To identify the items -from commonly used balance scales- that are sensitive to fear of falling.

Falls are a common cause for morbidity and mortality worldwide. Risk of falling is usually assessed by validated balance scales. However, it is unclear how much the patient’s fear of falling could affect the results of these scales. Also, we do not understand which items within commonly used balance scales are sensitive or resistant to fear.

We evaluated 48 balance tasks including those in the Tinetti’s Assessment Tool, Berg Balance Scale, Dynamic Gait Index and Functional Gait Assessment scales, the timed ‘Up & Go’, retropulsive pull, unipedal stance, functional reach and the sit-to-stand x5 tests. We used the Delphi methodology with 3 rounds. The 13 reviewers were selected to include a wide array of expertise in balance and fear. For each of the 48 items, the reviewers were asked to reflect on how fear of falling would affect the performance of that task. We measured quantitatively the responses, and progress through the multiple Delphi rounds. Strict pre-specified criteria were established to determine if consensus was reached.

All 13 participants completed the 3 Delphi rounds. Of them, 8 tasks were found to be resistant to fear of falling while 22 tasks were highly sensitive to fear of falling. For the rest 18 tasks, either they were found to be intermediate or consensus could not be reached for them.