A Systematic Review of Methods to Measure Balance and Walking Post-Stroke. Part 1: Ordinal Scales

Abstract

The rehabilitation of balance and walking is a cornerstone of stroke physiotherapy and our main interest is to assess the effectiveness of physiotherapy interventions. We therefore reviewed the literature to seek outcome measures which would be suitable for such a purpose. This article is limited to ordinal scales. CINAHL, Medline and Embase databases were searched for measurement tools which measured balance and/or walking post-stroke and could be used in clinical settings. They were assessed for reliability, validity, sensitivity to change, scale development, suitability for use in clinical settings and with a wide range of stroke severity. Twenty-six measurement tools were identified. All had some information about their psychometric properties but few had been rigorously tested. They were generally reliable and valid, but sensitivity to change was poor or untested and few showed a true hierarchy. None of the measurement tools fulfilled all the assessment criteria.