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: 2.53). 07/1996; 76(6):576-83; discussion 584-5.
Source: PubMed


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.

84 Reads
  • Source
    • "The average BBS of the study participants was 42.6. The scores below 45 were considered as increased risk for falls [39]. However, the relation of BBS scores between fallers and nonfallers is still controversial [20]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background. Poststroke impairment may lead to fall and unsafe functional performance. The underlying mechanism for the balance dysfunction is unclear. Objective. To analyze the relation between the motor level of the affected limbs and balance in poststroke subjects. Method. A prospective, cross-sectional, and nonexperimental design was conducted in a rehabilitation institute. A convenience sample of 44 patients was assessed for motor level using Brunnstrom recovery stage (BRS) and Fugl-Meyer Assessment: upper (FMA-UE) and lower extremities (FMA-LE). The balance was measured by Berg Balance Scale (BBS), Postural Assessment Scale for Stroke Patients (PASS), and Functional Reach Test (FRT). Results. BRS showed moderate correlation with BBS (ρ = 0.54 to 0.60; P < 0.001), PASS (r = 0.48 to 0.64; P < 0.001) and FRT (ρ = 0.48 to 0.59; P < 0.001). FMA-UE also exhibited moderate correlation with BBS (ρ = 0.59; P < 0.001) and PASS (ρ = 0.60; P < 0.001). FMA-LE showed fair correlation with BBS (ρ = 0.50; P = 0.001) and PASS (ρ = 0.50; P = 0.001). Conclusion. Motor control of the affected limbs plays an important role in balance. There is a moderate relation between the motor level of the upper and lower extremities and balance. The findings of the present study may be applied in poststroke rehabilitation.
    05/2014; 2014(1):767859. DOI:10.1155/2014/767859
  • Source
    • "BBS is a measure of dynamic balance, and Thorbahn et al.16) reported that a BBS score of <45 indicates an increased risk of a fall. In this study, the lower limb weight movement and stability exercise ofthe stationary bicycle exercise had a positive effect on the BBS score of the elderly women. "
    [Show abstract] [Hide abstract]
    ABSTRACT: [Purpose] A stationary bicycle exercise and a treadmill exercise were conducted in order to determine the effect of these exercises on the balance and walking ability of elderly women. [Subjects and Methods] Twenty-four elderly women aged 65 or older were equally assigned to a stationary bicycle exercise group and a treadmill exercise group, and they performed exercise three times per week for 8 weeks for 20 minutes each time. In order to examine gait, step length and time were measured as parameters of walking ability, and in order to examine dynamic balance, subjects were evaluated with the Berg balance scale (BBS). [Results] After the intervention, step time and step length and BBS significantly increased significantly decreased, in both groups. A comparison of BBS after the intervention between the two groups revealed that the stationary bicycle group showed larger increases than the treadmill group. [Conclusion] The stationary bicycle exercise group and treadmill exercise group showed significant improvements in gait and balance. Stationary bicycle exercise can help to prevent falls by improving the balance of elderly persons.
    Journal of Physical Therapy Science 03/2014; 26(3):431-3. DOI:10.1589/jpts.26.431 · 0.39 Impact Factor
  • Source
    • "In terms of the outcomes of the posturographic analysis, our results showed statistical difference for all the parameters between healthy and stroke subjects in the EO condition, whereas only four parameters were statistically different between the two subject populations in the EC condition (CoP path and CoPv, AP CoP path and AP CoPv). The lack of significant difference in the EC condition should not be necessarily attributed to a worst performance of SS subjects in EO condition, but could simply reflect the decrease in balance control in EC condition for CS subjects, decrease that has been well documented in previous studies [25]. While CS group’s performance clearly worsens in EC condition, SS group shows poor balance in both EC and EO conditions. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Stroke is often associated with balance deficits that increase the risk of falls and may lead to severe mobility disfunctions or death. The purpose of this study is to establish the relation between the outcome of instrumented posturography and of the most commonly used clinical balance tests, and investigate their role for obtaining reliable feedback on stroke patients' balance impairment. Romberg test was performed on 20 subjects, 10 hemiplegic post-stroke subjects (SS, 69.4 +/- 8.2 years old) and 10 control subjects (CS, 61.6 +/- 8.6 years old), with 1 Bertec force plate. The following parameters were estimated from the centre of pressure (CoP) trajectory, which can be used to define subjects' performance during the balance task: sway area; ellipse (containing 95% of the data); mean CoP path and velocity in the anterior-posterior and medio-lateral directions. The following clinical scales and tests were administered to the subjects: Tinetti Balance test (TB); Berg Balance test (BBT); Time up and go test (TUG), Fugl-Meyer (lower limbs) (FM), Motricity Index (lower limbs), Trunk Control Test, Functional Independence Measure. Comparison between SS and CS subjects was performed by using the Student t-test. The Pearson Correlation coefficient was computed between instrumental and clinical parameters. Mean +/- standard deviation for the balance scales scores of SS were: 12.5 +/- 3.6 for TB, 42.9 +/- 13.1 for BBT, 24 s and 75 cent +/- 25 s and 70 cent for TUG. Correlation was found among some CoP parameters and both BBT and TUG in the eyes open and closed conditions (0.9 <= R <= 0.8). Sway area correlated only with TUG. Statistically significant differences were found between SS and CS in all CoP parameters in eyes open condition (p < 0.04); whereas in eyes closed condition only CoP path and velocity (p < 0.02) differed significantly. Correlation was found only among some of the clinical and instrumental balance outcomes, indicating that they might measure different aspects of balance control. Consistently with previous findings in healthy and pathological subjects, our results suggest that instrumented posturography should be recommended for use in clinical practice in addition to clinical functional tests.
    Journal of NeuroEngineering and Rehabilitation 08/2013; 10(1):95. DOI:10.1186/1743-0003-10-95 · 2.74 Impact Factor
Show more