Fullerton Advanced Balance (FAB) Scale

What is the Fullerton Advanced Balance (FAB) Scale?

Fall-related injuries are common among older adults, often caused by age-related declines in balance, strength, and coordination. These risks are particularly significant for highly active ones who may encounter more dynamic balance challenges. The consequences of falls can range from minor bruises to severe injuries, such as fractures, impacting the overall quality of life and independence.

The Fullerton Advanced Balance (FAB) Scale was developed to provide a reliable and valid tool for assessing balance in functionally independent older adults. Designed to evaluate fall risk, the scale has two versions: the original long-form version with 10 activities, a total score of 40, and a cut-off score of 25, and a shorter version with a total score of 16 and a cut-off score of 9. Through its targeted activities, the FAB Scale assesses multiple balance domains, including reactive control, postural adjustments, and sensory integration.

With strong interrater, intrarater, and test-retest reliability (Rose et al., 2006), it effectively identifies individuals at risk and supports targeted interventions to prevent falls. Additionally, regular reassessment using the FAB Scale can monitor progress and inform balance training programs, making it a valuable tool for both evaluation and intervention.

What are the key components that make up the FAB scale?

The Fullerton Advanced Balance (FAB) Scale consists of ten performance-based activities that measure static and dynamic balance under varying sensory conditions. These activities include:

1. Standing with feet together and eyes closed
2. Reaching forward to an object
3. Turn in full circle
4. Step up and over
5. Tandem walk
6. Stand on one leg
7. Standing on foam with eyes closed
8. Two-footed jump (should be skipped if the step up and over wasn't performed safely)
9. Walking with head turns
10. Reactive postural control

The scale provides a comprehensive assessment that is particularly relevant for these functions and predicts fall risk in functionally independent older adults. It is also a valuable quantitative tool in clinical settings with applications in breast cancer-treated individuals (Wampler et al., 2007).

How does this FAB scale template work?

Our template includes the long-form version of the Fullerton Advanced Balance (FAB) Scale. It includes all the information you need for testing and safety procedures, equipment, verbal instructions and scoring categories. Follow these steps to get started:

Step 1: Download the template

You can access the Fullerton Advanced Balance Scale template from this guide. Click "Use template" to open it within the Carepatron platform, where you can customize it. You can also click "Download" for a free fillable PDF copy of this assessment.

Step 2: Explain to the patient

Briefly explain the test's purpose to the patient, highlighting that it measures various balance skills. Outline each activity to help the patient feel prepared and comfortable.

Step 3: Conduct the test

Guide the patient through each of the ten activities, observing their performance on tasks that assess various aspects of balance. Score each task on a 5-point scale from 0 to 4, with higher scores reflecting stronger balance. Demonstrate each activity before the patient attempts it, and stay ready to provide immediate support if needed for their safety.

Step 4: Record results and observations

Document the patient's score for each activity. The template also contains a Remarks section where you can note observations related to their balance or stability. This thorough record provides a clear image of the patient's current balance abilities.

Step 5: Store for future reference

Keep the completed template in the patient's file as a reference for future assessments or physical therapy sessions. This allows for tracking progress over time and supports continuity of care.

Scoring and interpretation

The Fullerton Advanced Balance (FAB) Scale uses a detailed scoring system to evaluate performance across ten specific activities. Each activity is scored from 0 to 4, allowing for a nuanced assessment where higher scores reflect better performance.

The total score for the long version, calculated by summing the individual scores, has a maximum of 40. Scores below 25 indicate an increased risk of falls, while higher scores suggest better balance. Interpreting the results requires a holistic view of the individual's overall performance.

When would you use the Fullerton Advanced Balance (FAB) Scale

The Fullerton Advanced Balance (FAB) Scale can be effectively applied in the following clinical situations:

Predicting fall risk in older adults

The assessment is ideal for assessing balance in older adults at risk of falls but remains functionally independent. By identifying specific balance deficits, you can create personalized fall prevention strategies.

Evaluating balance improvements over time

Use the FAB scale to track changes in balance after introducing interventions like physical therapy or exercise programs. Regular assessments provide clear insights into progress and help fine-tune treatment plans.

Designing targeted interventions

The scale helps pinpoint which aspects of balance, such as reactive control or postural adjustments, need improvement. This allows you to develop tailored interventions that address each patient's unique needs.

References

Rose, D. J. (2010). Fallproof!: A comprehensive balance and mobility training program (2nd ed., pp. 61–66). Human Kinetics.

Rose, D. J., Lucchese, N., & Wiersma, L. D. (2006). Development of a multidimensional balance scale for use with functionally independent older adults. Archives of Physical Medicine and Rehabilitation, 87(11), 1478–1485. https://doi.org/10.1016/j.apmr.2006.07.263

Wampler, M. A., Topp, K. S., Miaskowski, C., Byl, N. N., Rugo, H. S., & Hamel, K. (2007). Quantitative and clinical description of postural instability in women with breast cancer treated with taxane chemotherapy. Archives of Physical Medicine and Rehabilitation, 88(8), 1002–1008. https://doi.org/10.1016/j.apmr.2007.05.007