The Berg Balance Scale (or BBS) is a widely used clinical test of a person's static and dynamic balance abilities, named after Katherine Berg, one of the developers. For functional balance tests, the BBS is generally considered to be the gold standard.Langley, F.A. & Mackintosh, S.F.H. (2007).
Functional balance assessment of older community dwelling adults: A systematic review of the literature
The Internet Journal of Allied Health Sciences and Practice, 5(4). The test takes 15–20 minutes and comprises a set of 14 simple balance related tasks, ranging from standing up from a sitting position, to standing on one foot. The degree of success in achieving each task is given a score of zero (unable) to four (independent), and the final measure is the sum of all of the scores. The BBS has been shown to have excellent inter-rater (ICC = 0.98) and intra-rater relative reliability (ICC = 0.97), with an absolute reliability varying between 2.8/56 and 6.6/56, with poorer reliability near the middle of the scale, and is internally consistent (0.96). The BBS correlates satisfactorily with laboratory measures, including postural sway, and has good concurrent criterion, predictive criterion, and construct validity. Considerable evidence indicates that the BBS is also a valid measure of standing balance in post-

stroke Stroke is a medical condition in which poor cerebral circulation, blood flow to a part of the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemor ...

patients, but only for those who ambulate independently, due to the tasks that are required of the patient. The BBS was recently identified as the most commonly used assessment tool across the continuum of stroke rehabilitation and it is considered a sound measure of balance impairment. The BBS has been strongly established as valid and reliable but there are still several factors which may indicate that the BBS should be used in conjunction with other balance measures. For example, there are a few tasks in the BBS to test dynamic balance, which may limit its ability to challenge older adults who live independently in the community. A ceiling effect and floor effect has been reported for the BBS when used with community dwelling older adults. The use of the BBS as an outcome measure is compromised when participants score high on initial trials. In initial development of the BBS, the authors noted that a limitation to the scale was the lack of items requiring postural response to external stimuli or uneven support surfaces. This indicates that the BBS may be more appropriate for use with frail older adults rather than community-dwellers. In addition, the BBS has been shown to be a poor predictor of falls. The interpretation of the result is: Alternatively, the BBS can be used as a multilevel tool, with the risk of multiple falls increasing below a score of 45 and a significant increase below 40. In the original study, the value of 45 points was used to calculate relative risk estimates to demonstrate predictive validity, and a score of 45 has been shown to be an appropriate cut-off for safe independent ambulation and the need for assistive devices or supervision. An instrumented version of BBS is recently proposed to avoid observer bias and to facilitate objective assessment of Balance in home environments for periodic or long term monitoring.

Outcome measures

The Berg Balance Scale is used by clinical exercise physiologists,

physiotherapists Physical therapy (PT), also known as physiotherapy, is a healthcare profession, as well as the care provided by physical therapists who promote, maintain, or restore health through patient education, physical intervention, disease preventio ...

and occupational therapists to determine the functional mobility of an individual. This test can be administered prior to treatment for elderly individuals and patients with a history of but not limited to

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vertigo Vertigo is a condition in which a person has the sensation that they are moving, or that objects around them are moving, when they are not. Often it feels like a spinning or swaying movement. It may be associated with nausea, vomiting, perspira ...

cardiovascular disease Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases (e.g. angina, heart attack), heart failure, hypertensive heart disease, rheumati ...

and

respiratory disease Respiratory diseases, or lung diseases, are pathological conditions affecting the organs and tissues that make gas exchange difficult in air-breathing animals. They include conditions of the respiratory tract including the trachea, bronchi, ...

. The Berg Balance Scale Test can be administered every few months of treatment to determine if the treatment was effective for increasing the patient's functional mobility (a difference of 8 points is considered a significant change).

References

{{reflist Diagnostic neurology Medical scales Geriatrics

Outcome measures

See also

References