Berg Balance Scale

What is a Berg Balance Scale?

As a healthcare professional, keeping your elderly patients mobile and independent is a top priority. Balance problems become more familiar with increasing age, impacting activity levels, and raising fall risk. The Berg balance test can help you in occupational or physical therapy work.

The Berg Balance Scale was developed by Katherine Berg in 1989, with the initial target population having an average age of 73. This evidence-based clinical assessment tool measures balance and mobility in older adults and other individuals with impairments due to illness or injury (Miranda-Cantellops & Tiu, 2023).

This scale evaluates an individual's ability to perform everyday activities such as getting off a chair, reaching for objects on a shelf, or stepping up onto a step. Each task is scored on a 0-4 scale, where 0 indicates the individual cannot perform the task and 4 means they can do so independently, with no difficulty. Testing takes 15-20 minutes to complete the examination (Berg et al., 1989). It assesses balance with a maximum score of 56, where higher scores signify better balance.

By identifying balance impairments, the Berg Balance Scale helps healthcare professionals create personalized plans and interventions for elderly persons to improve their quality of life and overall balance.

How to use this Berg Balance Scale

We've grasped the fundamentals of the Berg Balance Scale. Let's leverage this knowledge to develop personalized treatment plans for our elderly patients. By effectively utilizing the BBS, we can create targeted interventions to improve balance and prevent falls. Here are the steps involved:

Step 1: Prepare for the assessment

Download the test. Familiarize yourself with the tasks and scoring criteria beforehand. Briefly explain the scale and each task to your patient to ensure understanding.

Step 2: Conduct the test

Guide your patient through each of the 14 tasks or items. Observe their performance and score them on a 0-4 scale (0 = unable to perform, 4 = independent and complete). Note any observations or concerns you have while talking to the patient.

Step 3: Analyze and develop a plan

Once you've completed the scale, calculate the total score. This score provides a general picture of your patient's balance ability. Analyze the individual scores to identify areas of strength and weakness. Use this information to create a personalized treatment plan to address specific balance deficits and improve overall mobility.

Step 4: Document and track progress

Document your patient's score and any relevant observations in their medical record. Consider using a secure electronic health record system like Carepatron for easy access and future reference. This allows you to track progress over time and evaluate the effectiveness of your interventions.

When would you typically use a Berg Balance Scale?

Using the Berg Balance Scale effectively empowers you to create targeted treatment plans for elderly patients. Now that we've explored the steps involved, let's delve into the ideal scenarios for utilizing the BBS in your physical therapy practice.

When assessing the risk of falls and mobility in older adults

This test can identify any impairments in balance or mobility. It can also help healthcare professionals create tailored interventions that reduce the risk of falls and injuries. A meta-analysis of 21 studies assessed the predictive validity of the Berg Balance Scale in predicting falls, showing its effectiveness, especially for those under 65 with neuromuscular disease, multiple falls, and a BBS cutoff of 45 to 49 (Park & Lee, 2016).

When assessing the progress of balance therapy

The Berg Balance Scale helps healthcare professionals track the progress of their patients' therapy over time, ensuring that the interventions they provide are effective. It measures postural balance in stroke patients, allowing therapists to assess fall risk and tailor rehabilitation programs for improved balance (Miyata et al., 2022).

When assessing pre- and post-operative balance

Using the Berg Balance Scale, you can measure a patient's balance before and after surgery. This helps you to get an accurate picture of the patient's overall balance. One study used the scale to evaluate balance function pre- and post-total knee arthroplasty (Kiyohara et al., 2021).

During annual health assessments for elderly individuals

During yearly check-ups for the aging population, healthcare professionals assess one's activity level using tools like the Berg Balance Scale to monitor changes in mobility and balance over time.

Who can use this Berg Balance Scale?

Having explored ideal situations for using the Berg Balance Scale, let's widen the lens to consider who can benefit from this assessment tool. While the BBS holds particular value for evaluating balance in older adults, its applications extend beyond this population. Specifically, it's a helpful tool for:

• Physiotherapists
• Occupational therapists
• Nurses
• Geriatricians
• Orthopedic surgeons
• General practitioners

With this resource, you can gather vital information to create effective action plans for individuals of all ages.

References

Berg, K., Wood-Dauphinee, S. L., Williams, J. I., & Gayton, D. (1989). Berg Balance Scale (BBS) [Database record]. APA PsycTests. https://doi.org/10.1037/t28729-000

Kiyohara, M., Hamai, S., Okazaki, K., Fujiyoshi, D., Mizu-uchi, H., & Nakashima, Y. (2021). Evaluation of the balance function before and after total knee arthroplasty using Berg balance scale. Archives of Orthopaedic and Trauma Surgery. https://doi.org/10.1007/s00402-021-04233-z

Miranda-Cantellops, N., & Tiu, T. K. (2023, February 17). Berg Balance Testing. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK574518/

Miyata, K., Tamura, S., Kobayashi, S., Takeda, R., & Iwamoto, H. (2022). Berg Balance Scale is a valid measure for plan interventions and for assessing changes in postural balance in patients with stroke. Journal of Rehabilitation Medicine, 54, jrm00359. https://doi.org/10.2340/jrm.v54.4443

Park, S.-H., & Lee, Y.-S. (2016). The diagnostic accuracy of the Berg Balance Scale in predicting falls. Western Journal of Nursing Research, 39(11), 1502–1525. https://doi.org/10.1177/0193945916670894