Recommendations for a Core Outcome Set for Measuring Standing Balance in Adult Populations: A Consensus-Based Approach
Identifieur interne : 001A97 ( Ncbi/Merge ); précédent : 001A96; suivant : 001A98Recommendations for a Core Outcome Set for Measuring Standing Balance in Adult Populations: A Consensus-Based Approach
Auteurs : Kathryn M. Sibley [Canada] ; Tracey Howe [Royaume-Uni] ; Sarah E. Lamb [Royaume-Uni] ; Stephen R. Lord [Australie] ; Brian E. Maki [Canada] ; Debra J. Rose [États-Unis] ; Vicky Scott [Canada] ; Liza Stathokostas [Canada] ; Sharon E. Straus [Canada] ; Susan B. Jaglal [Canada]Source :
- PLoS ONE [ 1932-6203 ] ; 2015.
Abstract
Standing balance is imperative for mobility and avoiding falls. Use of an excessive number of standing balance measures has limited the synthesis of balance intervention data and hampered consistent clinical practice.
To develop recommendations for a core outcome set (COS) of standing balance measures for research and practice among adults.
A combination of scoping reviews, literature appraisal, anonymous voting and face-to-face meetings with fourteen invited experts from a range of disciplines with international recognition in balance measurement and falls prevention. Consensus was sought over three rounds using pre-established criteria.
The scoping review identified 56 existing standing balance measures validated in adult populations with evidence of use in the past five years, and these were considered for inclusion in the COS.
Fifteen measures were excluded after the first round of scoring and a further 36 after round two. Five measures were considered in round three. Two measures reached consensus for recommendation, and the expert panel recommended that at a minimum, either the Berg Balance Scale or Mini Balance Evaluation Systems Test be used when measuring standing balance in adult populations.
Inclusion of two measures in the COS may increase the feasibility of potential uptake, but poses challenges for data synthesis. Adoption of the standing balance COS does not constitute a comprehensive balance assessment for any population, and users should include additional validated measures as appropriate.
The absence of a gold standard for measuring standing balance has contributed to the proliferation of outcome measures. These recommendations represent an important first step towards greater standardization in the assessment and measurement of this critical skill and will inform clinical research and practice internationally.
Url:
DOI: 10.1371/journal.pone.0120568
PubMed: 25768435
PubMed Central: 4358983
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<author><name sortKey="Stathokostas, Liza" sort="Stathokostas, Liza" uniqKey="Stathokostas L" first="Liza" last="Stathokostas">Liza Stathokostas</name>
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<front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title>
<p>Standing balance is imperative for mobility and avoiding falls. Use of an excessive number of standing balance measures has limited the synthesis of balance intervention data and hampered consistent clinical practice.</p>
</sec>
<sec id="sec002"><title>Objective</title>
<p>To develop recommendations for a core outcome set (COS) of standing balance measures for research and practice among adults.</p>
</sec>
<sec id="sec003"><title>Methodology</title>
<p>A combination of scoping reviews, literature appraisal, anonymous voting and face-to-face meetings with fourteen invited experts from a range of disciplines with international recognition in balance measurement and falls prevention. Consensus was sought over three rounds using pre-established criteria.</p>
</sec>
<sec id="sec004"><title>Data sources</title>
<p>The scoping review identified 56 existing standing balance measures validated in adult populations with evidence of use in the past five years, and these were considered for inclusion in the COS.</p>
</sec>
<sec id="sec005"><title>Results</title>
<p>Fifteen measures were excluded after the first round of scoring and a further 36 after round two. Five measures were considered in round three. Two measures reached consensus for recommendation, and the expert panel recommended that at a minimum, either the Berg Balance Scale or Mini Balance Evaluation Systems Test be used when measuring standing balance in adult populations.</p>
</sec>
<sec id="sec006"><title>Limitations</title>
<p>Inclusion of two measures in the COS may increase the feasibility of potential uptake, but poses challenges for data synthesis. Adoption of the standing balance COS does not constitute a comprehensive balance assessment for any population, and users should include additional validated measures as appropriate.</p>
</sec>
<sec id="sec007"><title>Conclusions</title>
<p>The absence of a gold standard for measuring standing balance has contributed to the proliferation of outcome measures. These recommendations represent an important first step towards greater standardization in the assessment and measurement of this critical skill and will inform clinical research and practice internationally.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id>
<journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id>
<journal-id journal-id-type="publisher-id">plos</journal-id>
<journal-id journal-id-type="pmc">plosone</journal-id>
<journal-title-group><journal-title>PLoS ONE</journal-title>
</journal-title-group>
<issn pub-type="epub">1932-6203</issn>
<publisher><publisher-name>Public Library of Science</publisher-name>
<publisher-loc>San Francisco, CA USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25768435</article-id>
<article-id pub-id-type="pmc">4358983</article-id>
<article-id pub-id-type="doi">10.1371/journal.pone.0120568</article-id>
<article-id pub-id-type="publisher-id">PONE-D-14-49047</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Recommendations for a Core Outcome Set for Measuring Standing Balance in Adult Populations: A Consensus-Based Approach</article-title>
<alt-title alt-title-type="running-head">Standing Balance Core Outcome Set in Adults</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Sibley</surname>
<given-names>Kathryn M.</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff002"><sup>2</sup>
</xref>
<xref rid="cor001" ref-type="corresp">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Howe</surname>
<given-names>Tracey</given-names>
</name>
<xref ref-type="aff" rid="aff003"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lamb</surname>
<given-names>Sarah E.</given-names>
</name>
<xref ref-type="aff" rid="aff004"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lord</surname>
<given-names>Stephen R.</given-names>
</name>
<xref ref-type="aff" rid="aff005"><sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Maki</surname>
<given-names>Brian E.</given-names>
</name>
<xref ref-type="aff" rid="aff002"><sup>2</sup>
</xref>
<xref ref-type="aff" rid="aff006"><sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rose</surname>
<given-names>Debra J.</given-names>
</name>
<xref ref-type="aff" rid="aff007"><sup>7</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Scott</surname>
<given-names>Vicky</given-names>
</name>
<xref ref-type="aff" rid="aff008"><sup>8</sup>
</xref>
<xref ref-type="aff" rid="aff009"><sup>9</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Stathokostas</surname>
<given-names>Liza</given-names>
</name>
<xref ref-type="aff" rid="aff010"><sup>10</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Straus</surname>
<given-names>Sharon E.</given-names>
</name>
<xref ref-type="aff" rid="aff006"><sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Jaglal</surname>
<given-names>Susan B.</given-names>
</name>
<xref ref-type="aff" rid="aff002"><sup>2</sup>
</xref>
<xref ref-type="aff" rid="aff006"><sup>6</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff001"><label>1</label>
<addr-line>Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada</addr-line>
</aff>
<aff id="aff002"><label>2</label>
<addr-line>Toronto Rehabilitation Institute- University Health Network, Toronto, Canada</addr-line>
</aff>
<aff id="aff003"><label>3</label>
<addr-line>School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom</addr-line>
</aff>
<aff id="aff004"><label>4</label>
<addr-line>Centre for Rehabilitation Research, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom</addr-line>
</aff>
<aff id="aff005"><label>5</label>
<addr-line>Neuroscience Research Australia, University of New South Wales, Sydney, Australia</addr-line>
</aff>
<aff id="aff006"><label>6</label>
<addr-line>University of Toronto, Toronto, Canada</addr-line>
</aff>
<aff id="aff007"><label>7</label>
<addr-line>California State University Fullerton, Fullerton, California, United States of America</addr-line>
</aff>
<aff id="aff008"><label>8</label>
<addr-line>Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, Canada</addr-line>
</aff>
<aff id="aff009"><label>9</label>
<addr-line>British Columbia Injury Research and Prevention Unit and Ministry of Health, Victoria, Canada</addr-line>
</aff>
<aff id="aff010"><label>10</label>
<addr-line>Canadian Centre for Activity and Aging, Western University, London, Canada</addr-line>
</aff>
<contrib-group><contrib contrib-type="editor"><name><surname>Bayer</surname>
<given-names>Antony</given-names>
</name>
<role>Academic Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1"><addr-line>Cardiff University, UNITED KINGDOM</addr-line>
</aff>
<author-notes><fn fn-type="conflict" id="coi001"><p><bold>Competing Interests: </bold>
The authors have declared that no competing interests exist.</p>
</fn>
<fn fn-type="con" id="contrib001"><p>Conceived and designed the experiments: KMS BEM SES SBJ. Performed the experiments: KMS TH SEL SRL DJR VS LS SBJ. Analyzed the data: KMS TH SEL SRL BEM DJR VS LS SES SBJ. Contributed reagents/materials/analysis tools: KMS SBJ. Wrote the paper: KMS TH SEL SRL BEM DJR VS LS SES SBJ.</p>
</fn>
<corresp id="cor001">* E-mail: <email>kathryn.sibley@umanitoba.ca</email>
</corresp>
</author-notes>
<pub-date pub-type="epub"><day>13</day>
<month>3</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="collection"><year>2015</year>
</pub-date>
<volume>10</volume>
<issue>3</issue>
<elocation-id>e0120568</elocation-id>
<history><date date-type="received"><day>5</day>
<month>11</month>
<year>2014</year>
</date>
<date date-type="accepted"><day>24</day>
<month>1</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-year>2015</copyright-year>
<copyright-holder>Sibley et al</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>
, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:type="simple" xlink:href="pone.0120568.pdf"></self-uri>
<abstract><sec id="sec001"><title>Background</title>
<p>Standing balance is imperative for mobility and avoiding falls. Use of an excessive number of standing balance measures has limited the synthesis of balance intervention data and hampered consistent clinical practice.</p>
</sec>
<sec id="sec002"><title>Objective</title>
<p>To develop recommendations for a core outcome set (COS) of standing balance measures for research and practice among adults.</p>
</sec>
<sec id="sec003"><title>Methodology</title>
<p>A combination of scoping reviews, literature appraisal, anonymous voting and face-to-face meetings with fourteen invited experts from a range of disciplines with international recognition in balance measurement and falls prevention. Consensus was sought over three rounds using pre-established criteria.</p>
</sec>
<sec id="sec004"><title>Data sources</title>
<p>The scoping review identified 56 existing standing balance measures validated in adult populations with evidence of use in the past five years, and these were considered for inclusion in the COS.</p>
</sec>
<sec id="sec005"><title>Results</title>
<p>Fifteen measures were excluded after the first round of scoring and a further 36 after round two. Five measures were considered in round three. Two measures reached consensus for recommendation, and the expert panel recommended that at a minimum, either the Berg Balance Scale or Mini Balance Evaluation Systems Test be used when measuring standing balance in adult populations.</p>
</sec>
<sec id="sec006"><title>Limitations</title>
<p>Inclusion of two measures in the COS may increase the feasibility of potential uptake, but poses challenges for data synthesis. Adoption of the standing balance COS does not constitute a comprehensive balance assessment for any population, and users should include additional validated measures as appropriate.</p>
</sec>
<sec id="sec007"><title>Conclusions</title>
<p>The absence of a gold standard for measuring standing balance has contributed to the proliferation of outcome measures. These recommendations represent an important first step towards greater standardization in the assessment and measurement of this critical skill and will inform clinical research and practice internationally.</p>
</sec>
</abstract>
<funding-group><funding-statement>The project was funded by a Canadian Institutes of Health Research (CIHR) planning grant (# MAG133935) - <ext-link ext-link-type="uri" xlink:href="http://www.cihr-irsc.gc.ca/e/193.html">http://www.cihr-irsc.gc.ca/e/193.html</ext-link>
. KMS was supported by a STIHR-CIHR Fellowship from Knowledge Translation Canada and the Toronto Rehabilitation Institute. SEL is supported by the NIHR Oxford CLARHC and BRU awards. SES holds a Canada Research Chair in Knowledge Translation and Quality of Care. SBJ holds the Toronto Rehabilitation Institute Chair in Rehabilitation Research at the University of Toronto. Infrastructure support was provided by the Toronto Rehabilitation Institute, with grants from the Canadian Foundation for Innovation, the Ontario Innovation Trust and the Ministry of Research and Innovation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement>
</funding-group>
<counts><fig-count count="2"></fig-count>
<table-count count="4"></table-count>
<page-count count="20"></page-count>
</counts>
<custom-meta-group><custom-meta id="data-availability"><meta-name>Data Availability</meta-name>
<meta-value>All relevant data are within the paper and its Supporting Information files.</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
<notes><title>Data Availability</title>
<p>All relevant data are within the paper and its Supporting Information files.</p>
</notes>
</front>
</pmc>
<affiliations><list><country><li>Australie</li>
<li>Canada</li>
<li>Royaume-Uni</li>
<li>États-Unis</li>
</country>
<region><li>Angleterre</li>
<li>Californie</li>
<li>Grand Londres</li>
<li>Manitoba</li>
<li>Ontario</li>
<li>Oxfordshire</li>
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<li>Oxford</li>
<li>Sydney</li>
<li>Toronto</li>
<li>Winnipeg</li>
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<orgName><li>Université d'Oxford</li>
<li>Université de Toronto</li>
<li>Université du Manitoba</li>
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<tree><country name="Canada"><region name="Manitoba"><name sortKey="Sibley, Kathryn M" sort="Sibley, Kathryn M" uniqKey="Sibley K" first="Kathryn M." last="Sibley">Kathryn M. Sibley</name>
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<name sortKey="Maki, Brian E" sort="Maki, Brian E" uniqKey="Maki B" first="Brian E." last="Maki">Brian E. Maki</name>
<name sortKey="Maki, Brian E" sort="Maki, Brian E" uniqKey="Maki B" first="Brian E." last="Maki">Brian E. Maki</name>
<name sortKey="Scott, Vicky" sort="Scott, Vicky" uniqKey="Scott V" first="Vicky" last="Scott">Vicky Scott</name>
<name sortKey="Scott, Vicky" sort="Scott, Vicky" uniqKey="Scott V" first="Vicky" last="Scott">Vicky Scott</name>
<name sortKey="Sibley, Kathryn M" sort="Sibley, Kathryn M" uniqKey="Sibley K" first="Kathryn M." last="Sibley">Kathryn M. Sibley</name>
<name sortKey="Stathokostas, Liza" sort="Stathokostas, Liza" uniqKey="Stathokostas L" first="Liza" last="Stathokostas">Liza Stathokostas</name>
<name sortKey="Straus, Sharon E" sort="Straus, Sharon E" uniqKey="Straus S" first="Sharon E." last="Straus">Sharon E. Straus</name>
</country>
<country name="Royaume-Uni"><noRegion><name sortKey="Howe, Tracey" sort="Howe, Tracey" uniqKey="Howe T" first="Tracey" last="Howe">Tracey Howe</name>
</noRegion>
<name sortKey="Lamb, Sarah E" sort="Lamb, Sarah E" uniqKey="Lamb S" first="Sarah E." last="Lamb">Sarah E. Lamb</name>
</country>
<country name="Australie"><noRegion><name sortKey="Lord, Stephen R" sort="Lord, Stephen R" uniqKey="Lord S" first="Stephen R." last="Lord">Stephen R. Lord</name>
</noRegion>
</country>
<country name="États-Unis"><region name="Californie"><name sortKey="Rose, Debra J" sort="Rose, Debra J" uniqKey="Rose D" first="Debra J." last="Rose">Debra J. Rose</name>
</region>
</country>
</tree>
</affiliations>
</record>
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