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.

    • "Optimal postural control in quiet standing therefore, is characterized by small CoP oscillations in amplitude, relatively unconstrained and irregular. Usually during balance tests the time that subjects are able to maintain a particular equilibrium position is recorded (Bogle Thorbahn and Newton, 1996; Graybel and Fregly, 1966) as further information for classification. Control of posture is connected to attention and to the instructional set, therefore these parameters should be considered in testing protocols of postural control (Nishiwaki et al., 2000). "
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    ABSTRACT: Objective: Falls are a serious health problem for older adults. Several studies have identified the decline of postural balance as one of the main risk factors for falls. Contrary to what may be believed, the capability of force platform measurements to predict falls remains uncertain. The focus of this narrative review is the identification of postural characteristics of older adults at risk of falling using both static and dynamic postural balance assessments. Methods: The literature analysis was conducted on Medline/PubMed. The search ended in May 2015. Results: Centre of pressure (CoP) path length, CoP velocity and sway in medial lateral and anterior-posterior are the variables that distinguish older adult fallers from non-fallers. Discussion: Recommendations to medical personnel on how to provide efficient balance training for older adults are offered, discussing the relevance and limitations of postural stability on static and dynamic board in falling risk prevention.
    No preview · Article · Dec 2015
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    • "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]. "
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    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.
    Full-text · Article · May 2014
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    • "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. "
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    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.
    Full-text · Article · Mar 2014 · Journal of Physical Therapy Science
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