)

Blennerhassett et Older adults Strong inverse relationship with Inter-rater NA 15 seconds NA NA NA NA al., 2008 who could step test: spearman ρ=−0.73 to reliability: walk at least −0.86 0.94–0.99 50m with minimal assistance

Duncan et al., Individuals NA Interrater ICC = NA 9.68 sec 73 57 31% NA 2013 with idiopathic 0.99 from Parkinson’s Test-retest 21% Disease reliability ICC = 0.78

Goh et al., 2013 Community- Correlation with TUG scores Intra-rater NA 11 73.3 93.3 NA NA dwelling older r=.59; P=.02 reliability:0.82- adults with 0.83 chronic stroke Interrater reliability >.99

Wagner et al., Relapsing- Excellent correlations between Test–retest, 4.6 NA NA NA NA NA 2013 remitting, the FSST and BBS (rs = -0.84, reliability:0.922 sec secondary P<0.001), DGI (rs = -0.81, P (0.831–0.965) progressive, <0.001), and ABC (rs = -0.78, P and primary <0.001). The FSST was also progressive moderately correlated with Multiple EDSS scores (rs=0.73, P<0.001). Sclerosis

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV 5 Times Sit Tiedemann et Community- NA ICC 0.89 (95% CI = NA NA NA NA NA NA to Stand al., dwelling adults 0.79-0.95) (10 Times Sit 2008 (age 74-98 y/o, n to Stand) = 362)

Buatois et al., Community- NA NA NA 12 s 55% 65% NA NA 2008 dwelling older Risk Ratio 1.74, adults (>65 y/o, CI=1.24-2.45, mean age 70±4) P<.001

Bohannon et Community- NA ICCs ranged from 0.64 NA NA NA NA NA NA al., 2011 dwelling older to 0.96. The adjusted (Systematic adults mean ICC calculated Review) from the reported ICCs was 0.81

Wallmann, et Community- NA Excellent interrater NA NA NA NA NA NA al., dwelling older reliability among all 2012 adults (mean age three researchers: ICC = 65 y/o) 1.000.

Fang Zhang, Community- NA NA NA Those who NA NA NA NA et al., dwelling older require > 16.6 s to 2013 adults finish 5TSTS have significantly higher likelihood of developing IADL-related disability at 3 year follow-up

Lusardi et al., Community- NA NA NA >12 s 49% 63% +LR 1.6; -20 2017 dwelling older Posttest (Systemic adults (age >65 Probability if Review) y/o) + 41 n > 30

Medina- Community- NA ICC for inter-observer NA NA NA NA NA NA Mirapeix, et dwelling older reliability of the 5STS al., adults s/p were 0.998 for men and 2018 unilateral Total women combined. For Knee test-retest 0.982 Replacement

10 Time Sit Bohannon Healthy older NA NA NA 60-69 11.4s NA NA NA NA to Stands 2006 adults (60+ y/o) 70-79 12.6s (Meta- 80-89 12.7s analysis)

Segura-Ortí, 39 adults NA Test-retest ICC 0.88 8.4 NA NA NA NA NA et al., undergoing sec; 2011 hemodialysis STS (mean age 60 10 y/o)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Activity-Based Topper et al., 17 men and 83 women NA NA NA NA NA NA NA NA Balance and Gait 1993 volunteers (aged 62-96 y/o) who ADL independently

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV

Activities Lajoie Y and Community-dwelling NA NA NA <67 89 96 NA NA Specific Balance Gallagher S P, older adults Confidence Scale 2004 (ABC)

Steffen T and Parkinson’s Disease (mean NA Test-retest 13 NA NA NA NA NA Seney M, 2008 age=71 y/o) reliability 0.90

Mak M K and NA NA NA NA <67 93 69 NA NA Pang M Y, 2009

Sakakibara et Unilateral lower limb NA ICC=0.93 NA NA NA NA NA NA al., 2011 amputation for at least 6 Test-re-test r= months (age ≥50 y/o) 0.84–0.95

An et al., 2017 Chronic stroke survivors, NA NA NA 81 71% 72% NA NA who have ability to ambulate > 10m without walking aides, with absence of lower motor neuron diseases or musculoskeletal problems, and with score of >24 on the Mini-Mental State Examination (MMSE).

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV

Activities Blanchard et Seniors residing in Convergent Test-retest: ICC (2,1) NA NA NA NA NA NA Specific Fall al., 2007 nursing homes or validity: with =.87; 95% CI, .78−.93 Caution Scale assistive living facility functional measures (TUG, Berg, etc.); Discriminant validity (with or without walking aid): p<0.05

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Alternate Step Tiedemann Community-dwelling NA ICC 0.78 (95% CI = NA > 10sec 69% 56% NA NA Test et al., 2008 adults (age 74-98 y/o, n 0.59, 0.89) = 362)

Chung et S/p stroke NA Inter-rater (ICC= 3.26sec NA NA NA NA NA al., 2014 0.991– 0.999), intra- rater (ICC= 0.946– 0.955) and test-retest reliability (ICC= 0.909–0.952) of the AST times for the participants with stroke

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Balance Haines et al., Australian adults in 2 Construct Cronbach NA NA NA NA NA NA Outcome 2007 states received PT validity with α: .87-.89 Measure for services (inpatient, Modified Elderly Elder outpatient and Mobility Scale Rehabilitation homecare) (MEMS), (ρ (BOOMER) =.88)

Kuys et al., Australian rehab Concurrent NA NA NA NA NA NA NA 2011 inpatient geriatric validity with unit patients Berg (ρ=.91; P<.01) with gait speed (ρ=.67; P<.01)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV

Balance Self- Shumway- Community-dwelling NA NA NA <50 73 82 NA NA Perception Test Cook et older adults al.1997

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Bed Rise Alexander, et Women 3 groups: NA NA NA 0-10 Min NA NA NA NA Difficulty Scale al., 1992 Young n=17, (24 y/o), difficulty, 11- Community-dwelling 20 Mod n=12, (71 y/o), difficulty, 21 Assisted living n=15. 30 severe (86 y/o) difficulty

. 38

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Berg Godi et al., 93 With scores of Mini-BESTest Test-retest reliability: MDC= NA 77% 97% NA NA Balance 2013 individuals at baseline and follow-up: ICC= 0.92 (95% 6.2 Scale with balance r= 0.85 CI.87-.97) (SEM= deficits Inter-rater reliability: 2.18) (mean age 66 ICC= 0.97 (95% y/o) CI .96-.99)

Major et al., n = 30, with NA Inter-rater reliability: NA NA NA NA NA NA 2013 lower ICC= 0.94 extremity amputation (mean age 54 y/o)

Wong 2014 5 individuals NA Inter-rater reliability: NA NA NA NA NA NA with lower ICC= 0.99 (95% limb CI .99-1.00) amputations Intra-rater reliability: ICC= 0.99 (95% CI .96-1.00)

Pickenbrock 53 patients With Static Balance test: r = Inter-rater reliability: NA NA NA NA NA NA et al., with acute 0.91 ICC= 0.87 2015 stroke

Chan et al., 92 patients At 2 weeks post-op: Inter-rater reliability: MDC= NA NA NA NA NA 2015 with total With FGA: r= 0.67 ICC= 0.98 (95% CI 2.00 knee With BESTest: r= 0.78 0.97-0.99) (SEM= arthroplasty With Mini-BESTest: r= 0.72 0.72) With BriefBESTest: r= 0.74 At 12 weeks post-op: With FGA: r= 0.51 With BESTest: r= 0.68 With Mini-BESTest: r= 0.58 With BESTest Brief: r= 0.64 At 24 weeks post-op: With FGA: r= 0.43 With BESTest: r= 0.64 With Mini-BESTest: r= 0.55 With BESTest Brief: r= 0.71

Telenius et 33 nursing NA Inter-rater reliability: MDC= NA NA NA NA NA al., 2015 home ICC= 0.99 1.92 patients with (SEM= mild to 0.97) moderate dementia (82 y/o)

Schlenstedt 85 patients Construct validity: NA NA To predict 0.64 0.67 NA NA et al., 2016 with r= 0.94 future falls: (95% (95% idiopathic Cutoff score CI: CI: Parkinson’s of <52/56 0.47- 0.50- Disease 0.78) 0.80)

Jacome et 46 patients With ABC scale: Inter-rater reliability: MDC= With and 0.73 0.77 3.20 0.35 al., 2016 with COPD rho= 0.75 ICC= 0.94 (95% 5.9 without (mean age 75 CI .88-.97) (SEM= history of y/o) 2.1) falls: Cutoff Intra-rater reliability: score of ICC= 0.52 (95% 52.5/56 CI .19-.74)

Lee at al., 75 NA NA NA To predict 79% 76% 72% 82% 2016 hemiparetic level of stroke community patients ambulation (mean age of (defined as 58 y/o) gait speed > 0.8 meters/sec): > 46.5/56

Marques et 122 With ABC scale: Inter-rater reliability: MDC= To identify 74% 72% 2.59 0.37 al., 2016 community- rho= 0.58 ICC= 0.88 (95% CI 4.6 participant dwelling 0.77-0.94) (SEM= with or older adults Test-retest reliability: 1.4) without (mean age of ICC= 0.50 (95% CI history of 76 y/o) 0.15-0.73 falls: Cutoff score of 48.5/56

Park et al., 9,743 NA NA NA NA 0.73 0.90 NA NA 2017 individuals (95% (95% (aged > 60 CI: CI: y/o) 0.65- 0.86- 0.79) 0.93

Jorgensen et 46 With mini-BESTest: NA NA Between NA NA NA NA al., 2017 individuals r= .889 walkers with chronic With TUG test: without spinal cord r= -.75 walking aids injury With SCIM: and those r= 0.88 with walking With 10 m walk time: aids: r= -.88 Cutoff score With WISCI II: of >47/56 r= 0.63 Between With FES-1: participant r= -0.62 with low/high concerns of falling: ≤46/56

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV BESTest Horak et Adults with With Interrater: NA NA NA NA NA NA al., 2009 neurological Activities BESTest (ICC disorders Specific = .91) Balance Components Confidence (.79-.96); n = Scale (ABC) 22 r=.69

Leddy et Adults with With Berg Interrater: NA NA NA NA NA NA al., 2011 Parkinson’s Balance Scale BESTest [ICC

Disease (>40 (BBS); r=.87 (2, 1) = .96]; y/o; no component description) (.79-.96); n = 15; Test-retest: BESTest [ICC (2, 1) = .88]; component (.63-.87); n = 24

Padgett et 13 adults with NA Interrater: NA 77 86% 95% NA NA al., 2012 and 13 adults BESTest: without ICC =.99; No Multiple component Sclerosis reported

Duncan et 80 participants NA NA NA 69% Retrospective Retrospective NA NA al., 2013 with 6 month: 6 month: Parkinson’s 84%; 76%; Disease, Prospective 6 Prospective 6 (68.2±9.3 y/o); month: 93%; month: 84%; Retrospective 6 Prospective Prospective month; 12 month: 12 month: Prospective 6 46% 74% month: Prospec tive 12 month 42

Rodrigues Adults with Against ABC Interrater: NA NA NA NA NA NA et al., 2014 hemiparesis r=.59 and BESTest

(61.1 ±7.5 y/o; BBS r=.78 [ICC(?) = .93]; no range) component (.85-.96); n = 16 Test-retest: BESTest [ICC = .98]; component (.71-.94); n = 16

Chinsongkr 12 adults with With BBS Interrater: NA NA NA NA NA NA am et al., subacute stroke (r=.96) BESTest [ICC

2014 (58.2; 24-90 (3, 1) = .99]; No y/o) component results reported; n = 12 Test-retest: BESTest [ICC (2, 1) = .96]; No component results reported; n = 12

Chinsongkr 49 adults with NA NA NA 10% of 80.8% 87.5% NA NA am et al., subacute stroke balance 2014 (58.2 y/o; 24- improvement 90)

Chan and Patients after (n = 46) Interrater: BESTest NA NA NA NA NA Pang, 2015 total knee Internal BESTest [ICC MDC =

arthroplasty consistency (2, 1) = .99]; 6.2% (65+ y/o) α=0.98; Component Component validated (.98-1.00); n = : 22.71%; n against BBS, 25 = 46 Functional Test-retest: Gait 43

Assessment BESTest [ICC

(FGA), and (2, 1) = .96]; ABC Scale Component (.76-.96); n = 45

Huang et 28 community- ABC (r=.73) Interrater: BESTest NA NA NA NA NA al., 2016 dwelling cancer BESTest [ICC MDC =

survivors (2, 1) = .96]; No 6.9%; No (68.4±8.1y/o) component component results results reported; reported Test-retest: BESTest [ICC (2, 1) = .92]; No component results reported

Jacome et 46 participants Against ABC Interrater: 6.3% 76.9% 64% 77% NA NA al., 2016 with COPD (rho = 0.61) BESTest [ICC

(75.9±7.1 y/o) (2, 1) = .85]; No component results reported; Intrarater:

BESTest [ICC

(2, 1) = .87]; No component results reported

Yingyongy 200 healthy NA NA NA 66% 76% 50% NA NA udha et al., adults with or 2016 without fall hx, (70.2±7.0 y/o)

Anson et 58 adults with NA Test-retest: 8.9 NA NA NA NA NA al., 2017 fall history and 0.86 self-reported balance problem, (78.1±7.0 y/o)

Margues et 66 adults with Against ABC NA NA 81 points 68% 71% NA NA al., 2017 Type II Diabetes (rho = 0.70) Mellitus (75±7.6 y/o)

Wang-Hsu Community- NA Interrater: BESTest NA NA NA NA NA et al., 2018 dwelling older BESTest [ICC MDC =

adults (85/5.5 (2, 1) = .97]; 8.2-point y/o; 70-94) Component (95%CI) (.85-.94); N = Component 32 : 2.1-3.4 Test-retest: point BESTest [ICC (95%CI); (2, 1) = .93]; N = 70 Component (.72-.89); N = 70

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV BESTest- Padgett et 13 adults with and 13 NA Interrater: NA NA 100% 100% NA NA Brief al., 2012 adults without ICC = .99 Multiple Sclerosis

Duncan et 80 participants with NA NA NA 11/24 Retrospective Retrospective NA NA al., 2013 Parkinson’s Disease, (45.8%) 6 month: 6 month: (68.2±9.3 y/o); also 76%; 84%; reported Prospective 6 Prospective 6 Retrospective 6 month: 71%; month: 87%; month; Prospective 6 Prospective Prospective month: and 12 month: 12 month: Prospective 12- 53% 93% month LR+, LR-, pretest probability of falling, 6 month posttest probability, and 12 month posttest probability of falling

Chan and Patients after Total (n = 46) Internal Interrater: MDC NA NA NA NA NA Pang, 2015 Knee Arthroplasty consistency [ICC (2, 1) = 3.2 (65+ y/o) α=0.97; validated = .97]; n = point; against Berg 25 n = 46 Balance Scale, Test-retest: Functional Gait [ICC (2, 1) Assessment = .94]; n = (FGA), and 45 Activities- speciﬁc Balance Conﬁdence (ABC) Scale

Jacobs et 42 adults with NA NA NA 14 70.6% 76.9% NA NA al., 2015 Parkinson’s Disease (67, range 64-70 y/o)

Bravini et 244 adults with Internal construct Cronbach 4.3 NA NA NA NA NA al., 2016 balance disorders validity using α=0.89; (65.3±14.9 y/o) Rasch analysis Interrater: demonstrated un- ICC (2, 1) fit model, = .90; recommend item Test-retest: 1 not fit ICC (2, 1) = .94

Huang et 28 community- ABC (r=.81) Interrater: MDC NA NA NA NA NA al., 2016 dwelling cancer [ICC (2, 1) = 2.55 survivors = .92]; point (68.4±8.1y/o) Test-retest: [ICC (2, 1) = .94];

Jacome et 46 participants with Against ABC Interrater: MDC 16.5 81% 73% NA NA al., 2016 COPD (75.9±7.1 y/o) (rho = 0.53) [ICC (2, 1) = 4.9 = .97]; Intra-rater: [ICC (2, 1) = .82]; Margues et 66 adults with Type Against ABC NA NA 15.5 67% 71% NA NA al., 2017 II Diabetes Mellitus, (rho = 0.62) (75±7.6 y/o)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV BESTest- Horak et al., 115 adults with Using Rasch NA NA NA NA NA NA NA mini 2011 neurological disorders analysis to select 14 items Padgett et al., 13 adults with and 13 NA Interrater: NA NA 71% 100% NA NA 2012 adults with balance ICC = .99 deficits Tsang et al., 106 post stroke and With BBS Interrater: 3 point 17.5 64.0% 64.2% NA NA 2013 48 control adults (rho = 0.83) ICC (2, 1) participated (55+ y/o) = .97 Test-retest: ICC (3, 1) = .96; n = 22 Duncan et al., 80 participants with NA NA NA 20/32 Retrospective Retrospective NA NA 2013 Parkinson’s Disease, 6 month: 6 month: (68.2±9.3 y/o); also 88%; 78%; reported Prospective 6 Prospective 6 Retrospective 6 month: 86%; month: 78%; month; Prospective 6 Prospective Prospective month: and 12 month: 12 month: Prospective 12 month 62% 74% LR+, LR-, pretest probability of falling, 6 month posttest probability, and 12 month posttest probability of falling Godi et al., 93 participants with Correlated to Cronback 3.5 NA 94% 81% NA NA 2013 various neurological BBS α=0.90; disorders (66.2±13.2 Interrater: y/o) ICC (2, 1) = .98; Test-retest: ICC (2, 1) = .96

Chinsongkram 49 adults with NA NA 3 points 21 84.6% 87.5% NA NA et al., 2014 subacute stroke (58.2 y/o; 24-90); responsiveness of the test

Chan and Pang, Patients after Total (n = 46) Interrater: MDC = NA NA NA NA NA 2015 Knee Arthroplasty Internal [ICC (2, 1) 3.71 (65+ y/o) consistency = .96] point; n α=0.96; Test-retest: = 46 validated [ICC (2, 1) against BBS, = .92]; n = Functional 45 Gait Assessment (FGA), and ABC Scale

Jacobs et al., 42 adults with NA NA NA 21 82.4% 65.4% NA NA 2015 Parkinson’s Disease (67 y/o, 64-70)

Wallen et al., 112 adults with Structure NA NA NA NA NA NA NA 2016 Parkinson’s Disease validity with (72.8±5.5 y/o) exploratory factor analysis (EFA) and Rasch analysis; recommend omit item 7

Ross et al., 52 adults with With BBS None None 22.5 cutoff NA NA NA NA 2016 Multiple Sclerosis (r=.79) reported reported for falls; (45.7±5.7 y/o) AUC = 0.77, Positive likelihood ratio 2.86, negative

likelihood ratio 0.19

Huang et al., 28 community- ABC (r=.52) Interrater: MDC = NA NA NA NA NA 2016 dwelling cancer [ICC (2, 1) 2.39 survivors 68.4±8.1y/o = .86]; point Test-retest: [ICC (2, 1) = .90];

Jacome et al., 46 participants with Against Interrater: MDC = 21.5 68% 65% NA NA 2016 COPD ABC (rho = [ICC (2, 1) 3.3 (75.9±7.1 y/o) 0.55) = .85]; Intrarater: [ICC (2, 1) = .88];

Schlenstedt et 66 adults with NA NA NA 19 0.52% 0.70% NA NA al., 2016 Parkinson’s Disease

Yingyongyudha 200 healthy adults NA NA NA 16 85% 75% NA NA et al., 2016 with or without fall history (70.2±7.0 y/o)

Anson et al., 58 adults with fall NA Test-retest: 4.0 NA NA NA NA NA 2017 history and self- 0.84 reported balance problem, (78.1±7.0 y/o)

Jorgensen et al., 46 ambulatory adults Correlates to NA NA 19 55-82% 54-75% NA NA 2017 with chronic spinal BBS cord injury (55±17 (r=0.90) y/o)

Margues et al., 66 adults with Type II Against NA NA 20.5 60% 71% NA NA 2017 Diabetes Mellitus ABC (rho = (75±7.6 y/o) 0.63)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Brunel Balance Tyson & Reliability testing (n Correlation 100% 1(stroke) Score ranges NA NA NA NA Assessment DeSouza, = 37, mean age 66) coefficients 0.83 agreement (K= from 0/12 2004 Validity testing (n = for Motor 1) for both test (lowest) to 55, mean age 68 y/o) Assessment Scale, retest reliability 12/12 0.97 with Berg and inter-tester (highest) Balance Test and reliability. 0.95 with Rivermead Mobility Index

Tyson, et al. Post CVA, n=75, Findings of this NA NA NA NA NA NA NA 2007 (mean age 70 y/o) study confirm the predictive validity of the BBA

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Canadian McColl et Disabled Construct validity with NA NA NA NA NA NA NA Occupational al., 2000 adults (18-75 Satisfaction with Performance Performance y/o); Scaled Questionnaire (SPSQ), Measure n = 61 Reintegration to Normal (COPM) Living Index (RNL), Life Satisfaction Scale (LSS) at p<.0005, correlations .37 - .46 Criterion validity with Perceived Problem Check List (PPCL): Frequency of reported problems: PPCL COPM Selfcare 60% 46% Productiv22% 23% Leisure 9% 31%

Sewell & COPD, NA Mean differences: NA NA NA NA NA NA Singh, pulmonary Performance =.14, 2001 rehabilitation Satisfaction = 42, outpatient CI 95% (53-79 y/o) Intraclass n = 15 correlation coefficients: Performance r = 0.92; Satisfaction r = 0.90, p<.0001

Cup et al., Stroke, s/p 2 Discriminant validity with: BI, Test-retest NA NA NA NA NA NA 2003 month, (26-83, FAI, SA-SIP30, EQ-5D, reliability rho = mean 68 y/o) Rankin Scale r = -0.225, - Performance .89 n = 26 0.115, 0.102, 0.143, 0.209 & respectively Satisfaction .88 at p<0.001

Dedding et Neurological Divergent validity with SIP68 NA NA NA NA NA NA NA al., 2004 and orthopedic Performance r = -0.20, p = adults 0.05; Satisfaction r = -0.19, p n = 99 = 0.07; Convergent validity with Disability & Impact

Profile (DIP) 63% corresponding items

Eyssen et Various Construct validity with SIP68, NA NA NA AUC NA NA NA al., 2011 diagnoses in DIP & Impact on Participation 0.79 adult and Autonomy (IPA) p = to outpatient <0.01 0.85 clinics n = 138 (51±13 y/o)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Clinical Di Fabio & Stroke Construct validity Interrater NA NA NA NA NA NA Test of Badke, patients, with Fugl-Meyer reliability Sensory 1990 university Sensorimotor Kappa .95, Interaction hospital Assessment (FMSA) P<.05 & Balance (29-70 y/o), Sensory rho = .55, (CTSIB); n = 10 P< .05 Balance rho = .77, p<.01 Total LE rho = .69, p<.05

(also called Anacker & Community- Construct validity Test retest NA NA NA NA NA NA SOT in ‘90s Di Fabio, dwelling with Get Up and Go reliability r but with 1992 elders; Fallers Test (GUGT) = .75, p<.05 same & non-fallers Spearman Rho = protocol on (65-96 y/o) -.67 fallers; -.44 level n = 47 non-fallers ground)

Cohen et Healthy adults Predictive validity Test-retest NA NA NA NA NA NA al., 1993 3 age groups of scores between reliability & vestibular the 2 groups. interrater dysfunction Condition 5 t = 4.17, reliability r adults - 4th P<.001 = .99, p<.01 group Condition 6: t Healthy n = =5.58, P<.001 15; (25-85 y/o) Vestibular n = 17; (30-87 y/o)

Di Fabio & Community- Construct validity: NA NA < 250 sec Identifying 90% NA NA Anacker, dwelling Discriminant fallers 1996 elders functions classified: 44% (65 -96 y/o). Non-fallers: 77% 16 Fallers, 31 Fallers: 63% No-Fallers

El-Kashlan Two Groups: Construct validity NA NA NA Sensitivity NA Normal NA et al., 1998 Healthy adults with Dynamic of 60% in CTSIB: 89 & Vestibular Posturography identifying % Dysfunction (SOT) on Balance vestibular Abnormal Normal: (20- Master dysfunctio CTSIB: 79 y/o) Baseline: r = 0.41, n 55% N =69 P≤0.018 Vestibular: 1 month: r = .74, (20-70 y/o); N P≤0.000 = 35 2 months: r = 0.89, P≤ 0.000 3 months: r = .41, P≤0.034

Bernhardt Stroke, acute Correlations NA NA NA NA NA NA NA et al., 1998 IP ( Pearson’s r) with (71.8± 10.5 Locomotion y/o) Measures (Step N =29 Test, gait velocity, Motor Assessment Scale ) >.40, p<0.0036

Freeman Parkinson’s Concurrent validity NA NA NA NA NA NA NA DL, 2018 Disease, with Instrumented Idiopathic mCTSIB & SOT Parkinson’s Composite Score = Disease r=-.43, p=0.03 to (62.7±13.5 0.64, p=<.001 y/o) Condition 1= N = 26 r=0.43, p.0.03 Condition 2= r=0.16, p=0.43 Condition 3 r= -.60, p=<.001 Condition 4 r= 0.54, p=<.001 Differentiation between fallers/non- fallers mean score P=0.04

Cohen HS, Community- NA NA NA NA NA NA Individual NA 2019 dwelling Test: ROC outpatient values screen for 0.67-0.84 vestibular yaw & disorders pitch head n=292 healthy movements controls n=90 vestibular patients

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Community Howe et TBI, undergoing Content validity with Inter, inter, test- 9.6 (SEM & NA NA NA NA NA Balance & al, 2006 inpatient and Therapist Global Rating retest reliability Cronbach’s a Mobility Scale outpatient Scale r = 0.62, P<0.001 & internal (CB&M) neurorehabilitation Construct validity with consistency N = 36 self-paced gait & max ICCs of 0.977, Phase 1 (31±9 y/o) gait velocity; r =0.53 0.977, 0.975 & Phase 2 (34±12 and r =0.64 at P<0.001 Cronbach’s y/o) respectively alpha 0.96 respectively

Knorr et Stroke community- Convergent validity NA Sensitivity to NA NA NA NA NA al., 2010 dwelling & with BBS, TUG, change, ambulatory Chedoke McMaster SRM = .83 (62.6±12 y/o) Stroke Assessment (ratio of mean N = 44 (CMSA) change in TUG &BBS P<.01, p scores divided = .70 -.83 by SD of CMSA, p= .67 at change P<.001 scores), P = <.001

Inness et Traumatic brain Construct validity with NA NA NA NA NA NA NA al., 2011 injury inpatient and Spatiotemporal Gait outpatient private measures, ABC and clinic undergoing Community integration neurorehabilitation, Questionnaire (CIQ) ambulatory CIQ r = 0.54, p<0.001 (18-60 y/o) ABC r = 0.60, p 0.011 N = 35 Spatiotemporal Gait Measures p < 0.05; moderate to excellent correlation with velocity, step length, step width, step time; correlation with dynamic instability, step time & step with variability, p<0.001

Weber et adults (60-70 y/o) correlated with multiple Interrater ICC2, NA NA NA NA NA NA al., 2018 participants other outcome measures k = 0.97; Intra- including TUG; rater ICC3, k = Internal consistency 1.00 alpha = 0.88

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV CONFbal Simpson et al Older people (mean 81 y/o) Cronbachs alpha ICC 0.95 3 points NA NA NA NA NA 2009 in day centers 0.91

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Conley Scale Palese et al., 2016 Acute Medical Unit (>65 Cronbachs alpha ICC 0.95 3 points NA 60.0 55.9 NA 98.5 y/o) 0.465

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Demura’s Demura et Healthy With Tokyo NA NA ≥ 1 point of 14.4% (total NA Odds ratios NA Fall Risk al., 2010 community- Metropolitan each of 5 risk score); 39.7% calculated for Assessment dwelling Institute of factor scores; (independent each risk factor Chart adults (≥ 60 Gerontology risk factor score & total (DFRA) y/o) (TMIG) scores) score; ≥ 3 points = odds ratio of ≥ 5 Demura et Healthy With TMIG NA NA Overall score .306; .072 NA NA al., 2012 community- 22 pts AUC .68(CI dwelling 95%) adults (≥60 y/o) PF-3 score 1 .869; AUC .797 .657 point (CI 95%)

Pf-4 score 2 .869; AUC .946 .906 pts (CI 95%)

Demura et Healthy NA Total score = NA Total Score >2 NA NA Total Score OR NA al., 2011 community- Test –retest pts 5 dwelling ICC .956, N adults (≥ 60 = 172 y/o)

Demura et Healthy NA NA NA Potential for .87; AUC .80 .66 NA NA al., 2013 community- falling 1 point (CI 95%) dwelling adults (≥ 60 Physical .40; AUC .63 y/o) function 10 pts (CI 95%) .81

Diseases & .30; AUC .63 .87 Physical 5 pts (CI 95%)

Behavior & .53; AUC .67 .75 character 3 pts (CI 95%) Environment 1 point .78; AUC .54 .27 (CI 95%)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV

Downton Nyberg et Geriatric stroke ≥ 3 high fall risk 91% 27% 44.4%; 81.5% Fall Risk al., 1996 rehabilitation unit Odds ratio Index 3.5

Rosendahl Residential care ≥ 3 high fall risk 91% 39% 36% fall et al., 2003 facility (81± 6 y/o); risk high 47% dementia 45% risk group; depression 32% 5% low stroke risk group

Vassallo et Geriatric general Predictive validity ≥ 3 high fall risk 92.2% 35/8% 33.1% CI 92.9% al., 2008 rehabilitation ward with STRATIFY CI CI 95% CI no significant 95%; 95% 95% difference

Bueno- Public hospital; all Poor external 58% 62% 1%; odds 99% Garcia et diagnoses validity in this ratio 2.31 al., 2017 population

Mojtaba et 6650 hospitalized Among individual The cutoff al., 2018 patients modules, only 3 points previous falls (IRR significantly 2.58, 95% CI 2.22 associated with to 3.01) and fall-related injury unsafe gait (IRR (IRR 1.94, 1.79, 95% CI 1.53 95% CI 1.60 to to 2.09) were 2.38). associated with fall-related injuries. Majtaba et Australian hospital, Concurrent validity ≥3 pts al., 2019 (>65 y/o) with fall-related n= 6650 injuries & high fall Stratified analysis risk at 6 months by gender IRR 1.94, 95% CI 1.60-2.38

Stratified Analysis higher risk for men 95% CI

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Dynamic Shumway- Community- Balance Self- Interrater r = .96; Test- NA ≤ 19 pts 59% 64% NA NA Gait Index Cook et al., dwelling adults (≥ Perceptions Test, retest r = .98; N = 44 (DGI) 1997 65 y/o) Berg Balance Test r = .76

Whitney et Adults (mean age NA NA NA ≤ 19 pts Odd NA NA NA al., 2000 62.5 y/o) with ratio vestibular disorder 2.58 at 95% Whitney et Outpatient With Berg Balance NA NA NA NA NA NA NA al., 2003 vestibular and Scale; r = .71; p < .01 balance dysfunction (Ages 14-88 y/o)

Wrisley et Outpatient NA Interrater k = .68; NA NA NA NA NA NA al., 2003 vestibular disorders Spearman Rho r = .95, (Ages 27-88 y/o) P < .0001; N = 30

Whitney et Outpatient NA NA NA ≤ 18 pts for 70% 51% NA NA al 2004 vestibular disorders previous 6 (Ages 14-90 y/o) month fall

Hall et al., Outpatient NA NA NA NA 77% 90% NA NA 2004 unilateral vestibular hypofunction (Ages 28-86 y/o)

Legters et Outpatient, With Activities- NA NA NA NA NA NA NA al., 2005 peripheral specific Balance vestibular disorder; Confidence Scale (Ages 24-87 y/o) (ABC); Total Sample: r = .58 (p < .0001); Mild-Mod vestibular weakness: r = .72 (p < .0001;

Severe-Total vestibular weakness: r = .48 (p < .0001)

McConvey Individuals with With 6.1 m Timed Interrater .983 (P<.05); NA NA NA NA NA NA et al., 2005 Multiple Sclerosis Walk; -.801, P<.01 Intra-rater reliability .910-.976 (p = .05); N =10

Dibble & Individuals with NA NA NA Previous .75 .30 NA NA Lange, 2006 Idiopathic research: ≤ 19 Parkinson’s Disease; (Ages 39- Current .89 .48 90 y/o) research: 22

Hall & Adults with NA Test-retest ICC 3,1 NA NA NA NA NA NA Herdman, peripheral = .86 2006 vestibular disorders

Marchetti & Individuals with 4-Item Test Interrater Kappa .54 NA 4-Item test 85% 75% NA NA Whitney, and without Cronbach’s alpha .89 - .80 <12 2006 vestibular and balance dysfunction 8-Item Test 8-Item Test < 86% 86% (Ages 14-91 y/o) Cronbach’s alpha .92 19

Cattaneo et Individuals with Berg Balance NA NA NA NA NA NA NA al., 2006 Multiple Sclerosis; Scale .78 TUG.72 (mean age = 45 y/o) Hauser De- ambulation Index .8 Dizziness Handicap Inventory -.39; ABC .54

Jonsdottir et Individuals with With Berg Balance Test-retest ICC .96 NA NA NA NA NA NA al., 2007 stroke, Scale r = .83 Interrater reliability rehabilitation ABC r = .68 ICC .96 outpatient Timed Walking Test r N = 25 = -.73 TUG r =-.77

Cakit et al., Individuals with With UPDRS motor NA NA NA NA NA NA NA 2007 Idiopathic subscale Parkinson’s Disease r = -.643, p < .01 Fall history R = .643, p < .01

Landers et Individuals with Discriminant: fallers NA NA NA NA NA NA NA al., 2008 Idiopathic 16.1 SD = 3.4 Parkinson’s Disease Non-fallers 19.6 SD = 2.6, p < .01

Lin et al., Individuals with With DGI-4 & Test-Retest ICC .94 4.0 NA NA NA NA NA 2010 stroke, outpatient Functional Gait (CI 95%) rehabilitation Assessment r > .91

Jonsson et Hospital and NA Hospital: Intra-rater NA NA NA NA NA NA al., 2011 outpatient ICC .90 rehabilitation center Interrater ICC .92; N with fall hx (≥ 65 =24 y/o) Rehabilitation Center: Intra-rater ICC .89 Interrater ICC .82: N = 24

Huang et al., Outpatient NA Test-Retest ICC .84 2.9 NA NA NA NA NA 2011 individuals with (CI 95%) (13.3) movement disorders (mean age 67.5 y/o)

Romero et Community- NA NA 2.9 NA NA NA NA NA al., 2011 dwelling, fall or (95%) near fall history (> 65 y/o)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Elderly Cwikel et Community- Concurrent with NA NA 2+ 83% 69% 66.7% NA Fall al. 1998 dwelling physician examination physician physician (physician); Screening adults (> 60 Predictive with f/u RR > 3.0 for Test y/o) interview fall related parameters

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Elderly Smith et Frail elderly With Barthel Index NA NA NA NA NA NA NA Mobility al., 1994 (70-93 y/o) (BI) (Spearman’s Scale Rho .962); Functional Independence Measure (FIM) (Spearman’s Rho .948) Prosser et Hospitalized With Barthel Index (r Interrater .88, NA NA NA NA NA NA al., 1997 elders; N = 66 = .79, p < .0001) p < .0001

Spilg et al., Community- EMS, Functional NA NA Low risk ≥ NA NA NA NA 2003 dwelling and Reach and Barthel 20 residential Index at discharge, for recurrent care elderly significantly falls s/p DC with mobility associated with the from problems risk of having two or geriatric Day (≥ 60 y/o) more falls (p = 0.008, Program 0.017 and 0.031) Yu et al., Elders, NA NA NA Functional 93.3%/CI 93.3% NA NA 2007 residential Mobility 95% CI 95% homes 13/14 Nolan et Acute Modified Rivermead Intra- NA NA NA NA NA NA al., 2008 hospitalized Mobility Index reliability 0.72 (≥ 55 y/o) (MRMI)p= .887, p < .05, CI 95%

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Euroqual (EQ- Brazier J et General practice Concurrent Spearman Rank NA Poor NA NA NA NA 5D al., 1993 patients; (16-70 validity with SF- correlation coefficient sensitivity at y/o); n=1980 36 range 0.48-0.60 the high Construct validity: (p<0.01) ceiling no statistics presented

Van Agt HM General population NA Test-retest analysis NA NA NA NA NA NA et al., 1994 n=208

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Falls Handicap Rai et al., 28 hospital patients validated with fall NA NA NA NA NA NA NA Inventory 1995 with fall history (78 efficacy scale (r = ± 5.6 y/o) -7.5, p< 0.0001)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Fall Perception Goncalves et Community- Content validity NA NA NA NA NA NA NA Questionnaire (F al., 2017 dwelling older coefficient RAQ) adults (> 60 y/o); 3 (VC): .71-.80 for focus groups of 3-5 the 3 categories participants

Methodological quantitative study with VC to evaluate item content, representativeness of the measure based on analysis of 3 judges

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Falls Finlayson ML, Adults with Rasch Validation: NA NA NA NA NA NA NA Prevention Peterson EW, Multiple Analysis indicated that the Strategy Fujimoto KA, Sclerosis rating scale structure (i.e., Survey Plow MA, response options) was valid. Of 2009 the original 19 items, 8 of them misfit and needed to be dropped to obtain a valid instrument under the Rasch model. With the final 11 items, the instrument was able to distinguish participants of different ability levels across a range of 11.58 logits.

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Fall Risk for Russell, M et Community- n = 20 concurrent study with; Inter- NA 18/19 71.3 56.1 NA NA Older People al., 2008 dwelling Functional Reach: r = .50 95% reliability .8 % 95% in the older adults CI 1 & intra- 95% CI Community (> 60 y/o) TUG: r =.62 95% CI reliability.9 CI (FROP-COM) 27 days post 3, 95% CI ED n = 20 (reliability) n = 34 (predictive)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Fall Clemson et Community-dwelling older Content validity index Test-retest NA no cutoff NA NA NA NA Behavior al., 2003 adults. nursing home and 28/30 items, CVI=93; reliability ICC scores Scale hospital-based residents Construct validity: scores =.94 (p<.01) established excluded positively associated with increasing age (rs = .46, p <.01); negatively associated with physical mobility (rs = .68, p <.01)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Falls Yardley et Community- NA Excellent NA NA NA NA NA NA Efficacy al., 2005 dwelling internal and test- Scale - Int older adults retest reliability Cronbach’s alpha .96 (ICC .86) Delbaere et Community- Content Validity: .93 ICC=.79 NA Fall concern: NA NA NA NA al., 2010 dwelling Positive associated with associated with 16-19 low older adults increase in age concern (mean age (rs=46, p<.01) 20- 77.4 y/o) Neg association with greater physical 27=moderate mobility (rs=-.68, p<.01) concern and leaving the home more often in the 28-64 high past week (rs=-.51, p<.01) concern Hauer et al., Cognitively NA Test-retest NA NA NA NA NA NA 2010 impaired ICC .96 older adults (mean age 82.5 y/o) Hauer et al., Older adults NA Test-retest NA NA NA NA NA NA 2011 without ICC .58 to .92 cognitive Excellent impairment internal (mean age consistency 81.6 y/o) (Cronbach’s alpha=.92) Morgan et Vestibular – Criterion validity: Test-retest 8.2 NA NA NA NA NA al., 2013 (mean age 54 excellent correlations with Activities ICC .94 y/o) Balance Confidence Scale (ABC) (scores: -.84 Dizziness Handicap Inventory (DHI) r=.75 Vestibular Activities and Participation (VAP) (r=.78) Adequate correlations: gait speed (r=-.55) Dynamic Gait Index (DGI) (r=-.55)

Dewan and Community- NA Test-retest NA NA NA NA NA NA MacDermid, dwelling ICC .96 2014 older adults

Visschedijk Older adults Internal consistency 3rd or 4th week Inter-rater 17.7 NA NA NA NA NA et al., 2015 s/p hip after SNF admission = (Cronbach’s reliability fracture alpha = .94) ICC.72 (mean age 83.1 y/o)

FES-I Kempen et Community- Correlation with FES-I = .97 Internal and test- NA NA NA NA NA NA short al., 2008 dwelling retest reliability older adults excellent with (> 60 y/o) Cronbach’s alpha .92 (ICC .83)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Fear Chugh EJ et 55 patients Construct Validity NA NA NA NA NA NA NA Avoidance al., 2013 with LBP FABQ-P Beliefs (mean age = -with FABQ-W significant Questionnaire 46 y/o, range correlation (r=0.496 p=0.00) 19-76) -with VAS significant correlation (r=0.0320 p=0.017) -with FABQ total significant correlation (r=0.794 p=0.00 -with RMDQ Roland Morris Disability Questionnaire significant correlation (r=0.372 p=0.005) -with Osteresky Disability Questionnaire no significant correlation (r=0.199 p=0.146)

Dedering &. 46 patients FABQ has concurrent validity Test retest NA NA NA NA NA NA Börjesson, with cervical for patients with cervical reliability: 2013 radiculopathy radiculopathy Good to moderate (Age-49± 9.8 for FABQ y/o); 41 Good correlation (spearman Weighted kappa healthy correlation coefficient >0.50) values (k-value is participants between FABQ-PA with TSK good if >0.60) (Age-44±6.6 (0.62) FABQ-PA -0.50 y/o) FABQ-W-0.67 Poor correlation between TSK (good) with FABQ-W (0.32) and FABQ SUM-0.68 FABQ-SUM (0.47) ICC of FAQB SUM -0.93

Internal consistency Cronbach’s Alpha = 0.89

Merrill et al., 64 ROC Curves & area under NA NA NA NA NA NA NA 2016 participants curve: with or Fallers at 1yr after assessment, without 95%CI 0.62-0.91; pathology frequent fallers at 1 year after assessment, 95%CI 0.70-0.95

Predictor variables used: Physical -BBS, TUGT, SSGS, DGI, SOT : Psychological -ABC, FABQ, FES

ABC and FABQ were the best at predicting future falls both independently and when compared against other predictor variables.

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Figure 8 Hess et al., 51 NA Interrater reliability NA NA NA NA NA NA Walk 2010 community- ICC (95% CI) Test dwelling older For time: 0.90 adults For number of steps: 0.92 (Mean For smoothness: 0.85 age=76.8±5.5 Test retest reliability y/o) ICC values (95%CI) For time: 0.84 For number of steps: 0.82 For smoothness: 0.64

Wong et 64 subjects NA Excellent intra-rater, inter- NA 8.2 seconds 100 89.2 NA NA al., 2013 (35 with rater and test–retest % % chronic stroke reliabilities (CC range and 29 healthy 0.944–0.999) elderly) Welch et 428 primary NA NA NA poorer NA NA NA NA al., 2016 care patients performance (>65 y/o, of F8WT by Median age = 1 second was 76.5 y/o) associated with 8% greater rate of falls (RR=1.08, CI: 1.03– 1.14) Barker et 74 older adults F8W and TUG were Intra-rater reliability at NA NA NA NA NA NA al., 2019 (> 55 y/o) one correlated for the overall 95% - 1.8 sec. year s/p Total sample (r = 0.921) and Inter-rater reliability at Knee subgroups: Home (r = 0.945) 95%, 1.2 sec. Arthroplasty and Clinic (r = 0.911). F8W in both home and Timed walk test were care and correlated for the overall outpatient sample (r = 0.834) and setting subgroups, Home (r = 0.864) and Clinic (r = 0.793)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Floor Rise Klima et al Community- NA gait speed (r = NA NA NA NA NA NA Test (Supine 2016 dwelling adults −.61; p < .001) to stand grip strength (r = test) −.30; p < .05) Timed Up and Go (TUG) performance (r = .71; p < .001)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Fullerton Rose et al., 46 community- NA Test re-test NA NA NA NA NA NA Advanced 2006 dwellers 0.96 Balance 31 with known Inter-rater Scale (FAB) balance issues 0.94-0.97 and 15 without Intra-rater balance issues 0.97-1.00 Hernandez Independently NA NA NA 25/40 points 74.6% 52.6% 8% increase NA & Rose, functioning older in chance of 2008 adults falls with each 1 point decrease in score Schlenstedt Idiopathic Spearman 0.87 Inter and intra 0.99 NA NA NA NA NA NA et al., 2015 Parkinson’s Disease (>40 y/o) Chauhan & Post-stroke, Concurrent Spearman correlation NA NA NA NA NA NA Padnani, independent validity with coefficient (r) for intra 2019 ambulatory BBS Spearman rater reliability is 0.96; correlation p <0.01; inter rater coefficient (r) reliability Spearman 0.86 p < 0.01 correlation coefficient (r) is 0.972, p < 0.01.

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Functional Mehrholz et Acute stoke, NA Test re-test NA FAC score ≥4 100% for 78% NA NA Ambulation al., 2007 inpatient Kappa .950 predicted community community for Category rehabilitation ambulation following ambulation community setting Inter-rater 4 weeks of rehab at 6 ambulation Kappa .905 months

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Functional Wrisely et Vestibular Criterion Validity: Excellent 8 points NA NA NA NA NA Gait al 2004 (mean age Excellent concurrent validity interrater from Assessment 58.7 y/o) with: Perception Dizziness reliability admissio Symptoms: (r=-.70); (ICC.84) n to Dizziness Handicap follow up Inventory (r=-.64) ABC (r=.64); number of falls in previous 4 weeks (r=-.66), DGI (r=.80); adequate with TUG (r=-.50)

Walker et Community- NA Excellent NA NA NA NA NA NA al., 2007 dwelling Interrater adults reliability healthy (aged (ICC=.93; 40-89 y/o) p<.001)

Thieme et Adults (mean Construct validity: Excellent NANA NA NA NA NA NA al., 2009 age 69.9 y/o) excellent correlation (p<.001) Interrater max 6 month with Functional Ambulatory reliability s/p CVA Category (.83), gait speed (ICC=.94) (.82), Berg Balance Scale (.93), Rivermead Mobility Index (.85), Barthel Index (.71).

Wrisley & Community- Concurrent Validity and NA NA <22/30 85% 86% (+) LR (-) LR Kumar, dwelling statistical significance predicting falls 3.6 0 2010 older adults excellent with BBS r=.84 PPV: (P<.000); TUG r=.84 58% (P<.000); with ABC scale (+) LR r=.53 (P<.001). <20/30 predict 100 76% 5.8 (-) LR Predictive validity: correctly falls in next 6 % PPV: NPV identified 6/7 unexplained months 43% 100% falls in the 6 months s/p the test

Lin et al., Adults (mean Convergent validity: Excellent test- 4.2 (5 NA NA NA NA NA 2010 age 54.9 y/o) Excellent statistical retest point) acute and association at 1st week, 2 reliability 14.4% chronic CVA months and 5 months post (ICC=.95, change therapy with 10MWT 95% CI) (r=.61-.87) and PASS (r=.74-.85)

Leddy et Community- NA Test-retest NA <15/30 72% 78% (+) LR (-) LR al., 2011 dwelling reliability predictive of 3.24 .36 older adults administered fall with by student: PPV NPV Parkinson’s excellent (ICC 59.6% 14.1% Disease =.80; 95% CI=.58-.91) administered by a PT excellent (ICC=.9; 95% CI=.80-.96 Interrater reliability (ICC=.93; 95% CI =.84-.98)

Ellis et al., Adults with Concurrent validity and NA NA NA NA NA NA NA 2011 Parkinson’s statistical sig Excellent with: Disease Berg Balance Scale (r=.77), PDQ-39 mobility subsection (r=. -66), postural instability score (r=-.68) Adequate with PDQ39 total score (r=-.57), age (r=-.44), bradykinesia composite score (r=-.55), freezing of gait score (r=-.54), functional reach (r=.52), 9 hole peg test (r=-.52)

Duncan et Adults with NA NA NA <15/30 (+) LR (-) LR al., 2012 Parkinson’s 6-month 3.37 .44 Disease prospective 64% 81% PPV NPV falls 56% 15% (+) LR (-) LR 12 months 46% 81% 2.42 .67 prospective PPV NPV falls 54% 24%

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Functional Hobart JC Inpatient Neuro Item Validity: Intra-rater NA NA NA NA NA NA Independence et al., 2001 rehabilitation; n = Disability- 0.82, reproducibility: Measure (FIM) 149 (age 16-77 y/o, Cronbach’s alpha; 0.98, ICC mean 46.2 y/o) Handicap, physical health status, mental health status psychological distress, global cognitive function, responsiveness ranged 0.10-0.48

Internal Consistency: 0.53-0.87, Alpha coefficient 0.95

Concurrent Validity with Barthel Index, 18- item FIM, 30-item FIM+FAM: Pearson’s r=0.96-0.996, ICC =0.95-0.995

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Functional Katz- Older adults s/p Responsiveness to test-retest ICC NA NA NA NA NA NA Reach Test Leurer, et acute CVA paretic side (effect range 0. 90 – al., Reliability n=10, size 0.80) forward 0.95 2009 (mean age 63 y/o) and nonparetic side Validity n=35, (effect size 0.57 – mean age 60 y 0.60)

Merchán- Older adults s/p NA Inter-rater 0.987 NA NA NA NA NA NA Baeza, et acute CVA intra-rater 0.983 al., n=5 2014 (mean age 76.7 y/o)

Bohannon, Hypertensive NA NA NA Hypertensive NA NA NA NA et al., adults, n=199 grp 27.5 cm 2017 (mean age 80.6 y/o) (SD 7.2cm) Consolidated data Consolidated from 20 studies, data 27.2 cm n=7535 (SD 0.9cm)

Modified Thomas & Frail elderly NA Intra-rater NA 18.5 cm; OR 75% 67% Fallers vs. NA Functional Lane, 2005 (>65y/o); n=30; reliability: .087, 5.28, CI 95%, at CI at CI non-fallers: Reach Test fallers (79.7 y/o) ICC P=.076 95% 95% t=2.024, non-fallers (81.4 P=.053, y/o) Power=.46

Outcome Measure Reference Population/ Psychometric property Fall Predictability Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV

Modified VanSwearingen Community- Concurrent Intra-rater NA NA NA NA NA NA Gait Abnormality et al., 1996 dwelling validity: gait reliability: Kappa Rating Scale speed r = - 0.493-0.676 0.679 ICC 0.95-0.984 Interrater Reliability: Kappa 0.789-0.886 ICC 0.968-0.975

Outcome Measure Reference Population/ Psychometric property Fall Predictability Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV

Gait Efficacy Scale Newell et al., Community- FES r 0.80 Test-retest NA NA NA NA NA NA (modified) 2012 dwelling ABC Scale reliability: ICC 0. older adults 0.88, and 93 (95% CI 0.85- Late Life 0.97) FDI Overall SEM 5.23 functional Subscale r = 0.88

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV

Gait Verghese J Community- NA NA NA Risk ratio (RR) for NA NA NA NA Speed et al., 2009 dwelling older falls per 10 cm/s adults (mean decrease gait speed age 80 ±5.4 <70 cm/s = slow gait, y/o). n=597 RR 1.540, 95% CI 1.095-2.150 70-100 cm/s, RR 1.276, 95% CI 0.906- 1.768 Peel et al., Community- NA NA NA Community-dwellers NA NA NA NA 2012 dwelling adults, 0.58 m/s usual pace hospital and 0.89 m/s maximal inpatient, pace; acute inpatient outpatient 0.46 m/s; outpatient settings settings 0.74 m/s Kon et al., Community- NA Inter-rater: Slow: NA NA NA NA NA 2012 dwelling older ICC 0.99 <0.8m/s adults with Test- Normal: COPD (Gold retest: ICC >0.8m/s Stage II-IV) 0.97

Hiengkaew Individuals with NA Comfortab (MDC 95%) NA NA NA NA NA et al., 2012 chronic stroke le speed: Comfortable +6 months from 0.96 speed: initial event Fast 0.18m/s (63.5±10.0 y/o) speed: Fast speed: 0.98 0.13 m/s

Peters et al., Healthy older 0.99-1.00 Test re- 4m: 0.02 NA NA NA NA NA 2013 adults between test ICC m/s stopwatch 10 m 10m: 0.01 and walk: 0.98 m/s automatic 4 m walk: timer 0.97

Elbers et al., Community NA NA NA 0.88m/s to predict NA NA NA NA 2013 ambulators with community Parkinson’s ambulation (70% Disease accurate) (67±7.54 y/o)

Blankevoort Older adults NA 6 m walk 6 m walk NA NA NA NA NA et al., 2013 with dementia test ICC test = 0.27 from nursing 0.86 m/s homes/day care centers (82.57 ±5.31 y/o)

Bijleveld- Community NA NA NA NA 0.89 0.70 0.92 (CI 0.61 Uitman et ambulatory with (CI (CI 95%; 0.89- (CI al., 2013 history of stroke 95%;0. 95%;0. 0.95) (95%; who completed 85– 58– (0.51– both an inpatient 0.91) 0.80) 0.70) and outpatient program

Bohannon et Stroke patients NA NA MDIC 0.13 NA 0.810 0.714 NA NA al., 2013 in inpatient m/s rehab (62.0±13.7 y/o)

Bongers et Community- NA NA NA NA NA NA Gait speed NA al., 2015 dwelling older for falls: adults; (mean AUC 0.53 age 76.2 y/o) Gait speed n=352 for recurrent falls: AUC 0.59 Gait speed with age, gender & fall hx for falls: AUC 0.64 and for recurrent falls: AUC0.69

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Geriatric Fear of Huang et al., Summary of 2 R=0.29 Test-retest 0.88 NA NA NA NA NA NA Falling Measure 2006 descriptive cross- p=0.002 (p<0.0001), paired T- sectional studies in with FES tests determined no Taiwanese significant difference in community dwelling mean scores older adults (pilot study n=100 and Inter-rater 0.91 for Risk follow up validation prevention, 0.94 for n=354) psychosomatic symptoms, and 0.89 for modifying behavior subscales at p<0.001 for all

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Global Reisberg et al., Elderly (65 y/o or Stage NA NA NA NA NA NA NA Deterioration 1982 older) with stages of progression Scale (dementia dementia correlated assessment with CT instrument) scan: p<0.05

Reisberg et al., 38 dementia patients NA Test-retest: Pearson’s NA NA NA NA NA NA 1988 correlation coefficient:0.92

Gottlieb et al., 43 possible NA Inter-rater: ICC = 0.82 NA NA NA NA NA NA 1988 Alzheimer’s Disease patients

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Gorningen Kempen et al., 4789 Concurrent 0.91 NA NA NA NA NA NA Activity 1996 community- validity against Restriction Scale based SF-20 (0.79) participants (age 57-85 y/o)

Metzelthin et al Older adults With GFI: NA NA NA NA NA NA NA 2011 (over 70 y/o) r = 0.57 With TFI: r = 0.61 With SPQ: R = 0.46

Wales et al. Hospitalized NA NA MDC: 7.04 NA NA NA NA NA 2017 older adults

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Grip Sayer et al., 2148 participants NA NA NA NA NA NA NA NA Strength 2006 from UK (59-73 y/o); falls had significantly lower grip strength

Pijappels et 17 healthy older NA NA NA Discriminative 86% 80% NA NA al., 2008 adults (70±4.5 model fallers vs y/o) non-fallers, no value reported

Xue et al., 352 women (74 NA NA NA NA NA NA NA NA 2011 y/o) declined grip strength inversely correlated with rate of falls

Silva et al., 24 with NA Inter-rater 6.34- NA NA NA NA NA 2015 Parkinson’s (65.5 reliability 7.4mmHg ± 6.2 y/o) and 26 ICC (2, 1) = healthy subjects 0.79-0.89 (63.4 ± 7.2 y/o) Bertrand et 34 adults with NA Test-retest 2.73- NA NA NA NA NA al., 2015 acute stroke (18- reliability 4.68Kg 80 y/o) ICC = 0.95- 0.99

Agular et al., 12 adults with Concurrent Intra-rater 95% CI NA NA NA NA NA 2016 subacute stroke validity with reliability 0.96- Berg (ρ=.91; ICC (2, 1) = 6.12Kg P<.01) 0.64-0.99 with gait Inter-rater speed (ρ=.67; reliability P<.01) ICC (2, 1) = 0.66-0.99

Vasconcelos 1374 community- NA NA NA Predict mobility Men Men NA NA et al., 2016 dwelling frail limitation 69% 73% older adults in Men= 25.8Kg Women Women Brazil Women=17.4Kg 60% 66%

Jenkins et 257 older adults NA Test-retest 2.67-5.5 NA NA NA NA NA al., 2017 with sarcopenia reliability Kg (98 men, 159 ICC = 0.93- women) 0.97

Sampaio et 578 older adults NA NA NA Predict fear of Men Men Men Men al., 2017 from community falling 39% 94% 0.81 0.71 centers of south Men=30Kgf; Brazil (70±6.7 Women= 21.7 Kg Women Women Women Women y/o) 29% 73% 0.67 0.36

Ikegami et 415 community NA NA NA Shift of one NA NA NA NA al., 2019 older adults Standard deviation (Japan) increased fall risk by 39%

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Hauser Syndulko et Patients with NA Test-retest: NA NA NA NA NA NA Ambulation al., 1996 chronic ICC= 0.91 Index progressive Multiple Sclerosis

Sharrack et 64 individuals NA Intra-rater: NA NA NA NA NA NA al., 1999 with Multiple ICC= 0.93 Sclerosis Interrater: ICC= 0.96 Cattaneo et 51 patients With Berg With NA NA NA NA NA NA al., 2006 with Multiple Balance Scale: r= Functional Sclerosis 0.74 Independence Measure: With Dynamic r=0.73 Gait Index: r=0.80 With Barthel Index = r-0.72 With TUG: r= 0.74 With SF-36 physical With ABC scale: functioning: r=0.45 r=0.87

With Dizziness Handicap Inventory: r=0.32

Outcome Reference Population/ Psychometric Property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff Score Sn Sp PPV NPV Hendrich II Ivziku et al. Older adults NA Inter-rater NA Score of > 0.86 0.43 0.11 0.97 Fall Risk 2011 (65+ y/o) in reliability: 0.87 or equal to (CI (CI (CI (CI Model geriatric (CI 95%: 0.71- 5 = at risk 95%: 95%: 95%: 95%: unit of 1.00) for falling 0.67- 0.34- 0.051- 0.94- hospital 1.04) 0.51) 0.17) 1.01)

Aranda- Acutely NA NA NA NA 0.628 0.640 NA NA Gallardo et hospitalized (CI (CI al adults 95%: 95%: 2013 (n=13,284 0.549- 0.630- included in 0.702) 0.651) analysis)

Nassar et al. Adult patients NA NA NA NA 55.2% 89.3% 16.5% 98.3% 2013 on the medical, surgical, oncology, and critical care units at a medical center

Jung and Acutely NA NA NA NA 0.80 0.59 NA NA Park hospitalized (maximum (maximum 2018 adults (15,480 point) point) total included in analysis)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV High Level Kleffelgaard Patients with NA Inter-rater +/- 3.25 NA NA NA NA NA Mobility et al. 2013 mild TBI at Oslo reliability: 0.99 points Assessment Tool University (95% CI = .98- Hospital 1.00) Intra-rater reliability: 0.95 (95% CI = .89-.98)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV

Home Falls and Mackenzie et 40 home visits, in NA Inter-rater NA NA NA NA NA NA Accidents al., 2002 urban and rural reliability: 0.62 Screening Tool settings, by pairs of raters, one of whom was an expert rater.

Vu et al., Community- NA Inter-rater: 0.82 NA NA NA NA NA NA 2012 dwelling older (95% CI, 0.66- adults (over 65 0.91) y/o) Test-retest: 0.77 (95% CI, 0.57- 0.88)

Mackenzie et 567 older women NA NA NA 9 73.9% 37.9% 30.6% 79.7% al., 2018 (mean 77.5 y/o) survey

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV International Kurtze, et 108 men (aged 20–39 Vigorous PA, hours ICC 0.30 for NA NA NA NA NA NA Physical al., 2008 y/o) per week and days moderate Activity were most strongly activity hours, Questionnaire correlated 0.80 for sitting (respectively 0.41, hours 0.40 and 0.36, r= p ≤ 0.01) with VO2max

Short version Lee et al., 23 studies from USA, Small effect size NA NA NA NA NA NA NA 2018 Japan, Hong Kong, when validated (systematic Switzerland, Canada, against other fitness review) etc. measurements Populations include military, chronic fatigue syndrome, schizophrenia, fibromyalgia, school students

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV L Test of Barry, et 93 people with unilateral NA ICC .96 for NA NA NA N NA NA Functional al., 2005 amputations (74% interrater A Mobility transtibial, 26% reliability transfemoral; 78% male, and .97 for 22% female; mean intra-rater age=55.9 y/o) from reliability outpatient clinic

Rushton, et 33 adults with LE NA NA MCID NA NA N NA NA al., 2015 amputation (mean age 4.5 s A 60 ± 13.0 y/o)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV LASA Pluijm et 1365 community NA NA NA cutoff point of 59% 71% NA NA Fall Risk al., 2006 -dwelling 65 5 (range 0–30) Profile years and older (mean age 75.3±6.4 y/o) cutoff point of 10 31% 92%

Peeters, et 408 adults (mean Area under NA NA 8 56.6% 71.4% 34.1% 85.6% al., 2010 age 77.9 ± the receiver (CI: 51.8, (CI: 67.0, (CI: 29.5, (CI: 82.2, 7.1y/o) 73.3% operating 61.4), 75.8), 38.7), 89.0) female (AUC) characteristic curve was 0.65(95% CI: 0.58, 0.72)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Late-Life Jette et al., 150 NA Test-retest NA NA NA NA NA NA Function 2002 community- ICC (.68–.82) and dwelling Disability older adults, Instrument (mean age 75.9±8.5 y/o)

Haley et 150 NA Test-retest NA NA NA NA NA NA al., 2002 community- ICC (.91 dwelling to .98). older adults, (mean age 75.9±8.5 y/o)

Sayers et 101 men and Moderately associated with the NA NA NA NA NA NA NA al., 2004 women (aged SPPB (r 5 0.65, Po.001), 400-m 80.8 + 0.4 W gait speed (r 5 0.69, Po.001) y/o)

Beaucham 17,301 adults There is extensive evidence to NA NA NA NA NA NA NA p, et al., support the construct validity and 2014 sensitivity to change of the LLFDI among various clinical populations of community- dwelling older adults. Further work is needed on predictive validity and values for clinically important change.

Pandya et 181 African Cronbach alpha 0.91 NA NA NA NA NA NA NA al., 2016 American breast cancer survivors (59.7 ± 7.2 y/o)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Missouri Calys et al., Homecare Correlated NA None ≥ 4 96.9 13.3% NA NA Alliance for 2012* retrospective with CT reported % Home Care analysis (n = 2247) scan: (MAHC-10) p<0.05

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Melbourne Barker et al., 87 hospital and NA Kappa k = NA NA NA NA NA NA Fall Risk 2009* nursing home 0.21 Assessment residents, Tool (MFRAT) (81.6±10.7 y/o)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Minimal Chair Reider et al., 167 community- NA NA NA 34 cm Fallers vs Non- 75% 62% NA NA Height 2015 dwelling older Fallers Standing adults (83.6±1.3 Ability y/o)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Mobility Lundin-Olsson 78 residential care NA 80% NA Classified as high risk of NA NA 78% 88% Interaction Fall et al., 2000 facility residents 82 agreement falling, i.e., stopped (CI (CI = Chart y/o (66-99) in (Kappa k = walking at turns 67- 79- Sweden 0.6) (log rank test 39.1; 87%) 95%) p<0.001; hazard ratio 12.1; 95% CI 4.6–31.8).

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Morse Fall Baek et al., Retrospective 51 (AUC = 0.77) 0.72 0.91 0.63 0.94 Scale 2013 inpatient (hospital data) Nassar et al., 1815 Cronbach’s Inter-rater 51 0.37 0.54 0.124 0.98 2013 inpatient/hospital alpha r = 0.64 reliability ICC = data 0.9 McKechnie et Systematic review Reliability < 25 pts low fall risk 78% 83% 10% 99% al., 2016 established prior 25-44 points; moderate to 2015 fall risk; > 45 high fall risk Sardo et al., 8356 hospital 45 correlated with 2016 patients diagnosis and length of say Bórikova et Long term care 44 correlated with fall al., 2018 residents history

Reference Population/ Psychometric property Fall Predictability Outcome Diagnosis Measure Validity Reliability MDC Cutoff score Sn Sp PPV NPV Motor Kinugasa et Community NA 0.92 NA NA NA NA NA NA Fitness al., 1998 dwellers n=62 Scale Aoyama et al., Community NA No associate with NA NA NA NA NA NA 2015 dwellers n=99 fallers or non- fallers

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Multiple Wagenaar et n=130 community NA 0.79-0.88 NA NA 73 63 NA NA Lunge Test al., 2012 dwellers % %

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Multiple Nilsagard et Community- NA NA NA ≥ 75 pts 52 82 83 50 Sclerosis al., 2009 dwellers with Walking Scale- Multiple Sclerosis 12 n=82 Motl et al., Community- Comfortable NA NA NA NA NA NA NA 2010 dwellers with walking speed Multiple Sclerosis 0.64; Fast walking speed 0.62

Cavanagh et Community- BBS -0.78 NA NA NA NA NA NA NA al., 2011 dwellers with Multiple Sclerosis n=21

Motl et al., Community- NA 6 month NA NA NA NA NA NA 2011 dwellers with 0.86; 12 Multiple Sclerosis; month 0.87 N = 260 Learmonth et Community- NA NA 22 points for NA NA NA NA NA al., 2014 dwellers with functional Multiple Sclerosis mobility n=82 Motl et al., Community- NA NA 4-6 points NA NA NA NA NA 2014 dwellers with with changes Multiple Sclerosis in walking n=82 ability Goldman et al., 159 people with Benchmark scores NA NA NA NA NA NA NA 2017 Multiple Sclerosis reflect to levels of function

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV

Norwegian Linghammer et al., Community-dwelling Falls were not NA dependence NA NA NA NA NA General Motor 2016 older adults correlated to 2.8 points, Function NGMF pain 4.9 (NGMF) points and assessment insecurity 6.1 scale points→ but none for falls

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV

Peninsula Stapleton et al., 2009 Multi-campus NA high NA NA NA NA NA NA Health Fall setting of an Aged Care reliability Risk and Rehabilitation (ICC = Assessment Peninsula includes 0.79) Tool (PHRAT) inpatient rehabilitation, hospital, nursing home, and psychogeriatric beds (mean age 78.8 y/o)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Physical Activity Stewart et al., Underactive Construct validity Test-retest NA NA NA NA NA NA Questionnaire 2001 community- with 6 Min Walk reliability 6 month (CHAMPS dwelling older Test, Self-Reported N = 91: Physical Activity adults, (65-90 y/o) Physical Caloric expenditure Questionnaire) n = 249 Functioning, 0.22- ICCs 0.67 - 0.66; 0.30, P < .001 Frequency measures ICCs 0.58 -0.62

Harada et al., Older community- Construct validity Test-retest NA NA NA NA NA NA 2001 dwelling and with Physical reliability 2 weeks: retirement home Activity Survey for All physical adults, (64+ y/o) the Elderly (PASE) measures ICCs = n = 87 &Yale Physical 0.59-0.69 Activity Survey Moderate-intensity (YPAS) 0.58- 0.68, measures ICCs = P < 0.0001 0.72-0.79

Hekler et al., Older community- Concurrent validity Test-retest NA NA NA NA NA NA 2012 dwelling adults with accelerometer, reliability, N = 748 (65+ y/o) n = 850; Spearman ICCs = 0.56-.70 n = 870 rank-order p = 0.06 -0.40, P < .001

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Physical Nitz et al., Adults, Concurrent validity Inter-rater NA NA NA NA NA NA Mobility 2006 residential care Rivermead Mobility reliability ICC Scale (35-90 y/o) Index (RMI) & 0.68-0.88 n = 9 Clinical Outcomes Variable Scale Physical (COVS) Therapists n = ICC .69-.90, P < 19 0.001

Barker et Older adults, Internal construct Inter-rater 4.39 pts, NA NA NA NA NA al., 2008 residential care validity reliability (28 90% facilities Rasch analysis: participants) confidence Cohort 1 – residual mean value k ≥.60 all (85.22±5.1 both cohorts = 0, items except; y/o); Cohort 2 SD=1.21 & 1.52 sitting, stand to (dementia respectively, P>.05 sit, mobility >50%) with k (81.59±10.69 = .46-.59 y/o) n = 189 CI 95% Pike et al., Older adults, NA Intra-rater MDC 3.98 NA NA NA NA NA 2010 long term care reliability ICC pts, 95% (81.4 ± 6.3 y/o) = 0.982 confidence n = 70 MCID 5 pts (n = 60)

Barker et Older adults, NA NA NA NA NA NA High fall risk: NA al., 2012 long term care PMS score 28- n = 87 36; Hazard Ration 1.98, 95%, CI 1.30- 3.03 Low fall risk: PMS score 0-9; hazard Ratio = 0.05 95% CI 0.01- 0.32

100

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Physical Reuben et Community Concurrent validity 9 Reliability 9 NA NA NA NA NA NA Performance al., 1990 and & 7-item tests: & 7-item Test (PPT) retirement Roscow Breslau r = tests: 7 & 9 item home 0.80 & 0.69 Cronbach’s tests dwelling Tinetti Gait score r = alpha = 0.99 older adults; 0 .78 & 0.69 & 0.93 one cohort of KATZ Activities of Inter-rater Parkinson’s Daily Living r = 0.65 reliability: p = Disease; & 0.50 0.99 & 0.93 (mean age 79, range 46- 94 y/o) N = 183; 106 9-item, 179 7-item test

Brown et Community- Concurrent validity NA NA Frailty Cutoff Scores: NA NA NA NA al., 2000 dwelling 9-item test: Not frail 32-36 older adults, Balance – obstacle Mild frailty 25-31 (83 ± 4 y/o) course, Berg Test, Moderate frailty 17-24 N = 107 Full Tandem, Functional Reach r = -.793, .710, .600, .51 1 with P = <.005, .005, .001, .00 5 respectively Gait – Preferred gait speed, Fast gait speed, cadence, stride length, % gait cycle spent in stance, double stance time r = .528, .518, .427, .4 43, .487, .375 with P = < .05, .05, .005, .05, . 05, .001 respectively

101

Lusardi et Community- NA NA NA Cutoff Frailty Scores: NA NA NA NA al., 2003 dwelling 9-item test – older adults 32-36 not frail (82.7 ± 7.9 25-32 mild frailty y/o) 17-24 moderate frailty n = 76 < 17 unlikely to function in community

7-item test – < 19.4 moderate frailty 19.4-24.8 mild frailty

Delbaere Community- NA NA NA NA NA NA OR NA et al., dwelling 4.16, 2006 older adults, 95% (60+ y/o) CI n= 257 2.22- 7.79, P <0.001

Paschal et Community- Test-retest reliability NA 2.5 pts NA NA NA NA NA al., 2006 dwelling ICC 7-item test older adults 0.818; 9-item test with o.895, 95% CI Parkinson’s disease, (62.4 ±6.3 y/o) n = 14

Farrell et Community- 7-Item Test: NA NA Cutoff score with best 83% 41% 1.41, .41 al., 2011 dwelling Intra-tester ICC .99, sensitivity & specificity 19 95% 95% older adults 95% CI pts CI CI with mild to Test-retest reliability moderate ICC .90, 95%CI dementia, (76/6±9.5 y/o) n= 34

102

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Physiological Lord et Community Individual item Individual item NA NA NA NA 75% NA Profile al., 2003 and validation reliability performed accuracy in Assessment institutional performed from from 1989-1996 determining (PPA) older adults 1989-1996 elders at fall (59-99 y/o) risk

Lorbach et Community- NA Test-retest reliability NA NA NA NA NA NA al., 2007 dwelling for visual acuity, older adults contrast sensitivity, with mild to knee extension moderate strength, stability and Alzheimer’s max balance Disease (63- range ICC = 0.78- 91 y/o) 0.90 n = 21 ICCs for tactile Long version sensitivity, ankle PPA dorsiflexion strength, hand reaction time, sway/foam/EC, overall fall risk score 0.43-0.75 ICCs for proprioception, foot reaction time, sway/floor EO & EC, sway/foam/EO 0.18- 0.39 Liston et Older adult Sig difference NA Sway Test of NA NA NA NA NA al., 2012 fallers between all age under 2500 referred to groups for mm2 had fall risk contrast significantly clinics (60- sensitivity, knee better contrast 90+ y/o) extensor sensitivity, n = 865 strength, proprioception Short version Sway/foam, fall , grip strength PAA risk score and lower fall P<0.01 risk scores

103

Sampaio Brazilian NA Intra-rater reliability NA NA NA NA NA NA et al., community - 2014 dwelling composite score .55 older adults contrast (75.2±5.17 sensitivity .94 y/o) proprioception .74 n = 10 strength .93 Short version reaction time .25 PPA sway .24

Inter-rater reliability – composite score .69 contrast sensitivity .93 proprioception .92 strength .95 reaction time .54 sway .62

ICC composite PPA & test components p<.005

Gunn et Outpatient PT NA NA NA NA NA NA Independent NA al., 2018 clinics with prediction Multiple of fallers Sclerosis n = odds ratio 416 1.30, 95% (51±12.0 y/o) CI 1.17-1.46

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Outcome Measure Reference Population/ Psychometric property Fall Predictability Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Push and Release Test Jacobs et al., Community- NA ICC: 0.84- NA NA Trial 1: NA NA NA 2006 dwellers with 0.83 100% Parkinson’s Trial Disease 3:91%

Outcome Measure Reference Population/ Psychometric property Fall Predictability Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Queensland Fall Risk Barker et al., 87 long term NA Test-retest 7.34 NA 61% 49% NA NA Assessment Tool 2009 care residents agreement (QFRAT) (81.59 ± 10.59 k=0.88; Inter- y/o) rater agreement k=0.51

Outcome Measure Reference Population/ Psychometric property Fall Predictability Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Rivermead Mobility Cho et al., Post-stroke Correlation of NA NA NA NA NA NA NA Index 2015 patients; 0.545 to FES (modified 389±236 days and 0.703 to version) BBS

105

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Romberg Olsson 152 Sweden NA NA NA 15 s Sensitivity Specificity NA NA Test Moller et community =22% = 91% al., 2012 older adults (81.5±6.3 y/o)

Grass et n = 100 Convergent Inter-rater reliability NA cutoff:>/=15 Sensitivity Specificity NA NA al., 2017 Mean Age: validity: Eyes open– s (Only 8% =94% =12% 71.8±7.8 SR EO: ICC =1.0 of y/o) correlation with Eyes Closed- individuals BBS (Pearson’s ICC=0.999 could Correlation Intra-rater Reliability perform coefficient with Eyes open- TRT) 95% CI=0.635) ICC=0.786 and TUG (- Eyes closed test 0.647); correlated ICC=0.701 with SR EC Test retest reliability (0.496) and 10 Eyes Open-ICC MWT (0.447), =0.589 p<0.01 Eyes Closed- ICC=0.670

106

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Self- Doba et al., 257 elderly Correlation between self-efficacy and Cronbach’s NA NA NA NA NA NA Efficacy 2016 people score on clinical frailty scale alpha = 0.79 Scale (SES) (82.3±3.8 Significant relationships between y/o) self-efficacy and non-parametric variables like Beck depression inventory score(p<0.001), physical strength or stamina and cognition or memory(p<0.001)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Short Stookey et 43 patients Significant correlation between SPPB NA NA NA NA NA NA NA Physical al., 2014 with stroke and 6 MWT(0.76; P < .001) and Performan (61.5 +/-9.8 between SPPB and peak O2 ce Battery y/o) consumption during a graded exercise test(r = 0.52; P < .001)

Bernabeu- 137 patients Convergent Validity: NA NA 10 77% 70% NA NA Mora et al., with COPD Positive Moderate co-relation with 2015 Mean Age: Quadriceps strength (66.9 y/o, Correlation Coeff-0.49 46-80) Divergent Validity: Positive but weak correlation with hand grip strength (Correlation Coeff-0.28) Lauretani et 451 frail Association with POMA; association NA NA NA NA NA NA NA al., 2018 older adults with fallers OR 0.83; AUC = 0.676 (82.1 ± 6.8 y/o) in a geriatric outpatient clinic

107

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV

Shuttle Bloemendaal et 75 rehab center after correlated to 6- Test-retest: ICC2, 1 SEM = 6% NA NA NA NA NA Walk al., 2012 stroke patients (58.8 min walk test = 0.961 (0.936- ± 9.8 y/o); 0.977) Netherland Houchen- 220 outpatient NA NA 70.0 meters or NA NA NA NA NA Wolloff et al., cardiac rehab patients 25% 2015 (65 ± 10.5 y/o); UK Costa et al., 45 outpatient patients NA Test-retest: ICC2, 1 NA NA NA NA NA NA 2018 with difficult to = 0.98 (0.96-0.98) control asthma (47 ± 13.8 y/o); Brazil

108

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Sickness Carter et 25 health Validation of scaled Reliability & NA NA NA NA NA NA Impact al., 1976 professionals – values by two different consistency of judges of Profile n = 1973 judgement groups, scaled items via deviate Physical 108 care correlation r = 0.092; score was good for 284 Dimension providers & p≤0.00001 items with 28 dropped (SIP) 1975 patients; or revised (18-74 y/o) Bergner et 278 adults in 4 Criterion validity NA NA NA NA NA NA NA al., 1976 outpatient Category scores settings discriminated among (18 - 75 y/o) subsamples ANOVA F = 57.48, p < 0.001 Categories ambulation, mobility and confinement and leisure pastimes high correlation to sickness & dysfunction r = .54, p, 0.001 Concurrent validity with Activities of Daily Living Index r = .46, P< 0.001 Concurrent validity with National Health Interview Survey Data (NHIS) r = .61, p < 0.001 Bergner et 1976 field test Concurrent validity 53 subjects used for test- NA NA NA NA NA NA al., 1981 of adults with: retest reliability 0.92; enrolled in Self-assessment & internal consistency prepaid group dysfunction r = 0.63 & Cronbach’s alpha 0.94 practice n = 0.69 696; family National Health practice Interview Survey Data outpatient n = (NHIS) r = .55 p < 0.001 199

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Gerety et Older adults NA Convergent validity of NA NA NA NA NA NA al., 1994 residents in SIP-NH Physical nursing homes Dimension with: SIP (≥ 60 y/o, mean Physical Dimension r age 78.2 y/o), n = 0.97, p < .001 = 231 Katz Activities of Daily Living r = .28, p≤ .0002 Physical Index r = -.35, p≤ .0001 Geriatric Depression Scale r = .21, p ≤ .0002 Folstein Mini-Mental State Exam r = -.08 Morishita Older adults NA Concurrent validity of NA NA NA NA NA NA et al., 1995 outpatient of SIP:Physical geriatric clinic, Functioning Dimension (mean age 77.3; (PFD) with Geriatric range 60-94 Depression Scale by y/o), n = 31 Telephone r = .90, p < .001

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Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Single Leg Adkin et al., Parkinson’s UPDRS posture NA NA NA NA NA NA NA Stance 2003 Disease and gait score explained a significant amount of variation in stance duration for the 1 leg stance test (r20.50; P 0.01

Jacobs et al., Parkinson’s NA NA NA 10 seconds 75% 74% NA NA 2006 Disease Springer et NA NA Inter-rater reliability ICC- NA NA NA NA NA NA al., 2007 0.994 (95% CI 0.989 to 0.996) for eyes open best of 3 trials, ICC=0.998 (95% CI 0.996-0.999) for eyes closed best of 3 trials, ICC=0.951 (95% CI 0.926 to 0.969) for eyes open mean of 3 trials, and ICC= 0.832 (95% CI 0.748 to 0.895) for eyes closed mean of 3 trials Goldberg et Adults (60- NA NA MDC at NA NA NA NA NA al., 2011 89 y/o) 95% confiden ce level was 24.1 seconds Chomiak et Parkinson’s NA test retest reliability ICC NA NA NA NA NA NA al., 2015 Disease 0.82 (95% CI: 0.64-0.91, P <0.01) and an ICC 0.83 (95% CI: 0.66-0.92, P<0.01) for right and left legs respectively 111

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV St. Thomas Oliver et al., 1997 Elderly hospital NA NA NA >2 points 93% 88% NA NA Risk inpatients (aged >65 Assessment y/o): Tool 116 cases and 116 (STRATIFY) controls in phase 1, 217 patients in phase 2, and 331 in >3points 92% 68% phase 3.

Smith et al., 2005 620 patients (over NA NA NA the age of 65 y/o) admitted to acute care center/teaching hospital during a 6 month period. acute stroke, >/= 2 points 11.3 89.5 25.0 76.6 baseline at rehab at DC >/=2 points 16.3 86.4 38.2 66.5

Aranda-Gallardo 647 nursing home NA NA NA 1 point or 47.6% 85% NA NA 2018 residence in Spain, more (411 fallers); (mean age 81.8 y/o)

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Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Stopping Shumway- Community- NA NA NA ≥ 13.5 sec Fallers 87% Nonfallers .77 NA Elderly Cook A et dwelling older (only uses 87% Accidents, al., 2000 adults TUG Deaths, & n = 15 non portion) Injuries fallers, (mean (STEADI) age 78, range 65-85 y/o) n = 15 ≥2 falls, (mean age 86.2, range 76- 95 y/o) Rubenstein Community- Concurrent validity Overall FRQ NA Indicated fall 96-100% for 66.7- NA NA LZ et al., dwelling older of the Fall Risk items alpha risk ≥ 4 original & 83.3% for 2011 adults (≥ 65 Questionnaire =.795 Revision 2 original & y/o), n = 40 (FRQ) with an Revision independent 2 geriatrician clinical fall risk examination items: fall past 6 month = Kappa 0.800 p <.0001 Fall concern = Kappa 0.700 p<.001 Feel unsteady = Kappa 0.500 p<0.001 Medication use = Kappa0.832 p<.0001 Depressed = Kappa 0.694 p<.001 Assistive device = Kappa 0.698 p<.0001

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Rest of items = Kappa 0.139 = .466

Panzer VP Community- Full Clinical Mobility NA NA AUC .80 .74 NA NA et al., 2011 dwelling older Measures Set Battery; 5 adults (64-94 Concurrent validity clinical y/o), n = 74 with: Tinetti variables Performance ICC >0.6 Oriented Mobility Assessment (POMA) 0.5 – 1.0, Sensory Organization Test (SOT).41 - .79 Stevens et Health care NA Quantitative NA NA NA NA NA NA al., 2013 providers n = approach 18 using focus 6 geriatricians, groups to 6 PCPs, 4 RNs, identify 2 NPs STEADI components Lohman Older US NA NA NA NA Discriminate NA Moderate NA MC et al., adults (≥ 65 between Fall Risk 2017 y/o), n = 7,392 fallers AUC OR = = 0.641 2.62, High Fall Risk OR = 4.76, Moderate Multiple Fall Risk Category OR = 4.05, High Multiple Fall Risk Category OR = 13.7,

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Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Stroke Breisinger 419 stroke patients 68 fallers, 351 NA NA NA 27; 0.78 0.63 0.29 0.94 Assessment Fall 2014 non-fallers; (age 67.5 ± 15.5 y/o) AUC=0.73 Risk admitted to inpatient rehab

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Stroop Stepping Schoene et 103 independent-living older NA NA NA NA game error NA NA NA Test al., 2014 adults (70-93 y/o); associated with fall history OR 1.65 (1.17- 2.34)

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Subjective Risk Hashidate 30 elderly adults (aged ≥ 65 y/o), NA Intra-rater NA ≥2 82 64 1.8 0.3 Rating of et al., 2011 in senior day care center ICC=727- Specific Scales 0.914

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff Sn Sp PPV NPV score Survey of Jonasson et 102 participants with Parkinson’s NA Internal NA NA NA NA NA NA Activities and al., 2014 Disease (Mean Age=73±8 y/o) Consistency Fear of Falling Cronbach’s in Elderly alpha= 0.94 (SAFFE) Test retest Reliability: ICC(95% CI)=0.85

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Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV The Means et 22 older adults NA Inter-rater NA NA NA NA NA NA Obstacle al., 1996* (68.8±5 y/o) with correlation 0.999; Course fall history and 22 intra-rater older adults correlation 0.98 (73.3±4 y/o) no fall history

Shamay et 29 people Positive Intra-rater 2.37 seconds 15.43 sec 96.6% 90.0% NA NA al., 2017 (57.9±5.5 y/o) correlation reliability ICC2,2 AUC = 0.975 with stroke and 30 between 0.937 (0.871- healthy adults obstacle course 0.970) (63.6±5.6 y/o) completion time Inter-rater (s) and TUG reliability ICC2,2 0.991 (0.980- 0.996) Test-retest reliability ICC2,2 0.968 (0.932- 0.985)

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Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Timed Up Barry et al, Community- NA NA NA ≥13.5 Sec 32% 73% NA NA and Go 2014 dwelling older (TUG) adults

Vance et al., Adults with NA NA NA ≥12 Sec 41% 73% NA NA 2015 Parkinson’s Disease

Rolenz & Community- With the 8-Foot NA NA ≥13.5 Sec 23.6% 91.7% NA NA Reneker, dwelling older Up and Go (r = 2016 adults with mild 0.92) cognitive impairment

Rolenz & Community- With the 8-Foot NA NA ≥13.5 Sec 12.5% 100% NA NA Reneker, dwelling older Up and Go (r = 2016 adults without mild 0.85) cognitive impairments

Lusardi et Community- NA NA NA ≥12 Sec 31% 85% NA NA al., 2017 dwelling older adults

Quinn et al, Adults with NA NA NA ≥9 Sec 82% 34% NA NA 2018 Multiple Sclerosis

Chow et al., Adults (≥65 y/o) NA NA NA ≥12 Sec 70.6% 28.4% 26.3% 72.7% 2018 presenting in the emergency department

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Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV TUG Vance et al., 2015 Adults with NA NA NA ≥14.7 Sec 76.5% 73.7% NA NA Dual Parkinson’s Task- Disease Cognitive

Lusardi et al., Community- NA Interrater reliability NA >13.5 sec 80% 93% 84 8 2017 (Based on dwelling older for both cog and data from adults manual: ICC .99 Shumway-Cook et al., 2000)

Quinn et al., 2018 Adults with NA NA NA ≥11 Sec 77% 30% NA NA Multiple Sclerosis

TUG Vance et al., 2015 Adults with NA NA NA ≥13.2 29.55% 68.4% NA NA Dual Parkinson’s Task- Disease Manual Lusardi et al., Community- NA Interrater reliability NA >13.5 sec 80% 93% 84 8 2017 dwelling older for both cog and (Based on data adults manual: ICC .99 from Shumway- Cook et al., 2000)

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Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV Tinetti Rehab Measure Older adults, Criterion ICC = 0.4- 4 19-21 64-85% 51-79% NA NA Performance- updated until 2011- stroke, validity 0.96 (Balance = Oriented 2013 Parkinson’s against TUG, 10-14) Mobility (Faber et al 2006, Disease, ALS FR, walking Assessment Harada et al 2005, speed (Tinetti POMA); Baloh et al 2008, van Tinetti Balance Iersel et al, Thomas et and Gait al 2005, Lin et al, Soyuer et al 2007, Daly et al 2006, Corriveau et al 2004, Kegelmeyer et al 2007, Behrman et al 2002, Gray et al 2009, Kloos et al 2004, Shore et al 2005 Contreras & Grandas 160 NA NA NA 17.5 60% 86% NA NA 2012 Parkinson’s (Balance (Balance (Balance Disease; 72 11.5/16; Gait 71%; 79%; men, 88 10.5/12) Gait Gait women; 71%) 74%) (72±9.5 y/o) Canbek et al., 2013 55 inpatient Criterion NA 6 NA NA NA NA NA stroke patients validity (75±11 y/o) against FIM motor domain; correlate with gait speed Knobe et al., 2016 34 older adults NA NA NA 20 45% 69% NA NA (79.5, range 66-93 y/o) Rovilta et al., 2019 90 patients of NA NA NA 18 0.71 0.81 NA NA rehab centers in Italy; (69.3±16.8 y/o)

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Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV The University Velozo et al., 106 community- NA Cronbach α NA NA NA NA NA NA of Illinois in 2001* dwelling older = 0.93 Chicago Fear of adults using Rasch Falling Measure Analysis (UIC FFM)

Chen et al., 2014 13 American and NA NA NA 37 (total score = (ISPRM 24 Chinese 48) proceeding) community- dwelling older US AUC=0.80 0.64 0.80 3.21 0.45 adults (aged 60-97, mean = 81.9 y/o) China 0.67 0.86 4.67 0.39 AUC=0.85

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Discussion The Outcome Measure Toolkit project took over two years to complete. After scouring the literature available to us, 245 different outcome measures were identified. Upon closer inspection of the psychometrics and levels of aid in predictability of falls, 150 of these measures, i.e., MMSE, were deemed irrelevant, as they were not directly related to balance, falls, or functional mobility. The remaining 107 measures were retained with varying degrees of applicability as genuine measures of fall risk. The taskforce performed a meticulous review of the psychometrics published for each of these measures, including the more recent studies effected within the last five years. Seminal work, published between ten and twenty years ago, was also included in the summary tables if the outcome measure had no recent evidence. There are 92 summary tables presented in this document, due to there being no evidence in 16 of the outcome measures of psychometrics related to balance and fall assessment. Our taskforce purposefully focused on proffering recent publications, that is, within the last ten years. Consequentially, some archaic but significant publications may have been omitted from this document. For optimal benefit, we recommend using this in conjunction with other resources. Although we did our best to be thorough in the reviewing process, some articles may have been missed, despite constant cross validation and updates. All feedback and suggestions are welcome! Ideally, the document must be updated every three to five years to remain topical; please do consider joining the taskforce to help our project stay up to date! Psychometric analysis categorizes the measures into four groups: outcome measures with evidence of psychometric properties and fall risk predictability, outcome measures not supported in relation to falls/balance assessment in the older adult, outcome measures related to balance and fall risk assessment but warranting additional research for further validation, and outcome measures that are widely utilized, but with limited recent supporting evidence. Broken down, there were 14 (13%), 29 (27%), 46 (43%), and 18 (17%), respectively. Quality of statistical analysis in the area of fall risk predictability was not commonly found in publications released before 2008. Several widely used outcome measures are not targeted at fall prediction in the older adults but do show emerging fall risk evidence and methods for fall prediction in pediatrics, dementia, Parkinson's Disease, and Multiple Sclerosis. We hope this anthology alludes the gap of knowledge and kindles the drive towards prospective research focusing on fall risk predictability.

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Appendix a. Compiled List of Outcome Measures found during Phase 1 Search 1. 10 meter Walk Test 26. Activity Measure for Post-Acute 47. CONFbal Scale of Balance 2. 10 m Maximal Walking Speed CARE (AM-PAC ADL) Confidence 3. 10 m Timed Walk Test 27. AM-PAC Functional 48. Conley Scale 4. 100% Limits of Stability 28. Ankle Dorsiflexor Strength 49. CSDD (Cornell Scale for 5. 10 Minute Walk Test 29. Anxiety and Depression Scale Depression in Dementia) 6. 10 Times Sit to Stand (HADS-A) 50. Demura's Fall Risk Assessment 7. 2 Min Salk 30. Area Ellipse of Postural Sway Chart (DFRA) 8. 2 Step Test 31. Attitudes to Falls-Related 51. Dizziness Handicap Inventory 9. 21 Item Fall Risk Index Interventions Scales 52. Downton Fall Risk Index 10. 25 Question Geriatric 32. Back Scratch Test 53. Dual Task Gait Speed Locomotive Function Scale 33. Balance Evaluation Systems Test 54. Timed Up and Go – Dual Task 11. 30 Second Chair Stand Test (BESTest) 55. Dual Task Assessments 12. 360 Degree Turn Time 34. Balance Outcome Measure for 56. Dynamic Gait Index 13. 4 Meter Walk Test Elder Rehabilitation (BOOMER) 57. Elderly Fall Screening Test 14. 4 Stair Climbing Test 35. Balance Self-Efficacy Test 58. Elderly Mobility Scale 15. 4 Step Square Test 36. Balance Self-Perceptions Test 59. Established Populations for the 16. 4 Stage Test (STEADI) 37. Barthel Index Epidemiologic Study of the 17. 5 m Walk Time 38. Bed Rise Difficulty (BRD) Scale Elderly 18. 5 Times Sit to Stand 39. Berg Balance Scale 60. Euroqual 19. 50 ft Speed Walk 40. BESTest 61. Fall Assessment and Intervention 20. 6 Minute Walk Test 41. Brief BESTest Record (FAIR) (6MWT) 42. Brunel Balance Assessment 62. Fall Assessment Risk and 21. 8 Foot Up and Go Test 43. Canada Occupational Management Tool (FARAM) 22. Activities Specific Balance Performance Measure 63. Fall Perception Questionnaire Confidence Scale (ABC) 44. Chair Stand Time 64. Fall Risk Assessment Tool 23. Activities Specific Fall Caution 45. Clinical Test of Sensory 65. Fall Risk Assessment Tool for Scale Interaction and Balance (CTSIB) Older People 24. Activity-Based Balance and Gait 46. Community Balance and 66. Fall Risk for Older People in the 25. Alternate Step Test Mobility Scale Community Assessment 67. Fall Risk Questionnaire 122

68. Falls Behavioral Scale 96. Gait Abnormality Rating Scale 122. International Physical Activity 69. Falls Efficacy Scale (FES) 97. Gait Efficacy Scale Questionnaire 70. Falls Efficacy Scale - 98. Gait Initiation Time 123. Katz Activities of Daily Living International 99. Gait-Related Dual Task Tests Index 71. Falls Prevention Strategy Survey 100. Gait Speed (m/s) 124. Knee Extension Strength (KES) 72. Falls Risk Assessment Tool 101. Gait Step Width 125. L Test 73. Falls-Efficacy Scale 102. Geriatric Depression Scale 126. LASA Fall Risk Profile 74. Fast Gait Speed (GDS) 127. Late Life Function and Disability 75. Fear Avoidance Beliefs 103. GDS-20 Instrument Questionnaire (FABQ) 104. GDS-5 128. Lateral Plank Time 76. Fear of Falling (yes, no) 105. Geriatric Depression Scale 129. Lateral Reach Test 77. Fear of Falling Measure 106. Geriatric Depression Scale Short 130. Lawton's Instrumental Activities 78. FES Form (GDS-15) of Daily Living scale 79. FES-1 107. Geriatric Fear of Falling 131. LE Strength/MMT 80. FHI (Falls Handicap Inventory) Assessment 132. Limits of Stability 81. FICSIT-4 Balance Test 108. Global Deterioration Scale 133. Missouri Alliance for Home Care 82. Figure 8 Walking Test 109. Goal Attainment Scale (MAHC-10) 83. Functional Independence 110. Grip Strength 134. Maximal Walking Speed Measure (FIM) 111. Groningen Activity Restriction 135. Maximum Step Length Test 84. Floor Rise Test Scale 136. Melbourne Fall Risk Assessment 85. Floor Transfer 112. Guralnik Test Battery Tool (MFRAT) 86. Frenchay Activity Index 113. Habitual Gait Speed 137. mFES 87. Fugl-Meyer Motor Assessment 114. Hospital Anxiety and Depression 138. Mini BESTest 88. Fullerton Advanced Balance Scale (HADS) 139. Mini International Scale (FAB) 115. Hand Grip Test Neuropsychiatric Interview 89. Fulllerton Advanced Balance 116. Hauser Ambulation Index 140. Mini Mental Assessment Scale 117. Health-Related Quality of Life 141. Mini Cog 90. Functional Ambulation Category (HRQOL) 142. Minimal Chair Height Standing 91. Functional Fitness Test 118. Hendrich II Fall Risk Model Ability 92. Functional Gait Assessment 119. High Level Mobility Assessment 143. Mini Mental State Examination 93. Functional Independence Tool (MMSE) Measure 120. Home Falls and Accidental 144. Mobility Interaction Fall Chart 94. Functional Mobility Assessment Screening Tool 145. Modified Clinical Test of Tools (FMA) 121. Illinois Fear of Falling Sensory Interaction and Balance 95. Functional Reach Test (mCTSIB)

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146. Modified Falls Efficacy Scale 172. Push and Release Test 199. Sickness Impact Profile Physical (MFES) 173. Quadriceps Strength Dimension 147. Modified Falls Efficacy Scale/ 174. Quantitative Gait Assessment 200. Single Leg Stance Short Falls Efficacy Scale 175. Queensland Fall Risk 201. Single Limb Stance 148. Modified Functional Reach Assessment Tool (QFRAT) 202. Single Stance Time 149. Modified Gait Efficacy Scale 176. RAFS II 203. Sit and Reach Test 150. Montly Fall Diaries 177. Rapid Step Test 204. 6 Minute Walk Test 151. Morse Fall Scale 178. Reaction Time Tests 205. St. Thomas's Risk Assessment 152. Motor Fitness Scale 179. rFES Tool (STRATFY) 153. Multi-Directional Reach Test 180. Rhomberg Stance 206. Stage 3 Balance Test 154. Multiple Lunge Test 181. Rivermead Mobility Index 207. Stair Climb Power Test (SCPT) 155. Multiple Sclerosis Walking Scale 182. Rogers Modular Obstacle Course 208. Static Posturography - 12 183. Romberg Test 209. STEADI 156. Muscle Power 184. SAFFE (Survey of Activities and 210. Step Quick Turn 157. NeuroCom Balance Tests Fear of Falling in the Elderly) 211. Step Reaction Time 158. Norwegian General Motor 185. Self-Reported Missteps (defined 212. Step Test Function Assessment as a trip, slip, or other loss of 213. Step Up Test 159. One Leg Stance Test balance in which recovery 214. STRATIFY (St Thomas Risk 160. Parameters of Gait occurred to prevent a fall) Assessment Tool) 161. Patient Specific Functional Scale 186. Self-Selected Gait speed 215. Strength Frail Older Adults 162. Penisual Health Fall Risk 187. Self-Selected Walking Speed Outcome Measure Assessment Tool (PHRAT) 188. Self-Efficacy Scale (SES) 216. Stride to Stride Variability 163. Perceived Participation and 189. Sensory Organization testing 217. Stroke Assessment of Fall Risk Autonomy 190. SF-12 218. Stroop Stepping Test 164. Performance Oriented Mobility 191. SF36 219. Subjective Risk Rating of Assessment (POMA) 192. Short Falls Efficacy Scale Specific Tasks (SRRT) 165. Performance Oriented Mobility International 220. Tandem Gait Assessment - Balance 193. Short Form Berg Balance Scale - 221. Tandem Stance 166. Peter James Centre Fall Risk 3 Point 222. Tandem Test Assessment Tool 194. Short Physical Performance 223. The Obstacle Course 167. Physical Activity Questionnaire Battery (SPPB) 224. The Step Test 168. Physical Mobility Scale 195. Short Form 12 225. Time to Walk 10 m 169. Physical Performance Scale 196. Short Form 36 226. Timed 25 Foot Walk Test 170. Physical Performance Test 197. Short Form Health Survey (SF-8) 227. Timed Get Up and Go Test 171. Physiological Profile Assessment 198. Shuttle Walk 228. Timed Tandem Stance

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229. Timed Up and Go 235. Toe Elevation Angles 242. Wall Sit Test 230. Timed Up and Go - Dual Task 236. TUG Dual Tasking 243. Weight Bearing Symmetry 231. Tinetti Balance and Gait 237. 2 Minute Walk Test 244. Western Ontario and McMaster Assessment 238. Unipedal Stance Osteoarthritis Index (WOMAC) 232. Tinetti Balance and Gait 239. University of Illinois at Chicago 245. World Health Organization Evaluation Fear of Falling Measure (UIC Quality of Life (WHOQoL) 233. Tinetti Gait and Balance Measure FFM) 234. Tinetti Performance-Oriented 240. Walking and Remembering Test Mobility Assessment 241. Walking While Talking Test

125 b. Outcome Measure Toolkit Project Article Review Instructions

1. Each month, each taskforce member received five outcome measures to review with suggested search terms/keywords 2. At the end of the month (or as finished), members sent back the results in a word document (one table per outcome measure) a. Template was provided as well as two examples 3. Members were instructed: a. If, in your research, you find that an outcome measure may not be appropriate, please flag it as such and let us know. b. If you are finished early and have extra time to dedicate to the project, please let us know and we can send you additional measures to look up c. If you cannot find evidence for a certain aspect (like reliability) don’t worry! It’s possible that many of these measures don’t have psychometrics to support their use in certain areas. d. We recommend that you use the name of the test as well as any similar names as listed in the Excel sheet. If you find a similar term used to describe the test, please let us know so we can add it to the main list. e. It is also helpful to search the following keywords in addition to the name of the test: . Validity Reliability MDC/MCID Cutoff Score Sensitivity Specificity Positive Predictive Value Negative Predictive Value f. Use “ “ to ensure your search terms come up in your search results and narrow down extraneous items

4. Each month, members had a conference call (2nd week of each month) to follow up on each person’s progress. It was at this time that taskforce shared aberrant findings such as: • Validated outcome measures without current (<5yr) evidence • Measures that might not be appropriate for consideration • Additional measures that should be included • Measures that were grouped d/t terminology but which should be separated • Measures that should be grouped with other measures d/t overt similarities • Not having access to an article (language, needing to pay for the article, access to data base) • Other problems that were identified

126 c. Outcome Measure Summary Table Template

Outcome Reference Population/ Psychometric property Fall Predictability Measure Diagnosis Validity Reliability MDC Cutoff score Sn Sp PPV NPV

Legend: * indicates the original article of the outcome measure. NA = Not assessed MDC = Minimum Detectable Change Sn = Sensitivity Sp = Specificity PPV = Positive Predictive Value NPV = Negative Predictive Value

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