Outcome measurement: when to use Berg, mini-BESTest, 6MWT, 10MWT, FGA, STREAM

1. Case. Three hypothetical patients arrive on the same day. (A) Day 4 post-stroke, sitting unsupported, not yet ambulating. (B) Day 30 post-stroke, ambulates with a quad cane and contact-guard assist 25 m. (C) Day 200 post-stroke, ambulates community distances with a single-point cane, asks about a return-to-hiking program.

2. CPG section. Core Set CPG (Moore 2018) recommends a core set of six measures applied across adults with neurologic conditions where goals exist: BBS, FGA, ABC, 10MWT, 6MWT, and 5x Sit-to-Stand. BBS and 10MWT carry strong recommendations (Level I); FGA, 6MWT, and ABC carry moderate-to-strong recommendations.

3. Reasoning walkthrough.

• Patient A (acute, no ambulation): STREAM for motor and basic mobility; Berg for sitting/standing balance once tolerated.
• Patient B (subacute, walking with assistance): Berg, 10MWT comfortable, FGA once safe, 6MWT once endurance allows.
• Patient C (chronic, community ambulator): mini-BESTest or FGA, 10MWT comfortable and fast, 6MWT, plus a goal-anchored measure (timed stair climb, Stroke Impact Scale).

Choose by construct (balance vs gait speed vs gait endurance vs motor) and by ceiling. Berg ceilings around 51–56 for higher-functioning chronic stroke; mini-BESTest is more sensitive in this range (Godi M et al. *Phys Ther*. 2013;93:158–167).

4. Outcome measurement principle. Three measures repeated faithfully beat eight measures done inconsistently. Anchor each to a goal.