Berg Balance Scale

Description: 14-item scale designed to measure balance of the older adult in a clinical setting. Equipment needed: Ruler, 2 standard chairs (one with arm rests, one without) Footstool or step, Stopwatch or wristwatch, 1 ft wal!wa" Completion: Time: Scoring: Interpretation: 1 -2# minutes $ fi%e-point ordinal scale, ranging from #-4. &#' indicates the lowest le%el of function and &4' the highest le%el of function. Score the ()*+S, performance. ,otal Score - . 41-56 = lo !all ris" #1-4$ = medium !all ris" $ %#$ = &ig& !all ris"

Criterion 'alidit(: &$uthors support a cut off score of 4 / . for independent safe ambulation'. Riddle and Stratford, 1000, e1amined 4 / . cutoff %alidit" and concluded2 Sensiti%it" - .43 (4orrectl" predicts fallers) Specificit" - 0#3 (4orrectl" predicts non-fallers) Riddle and Stratford encouraged a lower cut off score of 4#/ . to assess fall ris! Comments: 5otential ceiling effect with higher le%el patients. Scale does not include gait items

)inimal Detecta*le C&ange: &$ change of 4 points is needed to be 0 3 confident that true change has occurred if a patient scores within 4 - . initiall", 5 points if the" score within 6 -44, + points if the" score within 2 -64 and, finall", 5 points if their initial score is within #-24 on the 7erg 7alance Scale.'
8onoghue 89 5h"siotherap" Research and )lder 5eople (5R)5) group, Sto!es +:. (2##0). ;ow much change is true change< ,he minimum detectable change of the 7erg 7alance Scale in elderl" people. J Rehabil Med. 41( )2646-..

,orms:
(usardi, =.=. (2##4). Functional 5erformance in Communit( -i.ing /lder 0dults. Journal of Geriatric Physical Therapy, 2.(6), 14-22.

Februar" 2 , 2#14

5age 1 of

Berg Balance Scale

>ame2 ?????????????????????????????????? 8ate2 ???????????????????

(ocation2 ???????????????????????????????? Rater2 ??????????????????? @,+= 8+S4R@5,@)> Sitting to standing Standing unsupported Sitting unsupported Standing to sitting ,ransfers Standing with e"es closed Standing with feet together Reaching forward with outstretched arm Retrie%ing obAect from floor ,urning to loo! behind ,urning 6.# degrees 5lacing alternate foot on stool Standing with one foot in front Standing on one foot ,otal ???????? S4)R+ (#-4) ???????? ???????? ???????? ???????? ???????? ???????? ???????? ???????? ???????? ???????? ???????? ???????? ???????? ????????

B+>+R$( @>S,RC4,@)>S 5lease document each tas! and/or gi%e instructions as written. *hen scoring, please record the lowest response categor" that applies for each item. @n most items, the subAect is as!ed to maintain a gi%en position for a specific time. 5rogressi%el" more points are deducted if2 the time or distance reDuirements are not met the subAectEs performance warrants super%ision the subAect touches an e1ternal support or recei%es assistance from the e1aminer SubAect should understand that the" must maintain their balance while attempting the tas!s. ,he choices of which leg to stand on or how far to reach are left to the subAect. 5oor Audgment will ad%ersel" influence the performance and the scoring. +Duipment reDuired for testing is a stopwatch or watch with a second hand, and a ruler or other indicator of 2, , and 1# inches. 4hairs used during testing should be a reasonable height. +ither a step or a stool of a%erage step height ma" be used for item F 12.

Februar" 2 , 2#14

5age 2 of

Berg Balance Scale

S@,,@>B ,) S,$>8@>B @>S,RC4,@)>S2 5lease stand up. ,r" not to use "our hand for support. ( )4 able to stand without using hands and stabiliGe independentl" ( )6 able to stand independentl" using hands ( )2 able to stand using hands after se%eral tries ( )1 needs minimal aid to stand or stabiliGe ( )# needs moderate or ma1imal assist to stand S,$>8@>B C>SC55)R,+8 @>S,RC4,@)>S2 5lease stand for two minutes without holding on. ( )4 able to stand safel" for 2 minutes ( )6 able to stand 2 minutes with super%ision ( )2 able to stand 6# seconds unsupported ( )1 needs se%eral tries to stand 6# seconds unsupported ( )# unable to stand 6# seconds unsupported @f a subAect is able to stand 2 minutes unsupported, score full points for sitting unsupported. 5roceed to item F4. S@,,@>B *@,; 7$4: C>SC55)R,+8 7C, F++, SC55)R,+8 )> F())R )R )> $ S,))( @>S,RC4,@)>S2 5lease sit with arms folded for 2 minutes. ( )4 able to sit safel" and securel" for 2 minutes ( )6 able to sit 2 minutes under super%ision ( )2 able to able to sit 6# seconds ( )1 able to sit 1# seconds ( )# unable to sit without support 1# seconds S,$>8@>B ,) S@,,@>B @>S,RC4,@)>S2 5lease sit down. ( )4 sits safel" with minimal use of hands ( )6 controls descent b" using hands ( )2 uses bac! of legs against chair to control descent ( )1 sits independentl" but has uncontrolled descent ( )# needs assist to sit ,R$>SF+RS @>S,RC4,@)>S2 $rrange chair(s) for pi%ot transfer. $s! subAect to transfer one wa" toward a seat with armrests and one wa" toward a seat without armrests. Hou ma" use two chairs (one with and one without armrests) or a bed and a chair. ( )4 able to transfer safel" with minor use of hands ( )6 able to transfer safel" definite need of hands ( )2 able to transfer with %erbal cuing and/or super%ision ( )1 needs one person to assist ( )# needs two people to assist or super%ise to be safe S,$>8@>B C>SC55)R,+8 *@,; +H+S 4()S+8 @>S,RC4,@)>S2 5lease close "our e"es and stand still for 1# seconds. ( )4 able to stand 1# seconds safel" ( )6 able to stand 1# seconds with super%ision ( )2 able to stand 6 seconds ( )1 unable to !eep e"es closed 6 seconds but sta"s safel" ( )# needs help to !eep from falling S,$>8@>B C>SC55)R,+8 *@,; F++, ,)B+,;+R @>S,RC4,@)>S2 5lace "our feet together and stand without holding on. ( )4 able to place feet together independentl" and stand 1 minute safel" ( )6 able to place feet together independentl" and stand 1 minute with super%ision ( )2 able to place feet together independentl" but unable to hold for 6# seconds ( )1 needs help to attain position but able to stand 1 seconds feet together ( )# needs help to attain position and unable to hold for 1 seconds

Februar" 2 , 2#14

5age 6 of

Berg Balance Scale continuedI..

R+$4;@>B F)R*$R8 *@,; )C,S,R+,4;+8 $R= *;@(+ S,$>8@>B @>S,RC4,@)>S2 (ift arm to 0# degrees. Stretch out "our fingers and reach forward as far as "ou can. (+1aminer places a ruler at the end of fingertips when arm is at 0# degrees. Fingers should not touch the ruler while reaching forward. ,he recorded measure is the distance forward that the fingers reach while the subAect is in the most forward lean position. *hen possible, as! subAect to use both arms when reaching to a%oid rotation of the trun!.) ( )4 can reach forward confidentl" 2 cm (1# inches) ( )6 can reach forward 12 cm ( inches) ( )2 can reach forward cm (2 inches) ( )1 reaches forward but needs super%ision ( )# loses balance while tr"ing/reDuires e1ternal support 5@4: C5 )7J+4, FR)= ,;+ F())R FR)= $ S,$>8@>B 5)S@,@)> @>S,RC4,@)>S2 5ic! up the shoe/slipper, which is place in front of "our feet. ( )4 able to pic! up slipper safel" and easil" ( )6 able to pic! up slipper but needs super%ision ( )2 unable to pic! up but reaches 2- cm(1-2 inches) from slipper and !eeps balance independentl" ( )1 unable to pic! up and needs super%ision while tr"ing ( )# unable to tr"/needs assist to !eep from losing balance or falling ,CR>@>B ,) ()): 7+;@>8 )K+R (+F, $>8 R@B;, S;)C(8+RS *;@(+ S,$>8@>B @>S,RC4,@)>S2 ,urn to loo! directl" behind "ou o%er toward the left shoulder. Repeat to the right. +1aminer ma" pic! an obAect to loo! at directl" behind the subAect to encourage a better twist turn. ( )4 loo!s behind from both sides and weight shifts well ( )6 loo!s behind one side onl" other side shows less weight shift ( )2 turns sidewa"s onl" but maintains balance ( )1 needs super%ision when turning ( )# needs assist to !eep from losing balance or falling ,CR> 6.# 8+BR++S @>S,RC4,@)>S2 ,urn completel" around in a full circle. 5ause. ,hen turn a full circle in the other direction. ( )4 able to turn 6.# degrees safel" in 4 seconds or less ( )6 able to turn 6.# degrees safel" one side onl" 4 seconds or less ( )2 able to turn 6.# degrees safel" but slowl" ( )1 needs close super%ision or %erbal cuing ( )# needs assistance while turning 5($4+ $(,+R>$,+ F)), )> S,+5 )R S,))( *;@(+ S,$>8@>B C>SC55)R,+8 @>S,RC4,@)>S2 5lace each foot alternatel" on the step/stool. 4ontinue until each foot has touch the step/stool four times. ( )4 able to stand independentl" and safel" and complete L steps in 2# seconds ( )6 able to stand independentl" and complete L steps in M 2# seconds ( )2 able to complete 4 steps without aid with super%ision ( )1 able to complete M 2 steps needs minimal assist ( )# needs assistance to !eep from falling/unable to tr" S,$>8@>B C>SC55)R,+8 )>+ F)), @> FR)>, @>S,RC4,@)>S2 (8+=)>S,R$,+ ,) SC7J+4,) 5lace one foot directl" in front of the other. @f "ou feel that "ou cannot place "our foot directl" in front, tr" to step far enough ahead that the heel of "our forward foot is ahead of the toes of the other foot. (,o score 6 points, the length of the step should e1ceed the length of the other foot and the width of the stance should appro1imate the subAectEs normal stride width.) ( )4 able to place foot tandem independentl" and hold 6# seconds ( )6 able to place foot ahead independentl" and hold 6# seconds ( )2 able to ta!e small step independentl" and hold 6# seconds ( )1 needs help to step but can hold 1 seconds ( )# loses balance while stepping or standing S,$>8@>B )> )>+ (+B @>S,RC4,@)>S2 Stand on one leg as long as "ou can without holding on. ( )4 able to lift leg independentl" and hold M 1# seconds ( )6 able to lift leg independentl" and hold -1# seconds ( )2 able to lift leg independentl" and hold N 6 seconds ( )1 tries to lift leg unable to hold 6 seconds but remains standing independentl". ( )# unable to tr" of needs assist to pre%ent fall

) ,),$( S4)R+ (=a1imum - .)

Februar" 2 , 2#14 5age 4 of

Februar" 2 , 2#14

5age of