Article

Use of the Berg Balance Test to Predict Falls in Elderly Persons

Department of Physical Therapy, Bryn Mawr Rehabilitation Hospital, Malvern, PA 19355, USA.
Physical Therapy (Impact Factor: 3.25). 07/1996; 76(6):576-83; discussion 584-5.
Source: PubMed

ABSTRACT The purpose of this study was to determine whether the Berg balance test could be used to predict an elderly person's risk of falling.
Sixty-six residents of two independent life-care communities, aged 69 to 94 years (X = 79.2, SD = 6.2), participated.
Subjects completed a questionnaire pertaining to their fall history and activity level. The Berg balance test, consisting of 14 functional subtests, was then administered. Six months later, subjects again completed the questionnaire.
Performance of activities of daily living predicted 43% of the subjects' scores. There was a difference between the subjects who were prone to falling and those who were not prone to falling, but the test demonstrated poor sensitivity for predicting who would fall. The specificity of the test was very strong. The use of an assistive device was a strong predictor of performance on the Berg balance test. No relationship was noted between increasing age and decreasing performance on the Berg balance test.
Although the Berg balance test demonstrated only 53% sensitivity, the results support the test developers' use of 45 (out of 56) as a generalized cutoff score. Older adults who scored higher than the cutoff score on the test were less likely to fall than were those adults who scored below the cutoff score. Decreased scores, however, did not predict increased frequency of falls. Results must be viewed cautiously because self-report was the sole means of documenting fall history.

0 Followers
 · 
275 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: Walking requires coordination among multiple joints. Little is known about the association between the coordination ability and fall risks in elderly adults. This study investigated variability of inter-joint coordination in elderly adults and determined its correlation to clinical balance measures. METHODS: Gait analyses of 15 non-fallers and 15 fallers were performed during walking. Continuous relative phase, derived from phase angles of two adjacent joints, was used to assess the inter-joint coordination. Variability of inter-joint coordination was calculated as the average standard deviation of all points on the ensemble continuous relative phase curve over a gait cycle, namely the deviation phase. Outcomes from three clinical balance tests, including Berg Balance Test, Dynamic Gait Index and Timed Up-and-Go, were examined. FINDINGS: No significant group differences were detected in hip-knee deviation phase values after accounting for differences in walking speeds. For the knee-ankle deviation phase, fallers demonstrated significantly greater values in the stance phase but smaller values in the swing phase. The hip-knee deviation phase values demonstrated a negative correlation with Dynamic Gait Index, and the knee-ankle deviation phase values had a negative correlation with Dynamic Gait Index and a positive correlation with Timed Up-and-Go time. INTERPRETATION: Excessive variability of the supporting limb and reduced variability of the swing limb in knee-ankle inter-joint coordination of fallers may contribute to their risk of imbalance or tripping during walking. Compared to Berg Balance Test and Timed Up-and-Go, Dynamic Gait Index scores might be more sensitive to reflect declines in inter-joint coordination during walking.
    Clinical biomechanics (Bristol, Avon) 03/2013; 28(4). DOI:10.1016/j.clinbiomech.2013.03.001 · 1.88 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective. The purpose of this study was to explore the usefulness of the Mini-BESTest compared to the Berg Balance Scale in evaluating balance in people with PD of varying severity. We evaluated (1) the distribution of patients scores to look for ceiling effects, (2) concurrent validity with severity of disease, and (3) the sensitivity/specificity of separating people with or without postural response deficits. Subjects. Ninety-seven people with PD were tested for balance deficits using the Berg, Mini-BESTest, Unified Parkinson's Disease Rating Scale (UPDRS) III and the Hoehn & Yahr (H&Y) disease severity classification. Setting. Clinical research facility at Oregon Health & Science University. Results. The Mini-BESTest is highly correlated with the Berg (r = 0.79, P < 0.001), but avoids the ceiling compression effect of the Berg for mild PD (skewness -2.30 Berg, -0.93 Mini-BESTest). Consequently, the Mini-BESTest is more effective than the Berg for predicting UPDRS Motor score (P < 0.001 Mini-BESTest versus P = 0.86 Berg), and for discriminating between those with and without postural response deficits as measured by the H&Y (ROC differential P = 0.06). Conclusion. The Mini-BESTest is a promising tool for discerning balance deficits in patients with PD, most importantly those with more subtle deficits.
    01/2012; 2012(2090-8083):375419. DOI:10.1155/2012/375419
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Patients with multiple sclerosis (MS) tend to have movement difficulties, and the effect of physiotherapy for this group of patients has been subjected to limited systematic research. In the present study physiotherapy based on the Bobath concept, applied to MS patients with balance and gait problems, was evaluated. The ability of different functional tests to demonstrate change was evaluated. A single-subject experimental study design with ABAA phases was used, and two patients with relapsing-remitting MS in stable phase were treated. Tests were performed 12 times, three at each phase: A (at baseline); B (during treatment); A (immediately after treatment); and A (after two months). The key feature of treatment was facilitation of postural activity and selective control of movement. Several performance and self report measures and interviews were used. After intervention, improved balance was shown by the Berg Balance Scale (BBS) in both patients, and improved quality of gait was indicated by the Rivermead Visual Gait Assessment (RVGA). The patients also reported improved balance and gait function in the interviews and scored their condition as 'much improved'. Gait parameters, recorded by an electronic walkway, changed, but differently in the two patients. Among the physical performance tests the BBS and the RVGA demonstrated the highest change, while no or minimal change was demonstrated by the Rivermead Mobility Index (RMI) and Ratings of Perceived Exertion (RPE). The findings indicate that balance and gait can be improved after physiotherapy based on the Bobath concept, but this should be further evaluated in larger controlled trials of patients with MS.
    Physiotherapy Research International 06/2006; 11(2):104-16. DOI:10.1002/pri.327

Preview (2 Sources)

Download
12 Downloads