1. Purpose
   1. to measure a patient's functional balance and postural stability for the purpose of predicitng fall risk
2. What is it/What does it test?
   1. standardized clinical assessment that aids in evaluating a subjec's ability to modify gait in response to changing demands
   2. designed to examine a pt's ability to adapt their gait when task demands change
3. Target Population
   1. community-dwelling older adults (60+)
   2. patients with vestibular dysfunction
4. Psychometric Properties
   1. Interrater reliability: .96
   2. test-retest reliability: .98
   3. MS Pts. interrater and intrarater reliability= ICC of .983 and pearson bivariate range of .760-.986 respectively
   4. Concurrent validity with the BBS (r=.71) in pts. with vestibular disorders
   5. Correlates well with the Activities-Specific Balance Confidence Scale (r=.72)
5. Performance Rating
   1. Scale of 0-3
      1. 0= severe impairment
      2. 1=moderate
      3. 2= mild
      4. 3=normal
   2. Scoring
      1. Total possible= 24
      2. score of 19 or less=indicative of increased fall risk
      3. score of 22 or more= safe ambulators
6. 8 Tasks to be performed
   1. Ambulating on level surface
   2. Ambulating while changing speeds
   3. Ambulating with horizontal head turns
   4. Ambulating with vertical head turns
   5. Ambulating with pivot turns
   6. Stepping over obstacles
   7. Stepping around obstacles
   8. Ascending/descending stairs
7. Materials
   1. tape to mark off a 20 ft walkway
   2. shoe box to serve as the obstacle
   3. set of small stairs
8. Time required
   1. 10 mins
9. Pros
   1. Req min space & equipment
   2. easy & quick to administer
   3. can be used as a measure of progression and outcome
10. Cons
    1. operational definitions of the grades are ambiguous
    2. for pts with vestibular disorders there's a ceiling effect, especially if pt is younger because they tend to receive close to normal scores which fails to indicate fall risk or need for PT