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Objective: Challenging clinical balance tests are needed to expose balance deficits in lower-limb prost-hesis users. This study examined whether narrowing beam-walking could overcome conceptual and practical limitations identified in fixed-width beam-walking. Design: Cross-sectional. Participants: Unilateral lower-limb prosthesis users. Methods: Participants walked 10 times along a low, narrowing beam. Performance was quantified using the normalized distance walked. Heuristic rules were applied to determine whether the narrowing beam task was “too easy,” “too hard,” or “appropriately challenging” for each participant. Linear regression and Bland-Altman plots were used to determine whether combinations of the first 5 trials could predict participants’ stable beam-walking performance. Results: Forty unilateral lower-limb prosthesis users participated. Narrowing beam-walking was appropriately challenging for 98% of participants. Performance stabilized for 93% of participants within 5 trials, while 62% were stable across all trials. The mean of trials 3–5 accurately predicted stable performance. Conclusion: A clinical narrowing beam-walking test is likely to challenge a range of lower-limb prosthesis users, have minimal administrative burden, and exhibit no floor or ceiling effects. Narrowing beam-walking is therefore a clinically viable method to evaluate lower-limb prosthesis users’ balance ability, but requires psychometric testing before it is used to assess fall risk.

Objective: To compare the measurement properties of the de Morton Mobility Index (DEMMI) and the Hierarchical Assessment of Balance and Mobility (HABAM) in an older acute medical inpatient population. Design: Cross-sectional. Subjects: Older acute medical inpatients. Methods: The DEMMI, HABAM and further assessments were performed after hospital admission. Construct validity was assessed by testing 13 hypotheses on convergent and known-groups validity. Test–retest reliability and minimal detectable change were estimated based on a re-assessment of unchanged patients. Floor and ceiling effects were used to indicate adequacy of scale width. Results: For both the DEMMI and HABAM, 11 (85%) hypotheses regarding construct validity were confirmed (n = 158). Both scales showed strong correlations with other multi-component mobility scales (Spearman’s rho 0.75–0.92). Neither floor nor ceiling effects were evident. The intraclass correlation coefficient was 0.98 (95% confidence interval (95% CI) 0.96–0.99) for the DEMMI and 0.99 (95% CI 0.99–0.99) for the HABAM, respectively (n = 30). The minimal detectable change with 90% confidence was 6 points on the 100-point DEMMI scale and 1 point on the 26-point HABAM scale. Conclusion: The DEMMI and the HABAM appear to be suitable for measuring mobility in older acute medical patients.