The purpose of this study was to evaluate the effectiveness of frequently used functional balance measures in community dwelling elderly adults in establishing their effectiveness in assessing a person's fall risk. The functional balance measures assessed in this study include: the Timed Up and Go test, Functional Reach Test, the Berg Balance Test, and the Tinetti Assessment Tool. Methods: A detailed literature search was performed of electronic databases such as: PubMed, SciSearch, CINAHL, and the Cochrane Library. The following MESH subject terms and keywords were used together with all searches: aged, accidental falls, risk assessment, and postural balance; and were also searched with one of the following terms: Timed Up and Go, Functional Reach, Berg Balance Scale, Tinetti Assessment Tool, and the Performance Oriented Mobility Assessment. In addition, a hand search of bibliographic references of extracted articles and existing reviews was conducted to identify studies not captured in the electronic database search. The inclusion criteria for articles in this study were: a minimum of a subset of the study participants aged sixty-five years and older, involving community-dwelling adults, and evaluation of a(n) balance assessment(s) on fall risk. Articles were excluded from this study if: participants or a subset of participants were not classified as community-dwelling, and studies in which an underlying orthopedic or neurological pathology was evaluated solely for the effects such pathologies possess on influencing a person's fall risk. Results: A total of eight articles out of sixty-three available articles met the inclusion criteria and were reviewed for this study. Timed Up and Go test articles suggested promising results, but researchers varied on appropriate cut-off values. Functional Reach articles suggested poor correlation between scores and fall risk. Berg Balance test articles suggested poor sensitivity but high specificity in the ability of the test to determine increased fall risk. However, researchers varied on the range of scores that produced the greatest fall risk. Tinetti Assessment Tool articles suggested moderate sensitivity and a predictive value for predicting future fall risk in subjects without a history of falls. Discussion/Conclusion: There is not a particular balance assessment tool that demonstrates high validity and reliability in assessing a patient's fall risk in all cases. Therefore, it is important for clinicians who screen as well as assess an elderly adult's risk for falls to be aware of the testing limitations, and incorporate a comprehensive approach to fall risk assessment. A comprehensive tool is needed to screen and assess such fall risks in order to indicate elderly individuals who will benefit from physical therapy services in minimizing fall risk factors.


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Document Type



fall risk, elderly, functional balance

Available for download on Monday, March 14, 2118