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Validating the Berg Balance Scale for patients with Parkinson's disease: A key to rehabilitation evaluation

Southeastern Parkinson's Disease Research, Education, and Clinical Center, McGuire Veterans Medical Center, Richmond, VA 23249, USA.
Archives of Physical Medicine and Rehabilitation (Impact Factor: 2.44). 05/2005; 86(4):789-92. DOI: 10.1016/j.apmr.2004.11.005
Source: PubMed

ABSTRACT To assess the criterion-related validity of the Berg Balance Scale (BBS) in subjects with Parkinson's disease (PD).
Prospective, correlational analysis between the BBS and accepted measures of PD motor and functional impairment.
The federally funded PD research center, an interdisciplinary center of excellence for people with PD within a Veterans Affairs medical center.
Thirty-eight men (average +/- standard deviation, 71.1+/-10.5 y) with confirmed PD. Their initial diagnosis had been made on average 5.8+/-3.6 years earlier. All could stand or walk unassisted and had mild to moderate disability. Patients who could not ambulate without assistive devices were excluded.
Not applicable.
Correlational analyses between the BBS and the Unified Parkinson's Disease Rating Scale (UPDRS) motor scale, Modified Hoehn and Yahr Staging (Hoehn and Yahr) Scale, and the Modified Schwab and England Capacity for Daily Living Scale (S&E ADL Scale).
BBS score showed significant correlations with indicators of motor functioning, stage of disease, and daily living capacity. BBS score was inversely associated with the UPDRS motor score (-.58, P <.005), Hoehn and Yahr Scale staging (-.45, P <.005), and S&E ADL Scale rating (.55, P <.005). In all 3 correlations, lower scores on the BBS (indicating greater balance deficits) correlated with higher UPDRS scores (indicating greater motoric or functional impairment).
Results support the criterion-related validity of the BBS. Its utility in other balance conditions of older adults has been established. Rehabilitation interventions have been shown to improve the balance deficits associated with PD. Early referral and periodic reassessment is vital to achieving and maintaining improvements. Our research results agree with other published research in suggesting that the BBS may be used as a screening tool and ongoing assessment tool for patients with PD.

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    • "After providing informed consent, participants completed falls diaries over a period of 4 weeks, at the end of which they underwent a battery of assessments, including objective and self-reported measures of both motor and non-motor impairment. Relevant to the present analysis, the following data on measures of PD severity, motor function and mobility were extracted from the GABI database, and utilized for the assessment of construct validity of the ACM/PIGD: Items 13, 14, 15, 29, and 30 of the UPDRS [13] to calculate the ACM/PIGD; Hoehn and Yahr state while ON (HYS) as a measure of disease severity [14]; number of falls in the preceding 4 weeks (NOF); Activities Based Confidence Scale (ABC) [15] as a measure of the subjects' confidence in their own ability to ambulate safely; Freezing of Gait Questionnaire (FOG) [16] as a measure of freezing; Five Times Sit-to-Stand (FTSS) [17] [18], Timed Upand Go (TUG) [19] [20], Gait Velocity (GV) [21], as global measures of bradykinesia and overall mobility; and, Berg Balance Scale (BBS) [22] [23] as a measure of balance. Briefly, all objective assessments took place in the ON state, according to standardized protocols. "
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    • "The exceptionally strong relationship between changes in STV and changes in scores on the Berg Balance Scale and Sit-Stand Test both resulting from the exercise program supports the construct validity of STV as a measure of gait performance and postural stability. In clinical populations with PD, BBS, and SST are valid and reliable measures of postural stability and gait performance, respectively [21], [22]. Further, it could be reasoned that because significant changes were noted in the STV and not in BBS and SST, that perhaps the STV is a more sensitive tool for detecting improvements in gait and stability changes than these other clinical measures. "
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    • "Each task is scored between 0 and 4 and indicates the capacity of an individual to execute tasks independently. A total score of 56 is possible and higher scores point to better balance status (Qutubuddin et al., 2005; Scalzo et al., 2009) -Cognitive screening (Mini Mental Exam Examination - MMSE): a brief 30-point questionnaire to evaluate spatial and temporal orientation, memory, language, attention, ability to do calculations and constructive visual capacity. Scores under 24 means that the subject has its mental capacity impaired. "
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