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Berg Balance Scale | Falls SA, Exercises of Personal Health

14-item scale designed to measure balance of the older adult in a clinical setting. Equipment needed: Ruler, 2 standard chairs (one with arm rests, one without).

Typology: Exercises

2021/2022

Uploaded on 09/12/2022

shashwat_pr43
shashwat_pr43 🇺🇸

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Berg Balance Scale
Description:
14-item scale designed to measure balance of the older adult in a clinical setting.
Equipment needed: Ruler, 2 standard chairs (one with arm rests, one without)
Footstool or step, Stopwatch or wristwatch, 15 ft walkway
Completion:
Time: 15-20 minutes
Scoring: A five-point ordinal scale, ranging from 0-4. “0” indicates the lowest level
of function and “4” the highest level of function. Total Score = 56
Interpretation: 41-56 = low fall risk
21-40 = medium fall risk
0 –20 = high fall risk
Criterion Validity:
“Authors support a cut off score of 45/56 for independent safe ambulation”.
Riddle and Stratford, 1999, examined 45/56 cutoff validity and concluded:
Sensitivity = 64% (Correctly predicts fallers)
Specificity = 90% (Correctly predicts non-fallers)
Riddle and Stratford encouraged a lower cut off score of 40/56 to assess fall risk
Comments: Potential ceiling effect with higher level patients. Scale does not include gait items
Norms:
Lusardi, M.M. (2004). Functional Performance in Community Living Older Adults.
Journal of Geriatric Physical Therapy, 26(3), 14-22.
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Description:

14-item scale designed to measure balance of the older adult in a clinical setting.

Equipment needed: Ruler, 2 standard chairs (one with arm rests, one without)

Footstool or step, Stopwatch or wristwatch, 15 ft walkway

Completion:

Time: 15-20 minutes

Scoring: A five-point ordinal scale, ranging from 0-4. “0” indicates the lowest level

of function and “4” the highest level of function. Total Score = 56

Interpretation: 41-56 = low fall risk

21-40 = medium fall risk

0 –20 = high fall risk

Criterion Validity:

“Authors support a cut off score of 45/56 for independent safe ambulation”.

Riddle and Stratford, 1999, examined 45/56 cutoff validity and concluded:

  • Sensitivity = 64% (Correctly predicts fallers)
  • Specificity = 90% (Correctly predicts non-fallers)
  • Riddle and Stratford encouraged a lower cut off score of 40/56 to assess fall risk

Comments: Potential ceiling effect with higher level patients. Scale does not include gait items

Norms:

Lusardi, M.M. (2004). Functional Performance in Community Living Older Adults.

Journal of Geriatric Physical Therapy , 26(3), 14-22.

Name: __________________________________ Date: ___________________

Location: ________________________________ Rater: ___________________

ITEM DESCRIPTION SCORE (0-4)

Sitting to standing ________

Standing unsupported ________

Sitting unsupported ________

Standing to sitting ________

Transfers ________

Standing with eyes closed ________

Standing with feet together ________

Reaching forward with outstretched arm ________

Retrieving object from floor ________

Turning to look behind ________

Turning 360 degrees ________

Placing alternate foot on stool ________

Standing with one foot in front ________

Standing on one foot ________

Total ________

GENERAL INSTRUCTIONS

Please document each task and/or give instructions as written. When scoring, please record

the lowest response category that applies for each item.

In most items, the subject is asked to maintain a given position for a specific time.

Progressively more points are deducted if:

  • the time or distance requirements are not met
  • the subject’s performance warrants supervision
  • the subject touches an external support or receives assistance from the examiner

Subject should understand that they must maintain their balance while attempting the tasks.

The choices of which leg to stand on or how far to reach are left to the subject. Poor

judgment will adversely influence the performance and the scoring.

Equipment required for testing is a stopwatch or watch with a second hand, and a ruler or

other indicator of 2, 5, and 10 inches. Chairs used during testing should be a reasonable

height. Either a step or a stool of average step height may be used for item # 12.

Berg Balance Scale continued…..

REACHING FORWARD WITH OUTSTRETCHED ARM WHILE STANDING

INSTRUCTIONS: Lift arm to 90 degrees. Stretch out your fingers and reach forward as far as you can. (Examiner places a ruler at the end of fingertips when arm is at 90 degrees. Fingers should not touch the ruler while reaching forward. The recorded measure is the distance forward that the fingers reach while the subject is in the most forward lean position. When possible, ask subject to use both arms when reaching to avoid rotation of the trunk.) ( ) 4 can reach forward confidently 25 cm (10 inches) ( ) 3 can reach forward 12 cm (5 inches) ( ) 2 can reach forward 5 cm (2 inches) ( ) 1 reaches forward but needs supervision ( ) 0 loses balance while trying/requires external support

PICK UP OBJECT FROM THE FLOOR FROM A STANDING POSITION INSTRUCTIONS: Pick up the shoe/slipper, which is place in front of your feet. ( ) 4 able to pick up slipper safely and easily ( ) 3 able to pick up slipper but needs supervision ( ) 2 unable to pick up but reaches 2-5 cm(1-2 inches) from slipper and keeps balance independently ( ) 1 unable to pick up and needs supervision while trying ( ) 0 unable to try/needs assist to keep from losing balance or falling TURNING TO LOOK BEHIND OVER LEFT AND RIGHT SHOULDERS WHILE STANDING INSTRUCTIONS: Turn to look directly behind you over toward the left shoulder. Repeat to the right. Examiner may pick an object to look at directly behind the subject to encourage a better twist turn. ( ) 4 looks behind from both sides and weight shifts well ( ) 3 looks behind one side only other side shows less weight shift ( ) 2 turns sideways only but maintains balance ( ) 1 needs supervision when turning ( ) 0 needs assist to keep from losing balance or falling

TURN 360 DEGREES

INSTRUCTIONS: Turn completely around in a full circle. Pause. Then turn a full circle in the other direction. ( ) 4 able to turn 360 degrees safely in 4 seconds or less ( ) 3 able to turn 360 degrees safely one side only 4 seconds or less ( ) 2 able to turn 360 degrees safely but slowly ( ) 1 needs close supervision or verbal cuing ( ) 0 needs assistance while turning

PLACE ALTERNATE FOOT ON STEP OR STOOL WHILE STANDING UNSUPPORTED INSTRUCTIONS: Place each foot alternately on the step/stool. Continue until each foot has touch the step/stool four times. ( ) 4 able to stand independently and safely and complete 8 steps in 20 seconds ( ) 3 able to stand independently and complete 8 steps in > 20 seconds ( ) 2 able to complete 4 steps without aid with supervision ( ) 1 able to complete > 2 steps needs minimal assist ( ) 0 needs assistance to keep from falling/unable to try

STANDING UNSUPPORTED ONE FOOT IN FRONT

INSTRUCTIONS: (DEMONSTRATE TO SUBJECT) Place one foot directly in front of the other. If you feel that you cannot place your foot directly in front, try to step far enough ahead that the heel of your forward foot is ahead of the toes of the other foot. (To score 3 points, the length of the step should exceed the length of the other foot and the width of the stance should approximate the subject’s normal stride width.) ( ) 4 able to place foot tandem independently and hold 30 seconds ( ) 3 able to place foot ahead independently and hold 30 seconds ( ) 2 able to take small step independently and hold 30 seconds ( ) 1 needs help to step but can hold 15 seconds ( ) 0 loses balance while stepping or standing

STANDING ON ONE LEG INSTRUCTIONS: Stand on one leg as long as you can without holding on. ( ) 4 able to lift leg independently and hold > 10 seconds ( ) 3 able to lift leg independently and hold 5-10 seconds ( ) 2 able to lift leg independently and hold ≥ 3 seconds ( ) 1 tries to lift leg unable to hold 3 seconds but remains standing independently. ( ) 0 unable to try of needs assist to prevent fall

( ) TOTAL SCORE (Maximum = 56)