Content uploaded by Katherine Berg
Author content
All content in this area was uploaded by Katherine Berg on Aug 06, 2017
Content may be subject to copyright.
Measuring balance in the elderly: Preliminary development of an instrument
Abstract
The goal for this study was to develop a measure of balance appropriate for elderly individuals. In total, 38 patients, ranging in age from 60 to 93 years, and 32 professionals, including nurses, physicians, and physical and occupational therapists were surveyed in three distinct phases to develop the content. Reliability of the measure was assessed by having physical therapists evaulate the videotaped performances of geriatric subjects at two different points in time. The intraclass correlation coefficients measuring the inter and intra rater reliability for the test as a whole were .98 and .99 respectively. The correlation coefficients for the individual items ranged from .71 to .99. In addition, there was a high degree of internal consistency, a Cronbach's alpha of .96, which indicates the movements reflect a single underlying dimension. The scale consists of 14 movements common in everyday life. It is easy to administer and score and has measurement properties that are better than expected for a new instrument. Given the potential uses of such a measure for physical therapists and other health professionals, further development and testing of the scale are in order.
... The 14 items of BBS assess static sitting and standing balance and expected balance during activities commonly performed in daily functions. 16 The Activity-Specific Balance Confidence (ABC) Scale is a scale that evaluates the level of confidence perceived by the patient while performing the activities of daily living and the activities that can be done safely without falling. 17,18 It is very important to investigate the effects of VEMP responses along with posture and balance problems in OSAS patients, 19 and cVEMP changes have been clearly stated previously; however, oVEMP changes still need to be revealed more. ...
... The static and dynamic balance of the patients was evaluated with the BBS developed by Berg et al. 16 Each section was rated from 0 (lowest level of function) to 4 (highest level of function) on a 14-item scale. Dependency during positions such as standing up from sitting, standing and sitting without support, a transition from standing to sitting, transfers, standing with eyes closed-feet together and heel tiptoe, reaching forward, picking up objects from the ground, turning in place, balancing on one leg and/or the level of independence, and the person's ability to change positions were evaluated. ...
... On this scale, which is a total of 56 points, a score of 0 to 20 indicates poor balance, a score of 21 to 40 indicates fair balance, and a score of 41 to 56 indicates good balance. 16 Statistical Analysis SPSS 22 package program was used to evaluate the data. Participants' cVEMP and oVEMP latency and amplitude values, amplitude asymmetry ratios and interwave latency values, ABC scores, and BBS scores were recorded according to their groups. ...
Background While cardiovascular and neurological diseases induced by obstructive sleep apnea syndrome (OSAS) hypoxia are well established, the association between neuro-otological diseases and OSAS is not entirely understood. Vestibular and audiological tests have been used to evaluate the degeneration of neurons in the brainstem caused by recurrent hypoxia.
Purpose Evaluation of the vestibular-evoked myogenic potential (VEMP) test findings applied to detect the possible influence on the vestibular reflex arc due to hypoxia in patients diagnosed with OSAS using Activity-Specific Balance Confidence (ABC) and Berg Balance Scale (BBS) scales determination of scores.
Research Design This was a cross-sectional study.
Study Sample Participants aged 18 to 60 who underwent polysomnography due to snoring/sleep apnea were divided into an OSAS, and a control group of subjects were also included. Each group consisted of 20 participants.
Data Collection and Analysis All participants were evaluated with cervical VEMP (cVEMP) and ocular VEMP (oVEMP) tests. The groups were compared regarding variables such as the rate of oVEMP and cVEMP waves obtained, the interval between the waves, and the latency and amplitude. Also, BBS and ABC scales were applied to all participants.
Results The cVEMP (50%) and oVEMP (45%) response rates and amplitudes were significantly lower in the OSAS group. No significant difference was found between the groups when comparing other VEMP parameters. However, a statistically significant decrease was observed in the ABC and BBS scores in the OSAS group.
Conclusion The identification of VEMP alterations in the OSAS group is a clear indication that the vestibular reflex pathways may be adversely affected by hypoxia. Personal rehabilitation programs can be created by evaluating activities of daily living with the ABC and static and dynamic balances with BBS in patients with OSAS.
... Accurately assessing an individual's balance typically requires a trained professional, such as a physical therapist (PT). The Berg balance scale (BBS) is often widely used for this purpose [5]. The BBS test comprises 14 balance tasks, where performance on each is graded on a scale of 0 to 4 by a PT. ...
... The BBS was used the balance score metric [5]. In a BBS evaluation, a participant performs 14 tasks, and a professional PT scores each task on a scale from 0 to 4, where 0 indicates inability to perform the task and 4 indicates complete execution. ...
A long-term gait-balance monitoring system for various terrain types was developed using an inertial measurement unit (IMU) and deep-learning model. The system aims to identify unstable gait caused by lower-limb degeneration to prevent fall-related injuries. Unlike previous studies that have only focused on gait stability in flat terrain walking, the proposed system is also capable of analyzing stability on stairs and slopes. A lightweight, nine-axis IMU was used for data collection, and a combined convolutional neural network with gated recurrent unit model was implemented on the portable Raspberry Pi Zero 2 W for predicting Berg balance scale (BBS) scores. The BBS scores and gait data were then wirelessly transmitted to a cloud provider for long-term data storage. The system is as small and lightweight as a baseball and can monitor users for extended periods. The system can identify abnormal balance scores to provides physicians with long-term gait information, assisting their analysis and decision-making. This prevents falling and the corresponding consumption in healthcare resources that comes with fall-related injuries.
... Similar to the TUG, the results for fall risk prediction are not consistent [68]. Another well-known functional balance assessment is the BBS [72]. A meta-analysis revealed heterogeneous findings on the validity of the BBS, i.e. the BBS was only valid for fall prediction in specific subgroups (e.g. ...
With increasing age, motor performance declines. This decline is associated with less favorable health outcomes such as impaired activities of daily living, reduced quality of life, or increased mortality. Through regular assessment of motor performance, changes over time can be monitored, and targeted therapeutic programs and interventions may be informed. This can ensure better individualization of any intervention approach (e.g. by considering the current motor performance status of a person) and thus potentially increase its effectiveness with regard to maintaining current performance status or delaying further decline. However, in older adults, motor performance assessment is time consuming and requires experienced examiners and specific equipment, amongst others. This is particularly not feasible in care facility/nursing home settings. Wearable robotic devices, such as exoskeletons, have the potential of being used to assess motor performance and provide assistance during physical activities and exercise training for older adults or individuals with mobility impairments, thereby potentially enhancing motor performance. In this manuscript, we aim to (1) provide a brief overview of age-related changes of motor performance, (2) summarize established clinical and laboratory test procedures for the assessment of motor performance, (3) discuss the possibilities of translating established test procedures into exoskeleton-based procedures, and (4) highlight the feasibility, technological requirements and prerequisites for the assessment of human motor performance using lower limb exoskeletons.
... It took 5 minutes to administer. 19 TREATMENT PROTOCOL 1. FUNCTIONAL TASK TRAINING 15 TIME ACTIVITIES 1 Minute ...
Background: Balance problem often occur with aging, even for those with good health. Functional task training and resistance training can improve the balance of older adults maintaining independence and quality of life. Study design: A Quasi experimental design. Aim: To assess the impact of functional task training and resistance training on balancing in older adults. Objective: To evaluate outcome of functional task training and resistance training on balancing in older adults by using berg balance scale (BBS). Participants: The participants were recruited based on exclusion and inclusion criteria. The participants were divided into four groups; Functional task training group, Resistance training group, Functional task training +Resistance training group and Conventional balance training. With 12 participants in each group. A Total of 48 participants were included in the study. Methods: A quasi-experimental design was conducted on 48 participants at Santosh college of Occupational therapy, Ghaziabad. The total sample was randomly divided into four equal groups. Functional task training (N=12), Resistance training (N=12), Functional task training + resistance training (N=12) and Conventional balance training (N= 12). Result : In Berg balance scale (BBS) pre and post mean score for Functional task training, resistance training, functional task training +resistance training and Conventional were ( 30.00, 30.00, 28.08, 31.75) respectively accompanied by standard error (2.216, 3.885, 5.368, 2.927) respectively and subsequently post mean value of BBS increased (33.50, 32.42, 31.75, 34.25 ) standard error (.764, .981, .845, .827) and standard deviation (2.646, 3.397, 2.927, 2.864) which indicate progress. CONCLUSION: The study highlights that the outcome of Functional task training and Conventional training is more effective than Resistance training and combination of Functional task training with resistance training to improve balance abilities in older adults.
... In total each participant would be asked to commit approximately five hours of their time to assessments over a 12-month period. Visiting the laboratory on two occasions is a potentially significant burden for both participants and carers who may be required to assist with Falls Efficacy Scale-International [38] International Physical Activity Questionnaire-Elderly (IPAQ-E) [39] Timed-up-and-go (TUG) [40]* Hospital Anxiety and Depression Scale (HADS) [41] Walk-12G Questionnaire [42] 6-minute walk (6MWT) [43] * Apathy Evaluation Scale-Self Report [44] Five times Sit to Stand [45]* EQ-5D-5L [46] Berg Balance Scale [47] *Selected physical outcome measures will also include additional data collection as below 1. 6-minute Walk Test (6MWT): In addition to standard completion, change in walking speed monitored over time via time taken per 60m lap. Time per lap during the 6MWT will be recorded for each participant. ...
Background
Individuals with Parkinson’s Disease (PD) often experience not only physical symptoms but also a higher prevalence of psychological issues, including depression, anxiety, schizophrenia, and psychotic symptoms, compared to the general population. The relationship between these physical and psychological symptoms remains poorly understood, particularly in relation to commonly used measures of physical function and a wider variety of psychological symptoms. Investigating this link is essential for optimising patient care. This cohort study is registered with OSF (https://osf.io/c7tvd).
Objective
The primary aim of this study is to investigate the association between physical and psychological symptoms in PD. We will focus specifically on measures of physical function such as balance and mobility, assess the similarities between physiotherapist and participant-rated measures, and monitor changes over time.
Methods
This cohort study plans to recruit 30 participants with PD, who will be monitored over a 12-month period. Data will be collected at baseline and completion, providing two data points per participant. Selected outcome measures will include physical function (objective measures), non-motor symptoms, participants perceived function, and engagement in physical activity. Correlations between outcomes will be analysed, and multivariate regression modelling may be employed for time-series analysis to evaluate how relationships change over time. Descriptive summaries of all outcomes will be presented in tables.
Results
Ethical approval for this study was obtained on 15th July 2024, with participant recruitment scheduled to begin in October 2024. Data collection is expected to conclude by August 2026, with final results anticipated within six months of study completion.
Conclusions
This study will be the first to monitor this specific set of physical and psychological outcomes over time in individuals with PD. The findings are expected to provide valuable insights into the relationship between these symptoms, informing future research and potentially leading to larger-scale, multi-site studies conducted over extended assessment periods.
... The primary endpoint was balance ability in stroke outpatient rehabilitation, measured via the German version of the Berg balance scale (BBS) before and after the intervention was administered; this was conducted by one blinded therapist during the years 2021 and 2022, the intervention period ran from December 2021 to March 2022. [22][23][24]. The BBS was chosen because represents the gold standard for measuring balance in a clinical setting, furthermore it enables the results of this therapy to be compared with other interventions [25][26][27]. ...
Recently, neuroathletic training has been increasingly applied in competitive sports, in therapy, and in prevention. Scientific evidence on the effectiveness of this approach, however, has been poorly developed. Potentials of neuropathologic perceptual exercises to potentially improve balance control in the context of movement therapy in stroke rehabilitation appear promising. To investigate the possible effects of neuroathletic exercises on the balance ability of poststroke patients with ischemic infarcts and intracerebral hemorrhages, a controlled trial of a standardized protocol of daily neuroathletic exercises compared to traditional movement therapy during a four-week period of medical rehabilitation was conducted (n = 19). Patients were assessed with the Berg-Balance Scale (BBS), which represents the Gold standard for clinical measurement of balance. The results of the prepost BBS measurement showed significant balance improvements in the intervention and control groups, whereas the intervention group reached a higher total score by half the size of the standard deviation. A comparison of the results of both groups supported the general effectiveness of movement therapy for improving balance in stroke rehabilitation. However, neuroathletic training exercises did not lead to a stronger effect. Moreover, the intervention group did not score significantly lower than the control group. A negative influence can therefore not be assumed. For further investigations of neuroathletic training compared to treatment-as-usual training to improve balance in stroke rehabilitation, additional studies with larger sample sizes and longer treatment periods should be conducted.
Trial registration United States National Library of Medicine, NCT06391801, date: 04.29.2024.
... Gait function was specifically investigated using the Berg Balance Scale (BBS) 24 . Higher scores reveal better balance. ...
Idiopathic Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by tremor, rigidity, bradykinesia, and postural instability. Magnetic Resonance-guided high-intensity focused ultrasound (MRgFUS) of the subthalamic nucleus (STN) is gaining recognition as a minimally invasive surgical option. This study assesses the safety and efficacy of unilateral MRgFUS subthalamotomy, aiming to create the smallest effective lesion. Between June 2021 and October 2023, twelve PD patients underwent the procedure, with primary outcomes focused on safety and motor improvements after six months. Results indicated significant motor improvements, with over 50% reduction in tremor, rigidity, and bradykinesia, while balance and gait remained stable. Quality of life also improved. Side effects were generally mild and transient, though some patients experienced involuntary movements, managed through medication adjustments. Despite limitations, this technique appears to offer a promising, less-invasive alternative for managing PD symptoms with a favorable risk-benefit profile. Further research is necessary to refine the procedure and assess long-term outcomes.
... 10,11 Over the past decades, various assessment tools have been devised and described to predict fall risk, including the Hendrich II Fall Risk Model, 12 Comprehensive Geriatric Assessment, 13 timed "up and go" (TUG) test, 14 Dynamic Gait Index (DGI), 15 and Berg-Balance-Scale (BBS). 16 These methods often lack the sensitivity needed to detect subtle changes in fall risk. 17 Moreover, these approaches may not adequately address the unique vulnerabilities inherent in patients with diabetes with the combination of confounding factors (e.g., hypoglycemia, 5 peripheral neuropathy, 18 cognitive decline 19 ), highlighting the need for innovative solutions. ...
Background
Fall(s) are a significant cause of morbidity and mortality especially amongst elderly with polyneuropathy and cognitive decline. Conventional fall risk assessment tools are prone to low predictive values and do not address specific vulnerabilities. This study seeks to advance the development of an innovative, engaging fall prediction tool for a high-risk cohort diagnosed with diabetes.
Methods
In this proof-of-concept cohort study, between July 01, 2020, and May 31, 2022, 152 participants with diabetes performed clinical examinations to estimate individual risks of fall (timed “up and go” (TUG) test, dynamic gait index (DGI), Berg-Balance-Scale (BBS)) and participated in a video game-based fall risk assessment with sensor-equipped insoles as steering units. The participants engaged in four distinct video games, each designed to address capabilities pertinent to prevent fall(s): skillfulness, reaction time, sensation, endurance, balance, and muscle strength. Data were collected during both, seated and standing gaming sessions. By data analyses using binary machine learning models a classification of participants was achieved and compared with actual fall events reported for the past 24 months.
Findings
Overall 22 out of 152 participants (14.5%) underwent at least one episode of fall during the past 24 months. Adjusted risk classification accuracies of TUG, DGI, and BBS reached 58.7%, 58.3%, and 47.5%, respectively. Data analyses from gaming sessions in seated and standing positions yielded two models with six predictors from the four games with accuracies of 82.8% and 88.6% (area under the receiver-operating-characteristic curve 0.84 (95% confidence interval (CI): 0.77–0.91) and 0.91 (95% CI: 0.85–0.97), respectively). Key capabilities that were distinctly different between the groups related to endurance (0.6 ± 0.1 vs. 0.5 ± 0.2; p = 0.03) and balance (0.7 ± 0.2 vs. 0.6 ± 0.2; p = 0.05). The AI-driven analysis allowed to extract a list of game features that showed highly significant predictive values, e.g., reaction times in specific task, deviation from ideal steering routes in parcours and pressure-related parameters.
Interpretation
Thus, video game-based assessment of fall risk surpasses traditional clinical assessment tools and scores (e.g., TUG, DGI, and BBS) and may open a novel resource for patient evaluation in the future. Further research with larger, heterogeneous cohorts is needed to validate these findings and especially predict future fall risk probabilities in clinical as well as outpatient settings.
Funding
This project was funded by the Ministry of Science, Economics, and Digitalization of the State of Saxony-Anhalt and the European Fund for Regional Development under the Autonomy in Old Age Program (Funding No: ZS/2016/05/78615, ZS/2018/12/95325) and Healthy Cognition and Nerve function (HeyCoNer, ZS/2023/12/183088).
... We measured the ROF with the Berg Balance Test (BBT; Berg et al., 1989). This test assesses a person's functional balance via their performance on 14 distinct activities commonly encountered in daily life. ...
The prevalence of falls in older individuals worldwide is around 26.5%. There is an urgent need to identify factors antagonistic to advanced age-related falls regarding personal safety, family or nursing care time, and healthcare costs. The aim of the study was to examine the relationship between functional fitness, mental health indicators, and the risk of falling (ROF) in older adults. Thirty-eight older adults (60–94 years; 66% female) were tested individually with the Fullerton Functional Fitness Test (FFFT) after completing five instruments gauging resilience, well-being, satisfaction with life, happiness, and perceived stress. We measured the ROF with the Berg Balance Test. All objective and subjective measures correlated significantly with the ROF. Bayesian linear regressions revealed that complex movement coordination accounted for 68.8%, while resilience accounted for 48.5% of the variance in the ROF. Moreover, resilience was also a mediator between complex movement coordination and ROF. These results suggest that complex movement coordination-developing and resilience-enhancing training strategies might be beneficial in reducing the ROF in older adults.
Purpose
Patient-reported outcome measures (PROMs) are being used more frequently in total knee arthroplasty (TKA). By utilizing high-quality scales, surgeons can achieve a more comprehensive and accurate evaluation of the effectiveness of TKA surgery. Currently, there is no widely accepted conceptual model for TKA PROMs. The objective of this study is to fill this gap by developing a conceptual model and preliminary content for a PROM that is specifically designed for TKA patients in mainland China.
Methods
The study design consisted of three stages: (1) a targeted literature review followed by the formation of a conceptual model pool; (2) qualitative data collection involving experts and patients, leading to the development of the preliminary Chinese TKA PROM (CTP); and (3) review of the CTP by experts using the Delphi method, along with cognitive debriefing interviews with patients.
Results
64 patients and 28 experts took part in this study. The conceptual model focused on six key concepts: pain, symptom, function, quality of life, expectation, and satisfaction. To match the model, the authors developed a total of 35 items.
Conclusion
A conceptual model and preliminary content for CTP was developed with substantial participation from patients and a multidisciplinary group of experts. The integration of patient and clinical perspectives ensured a comprehensive representation of all relevant disease experiences and the focus of clinical practice. With further refinement through psychometric testing, the CTP is positioned to provide a standardized, comprehensive measure for research specific to Chinese TKA patients.
ResearchGate has not been able to resolve any references for this publication.