Oncology Section Task Force on Breast Cancer Outcomes: Clinical Measures of Balance A Systematic Review

Background: Balance deficits are a common morbidity following treatment for breast cancer. Accurate assessment of balance following breast cancer treatments is essential in identifying deficits and risk for falls along with planning rehabilitation strategies. Purpose: This systematic review identifies balance outcome measures for use with women treated for breast cancer that possess strong psychometric properties and are clinically useful. Methods: Multiple electronic databases were searched from February to July 2014. The review included studies of outcome measures for assessing balance that met the following criteria: Reported psychometric properties, clinically feasible methods, adults (preferably female), published between January 1, 1995, to July 31, 2014, in the English language. Each outcome measure was reviewed and rated independently by two reviewers. A single Cancer EDGE Task Force Outcome Measure Rating Form was completed for each balance measure, and a recommendation was made using the 4-point Breast Cancer EDGE Task Force Rating Scale. Results: Of the original 683 articles found, 36 were included in this review. None of the balance outcome measures reviewed merited the highest rating of 4, strongly recommended. The Fullerton Advanced Balance (FAB) Scale and Timed Up and Go (TUG) were rated 3, recommended for clinical use. Six outcome measures were rated 2B, unable to recommend at this time. Six outcome measures were rated 2A, unable to recommend at this time. Conclusions: This review demonstrates that there is a lack of research evidence supporting the psychometric properties of outcome measures for balance in breast cancer survivors. No studies have examined cutoff scores of balance assessment tools for detecting fallers in breast cancer survivors. Future research is necessary to identify self-reported outcome measures for assessing balance and fall risks, and to differentiate tools specifically for different practice settings throughout the continuum of cancer survivorship.