1.3 The Berg Balance Score

Describe the Berg Balance Score.  

1.  Assessment of balance.

2.  14 items from 0-4 per item for maximum score of 56.

3.  Score <45 is at risk of falling.

  • The Berg Balance Scale provides a quantitative assessment of balance in older adults11.
     
  • It was intended for use in monitoring the clinical status of patients or effectiveness of treatment interventions over time 12.
     
  • The scale consists of 14 items (common to everyday life) requiring subjects to maintain positions or complete movement tasks of varying levels of difficulty.
     
  • Administration of the scale requires a ruler, a stopwatch, chair, step or stool, room to turn 360 degrees and 10 – 15 minutes and is administered via direct observation of task completion12;13.
     
  • Items receive a score of 0-4 based on ability to meet the specific time and distance requirements of the test.
     
  • A score of zero is represents inability to complete the item and a score of 4 represents the ability to complete the task independently.
     
  • The maximum score is 56, although it is generally accepted that scores of less than 45 are indicative of balance impairment 14;15.

What are the strengths of the Berg Balance Score?

  • Measures a number of difference aspects of balance, both static and dynamic.
     
  • Requires little equipment or space and no specialized training.
     
  • High levels of reliability even when test is administered by an untrained assessor.
     
  • Particularly well suited to acute stroke rehabilitation, as the majority of patients do not obtain maximum scores on admission to rehabilitation; likely similar with ABI.

What are the limitations of the Berg Balance Score?

  • Decreased sensitivity in the early stages post-stroke among severely affected patients as scale includes only one items relating to balance in the sitting position; likely also true with ABI patients.
     
  • Takes somewhat longer to administer than other balance measures and may not be suitable for the evaluation of active, elderly person, as the items included are not sufficiently challenging for this group.
     
  • No common standards for interpretation of BBS scores exist, their relationship to mobility status and the requirement for mobility aids.
     

For a detailed discussion on the advantages and limitations of the scale please see ERABI/Assessment of Outcomes Following Acquired/Traumatic Brain Injury