BACKGROUND: Disorders of posture, gait, and balance in Parkinson's disease (PD) are common and debilitating. This MDS-commissioned task force assessed clinimetric properties of existing rating scales, questionnaires, and timed tests that assess these features in PD. METHODS: A literature review was conducted. Identified instruments were evaluated systematically and classified as "recommended," "suggested," or "listed." Inclusion of rating scales was restricted to those that could be used readily in clinical research and practice. RESULTS: One rating scale was classified as "recommended" (UPDRS-derived Postural Instability and Gait Difficulty score) and 2 as "suggested" (Tinetti Balance Scale, Rating Scale for Gait Evaluation). Three scales requiring equipment (Berg Balance Scale, Mini-BESTest, Dynamic Gait Index) also fulfilled criteria for "recommended" and 2 for "suggested" (FOG score, Gait and Balance Scale). Four questionnaires were "recommended" (Freezing of Gait Questionnaire, Activities-specific Balance Confidence Scale, Falls Efficacy Scale, Survey of Activities, and Fear of Falling in the Elderly-Modified). Four tests were classified as "recommended" (6-minute and 10-m walk tests, Timed Up-and-Go, Functional Reach). CONCLUSION: We identified several questionnaires that adequately assess freezing of gait and balance confidence in PD and a number of useful clinical tests. However, most clinical rating scales for gait, balance, and posture perform suboptimally or have been evaluated insufficiently. No instrument comprehensively and separately evaluates all relevant PD-specific gait characteristics with good clinimetric properties, and none provides separate balance and gait scores with adequate content validity for PD. We therefore recommend the development of such a PD-specific, easily administered, comprehensive gait and balance scale that separately assesses all relevant constructs. © 2016 International Parkinson and Movement Disorder Society.

1st Faculty of Medicine and General University Hospital Dept of Neurology and Centre of Clinical Neuroscience Charles University Prague Czech Republic

Alzheimer Center Reina Sofia Foundation and CIBERNED Carlos 3 Institute of Health Madrid Spain

Department of Neurological Services Rush University School of Medicine Chicago Illinois USA

KU Leuven University of Leuven Department of Rehabilitation Sciences Leuven Belgium

Leiden University Medical Center Department of Neurology Leiden The Netherlands

Radboud University Medical Centre Donders Institute for Brain Cognition and Behaviour Dept of Neurology Nijmegen The Netherlands

Sun Life Financial Movement Disorders Research and Rehabilitation Centre; Department of Kinesiology and Physical Education Wilfrid Laurier University Waterloo Ontario Canada

UCL Institute of Neurology University College London UK

University of Utah Department of Physical Therapy Salt Lake City Utah USA

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