The Clinical Relevance of Force Platform Measures in Multiple Sclerosis: A Review

Table 1

Commonly used clinical scales to assess balance in patients with multiple sclerosis.

Tool	Authors Journal	Brief description	Time of administration	Overall score	Test-retest reliability in PwMS	Accuracy in predicting fall status in PwMS
Activities-specific balance confidence (ABC)	Powell and Myers [33]; J. Gerontol. A. Biol. Sci. Med. Sci. 1995	16-item self-administered questionnaire rating the perceived level of confidence in performing daily living activities	15 minutes	0 to 100	92%	SE: 65%, SP: 77% (cutoff: 40) [14]
Balance evaluation system test (BESTest)	Horak et al. [34]; Phys. Ther. 2009	36-item physician-rated scale evaluating 6 systems (biomechanical constraints, stability limits/verticality, anticipatory postural adjustments, postural responses, sensory orientation, and stability in gait)	30 minutes	0 to 108	88%–91%^b	SE: 86%, SP: 95% [35]
Berg balance scale (BBS)	Berg et al. [36]; Can. J. Public Health. 1992	14-item physician-rated scale exploring the ability to sit, stand, lean, and turn and postural transition.	15 minutes	0 to 56	96%	SE: 40%, SP: 90% (cutoff: 44) [14]; SE: 94%, SP: 32% (cutoff: 55) [16]; SE: 32%, SP: 87% (cutoff: 44) [24]
Dizziness handicap inventory (DHI)	Jacobson and Newman [37]; Arch. Otolaryngol Head Neck Surg 1990	Multidimensional 25-item self-administered questionnaire quantifying the level of disability in three domains: physical, emotional, and functional	15 minutes	0 to 100^a	90%	SE: 50%, SP: 74% (cutoff: 59) [14]
Dynamic gait index (DGI)	Whitney et al. [38]; J. Vest. Res. 2000	8-item physician-rated scale exploring mobility function and dynamic balance	10 minutes	0 to 24	85%	SE: 45%, SP: 80% (cutoff: 12) [14]
Four-square step test (FSST)	Dite and Temple [39]; Arch. Phys. Med. Rehabil 2002	Stop-watch measurement of the duration of rapidly step over low obstacles in clockwise and counterclockwise direction	3 minutes or less	N/A	93%–98%^b	SE: 60%, SP: 75% (cutoff: 16.9 s) [16]
Functional reach test (FRT)	Duncan et al. [40]; J. Gerontol. 1990	Measurement of the maximum distance reached forward while standing in a fixed position.	N/A	N/A	85%–95%^b	—
Timed-up-and-go test (TUG)	Podsiadlo and Richardson [41]; J. Am. Geriatr. Soc. 1991	Stop-watch measurement of the duration of standup from a chair, walking 3 meters, turning around, walking back and siting down.	3 minutes or less	N/A	98%	SE: 73%, SP: 54% (cutoff: 13.6 s)^c [16]

PwMS: patients with multiple sclerosis; SE: sensitivity; SP: specificity; ^athe only scale in which the lower the score, lower the level of disability; ^bas estimated in populations other than MS; ^ccognitive TUG was used in this study.