_id

683a165dc782e11e38d1b39a

id

10567

title

Berg Balance Scale (BBS)

full_title

Berg Balance Scale (BBS)

short_title

Berg Balance Scale (BBS)

med_description

Assesses balance and risk for falls in older community-dwelling adults.

short_description

Balance and fall risk in older adults.

slug

berg-balance-scale-bbs

description

The Berg Balance Scale (BBS) assesses balance and risk for falls in older community-dwelling adults.

keywords

Berg Balance Scale (BBS), BBS, balance, fall, fall risk, neurologic disorders, postural balance, psychometrics, rehabilitation, balance in elderly, stroke, Parkinson’s disease, multiple sclerosis, MS, traumatic brain injury, peripheral neuropathies, elderly fall, functional balance, automatic postural response, impaired balance

complaint

[ "Dizziness", "Fatigue", "Head Injury", "Joint Pain", "Muscle Stiffness", "Myalgias", "Neurologic Deficit", "Numbness", "Preventive Care/Screening", "Vision Loss", "Weakness", "Weight Loss/Gain", "Involuntary Movements" ]

formula

The BBS is calculated by adding the selected points for each variable:

evidence

measurements

[]

information

Interpretation:

refrences

{ "Clinical Practice Guidelines": [], "Manufacturer Website": [], "Original/Primary Reference": [ { "href": "https://utpjournals.press/doi/10.3138/ptc.41.6.304", "text": "Berg K. Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada. 1989;41(6):304-311." } ], "Other References": [ { "href": "https://pubmed.ncbi.nlm.nih.gov/8996463/", "text": "Shumway-Cook A, Gruber W, Baldwin M, Liao S. The effect of multidimensional exercises on balance, mobility, and fall risk in community-dwelling older adults. Physical Therapy. 1997;77(1):46-57." }, { "href": "https://pubmed.ncbi.nlm.nih.gov/11856064/", "text": "Steffen TM, Hacker TA, Mollinger L. Age- and gender-related test performance in community-dwelling elderly people: six-minute walk test, berg balance scale, timed up & go test, and gait speeds. Physical Therapy. 2002;82(2):128-137." }, { "href": "https://pubmed.ncbi.nlm.nih.gov/18292215/", "text": "Blum L, Korner-Bitensky N. Usefulness of the berg balance scale in stroke rehabilitation: a systematic review. Physical Therapy. 2008;88(5):559-566." } ], "Outcomes": [], "Validation": [ { "href": "https://pubmed.ncbi.nlm.nih.gov/8650273/", "text": "Bogle Thorbahn LD, Newton RA. Use of the berg balance test to predict falls in elderly persons. Physical Therapy. 1996;76(6):576-583." }, { "href": "https://pubmed.ncbi.nlm.nih.gov/22521926/", "text": "La Porta F, Caselli S, Susassi S, Cavallini P, Tennant A, Franceschini M. Is the berg balance scale an internally valid and reliable measure of balance across different etiologies in neurorehabilitation? A revisited rasch analysis study. Archives of Physical Medicine and Rehabilitation. 2012;93(7):1209-1216." }, { "href": "https://pubmed.ncbi.nlm.nih.gov/30213258/", "text": "Alghadir AH, Al-Eisa ES, Anwer S, Sarkar B. Reliability, validity, and responsiveness of three scales for measuring balance in patients with chronic stroke. BMC Neurol. 2018;18(1):141." } ], "Validations": [] }

pearls

• May not be suitable for patients who are acutely ill or have severe mobility limitations, as it requires a certain level of physical ability to complete.
• The scale may experience ceiling effects in very mildly impaired individuals, failing to capture subtle balance deficits.
• Multiple studies have identified different optimal cutoff values for assessing fall risk. This tool adheres to the original study’s cutoff of <45 to indicate a higher risk of falls (Berg, 1989). Other researchers have proposed various cutoff scores, typically ranging from 40 to 50. This includes specific suggested cutoff points for patients with a history of falls (Shumway-Cook, 1997) or with stroke (Simpson, 2011).

usecase

• Use to assess balance and the fall risk in older adult patients, those recovering from stroke, or individuals with potential balance impairment due to neurological disorders.
• Useful for both initial assessments and ongoing monitoring to evaluate changes in balance over time.
• May be used in rehabilitation settings to gauge a patient’s balance capabilities and tailor appropriate balance exercises and therapy.

reasons

Evaluates various aspects of balance through 14 simple tasks. Helps predict fall risk in older adult patients, assisting with planning and implementation of preventive measures. Provides a quantitative measure of balance that can be tracked over time.

next_advice

• This tool adheres to the original study's cutoff of <45 to indicate a higher risk of falls (Berg, 1989).
• Use results to guide personalized intervention plans that focus on improving specific areas of balance.
• Schedule regular follow-ups to reassess balance using the BBS to monitor progress and adjust treatment plans as necessary.
• Combine BBS outcomes with other assessments (e.g., muscle strength, gait analysis) for a comprehensive approach to managing fall risk.

next_actions

next_management

diseases

[ "Diabetes Mellitus", "Fracture", "Intracranial Hemorrhage", "Multiple Sclerosis", "Neuropathy", "Parkinson's Disease", "Rheumatoid Arthritis", "Stroke/TIA", "Subarachnoid Hemorrhage", "Trauma", "Traumatic Brain Injury", "Osteoporosis", "Spinal Injury" ]

input_schema

[ { "conditionality": null, "default": 4, "label_en": "<p>Sitting to standing</p>", "mdcalc_info_concept": null, "name": "q1", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Needs moderate or maximal assist to stand", "value": 0 }, { "label": "Needs minimal aid to stand or to stabilize", "value": 1 }, { "label": "Able to stand using hands after several tries", "value": 2 }, { "label": "Able to stand independently using hands", "value": 3 }, { "label": "Able to stand without using hands, stabilizes independently", "value": 4 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 4, "label_en": "<p>Standing unsupported</p>", "mdcalc_info_concept": null, "name": "q2", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Unable to stand 30 seconds unsupported", "value": 0 }, { "label": "Needs several tries to stand 30 seconds unsupported", "value": 1 }, { "label": "Able to stand 30 seconds unsupported ", "value": 2 }, { "label": "Able to stand 2 minutes with supervision", "value": 3 }, { "label": "Able to stand safely for 2 minutes", "value": 4 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 4, "label_en": "<p>Sitting with back unsupported</p>", "mdcalc_info_concept": null, "name": "q3", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Unable to sit without support for 10 seconds", "value": 0 }, { "label": "Able to sit 10 seconds", "value": 1 }, { "label": "Able to sit 30 seconds", "value": 2 }, { "label": "Able to sit 2 minutes under supervision", "value": 3 }, { "label": "Able to sit safely and securely for 2 minutes", "value": 4 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 4, "label_en": "<p>Standing to sitting</p>", "mdcalc_info_concept": null, "name": "q4", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Needs assistance to sit ", "value": 0 }, { "label": "Sits independently but has uncontrolled descent", "value": 1 }, { "label": "Uses back of legs against chair to control descent", "value": 2 }, { "label": "Controls descent by using hands", "value": 3 }, { "label": "Sits safely with minimal use of hands", "value": 4 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 4, "label_en": "<p>Transfers</p>", "mdcalc_info_concept": null, "name": "q5", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Needs two person assistance or supervision for safety", "value": 0 }, { "label": "Needs one person assist", "value": 1 }, { "label": "Able to transfer with verbal cueing and/or supervision", "value": 2 }, { "label": "Able to transfer safely with definite need of hands", "value": 3 }, { "label": "Able to transfer safely with minor use of hands", "value": 4 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 4, "label_en": "<p>Standing unsupported with eyes closed</p>", "mdcalc_info_concept": null, "name": "q6", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Needs help to keep from falling", "value": 0 }, { "label": "Unable to keep eyes closed 3 seconds but stays safely", "value": 1 }, { "label": "Able to stand 3 seconds ", "value": 2 }, { "label": "Able to stand 10 seconds with supervision", "value": 3 }, { "label": "Able to stand 10 seconds safely", "value": 4 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 4, "label_en": "<p>Standing unsupported with feet together</p>", "mdcalc_info_concept": null, "name": "q7", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Needs help to attain position and unable to hold 15 seconds", "value": 0 }, { "label": "Needs help to attain position but able to stand 15 seconds feet together", "value": 1 }, { "label": "Able to place feet together independently but unable to hold for 30 seconds", "value": 2 }, { "label": "Able to place feet together independently and stand 1 minute with supervision", "value": 3 }, { "label": "Able to place feet together independently and stand 1 minute safely", "value": 4 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 4, "label_en": "<p>Reaching forward with outstretched arm while standing</p>", "mdcalc_info_concept": null, "name": "q8", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Loses balance while trying/requires external support", "value": 0 }, { "label": "Reaches forward but needs supervision", "value": 1 }, { "label": "Can reach forward 5 cm (2 inches) safely", "value": 2 }, { "label": "Can reach forward 12 cm (5 inches) safely ", "value": 3 }, { "label": "Can reach forward confidently 25 cm (10 inches)", "value": 4 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 4, "label_en": "<p>Pick up object from the floor from a standing position</p>", "mdcalc_info_concept": null, "name": "q9", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Unable to try/needs assist to keep from losing balance or falling", "value": 0 }, { "label": "Unable to pick up and needs supervision while trying ", "value": 1 }, { "label": "Unable to pick up but reaches 2-5 cm (1-2 inches) from slipper and keeps balance independently", "value": 2 }, { "label": "Able to pick up slipper but needs supervision", "value": 3 }, { "label": "Able to pick up slipper safely and easily", "value": 4 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 4, "label_en": "<p>Turning to look behind over left and right shoulders</p>", "mdcalc_info_concept": null, "name": "q10", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Needs assist to keep from losing balance or falling", "value": 0 }, { "label": "Needs supervision when turning", "value": 1 }, { "label": "Turns sideways only but maintains balance", "value": 2 }, { "label": "Looks behind one side only, other side shows less weight shift", "value": 3 }, { "label": "Looks behind from both sides and weight shifts well", "value": 4 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 4, "label_en": "<p>Turn 360 degrees</p>", "mdcalc_info_concept": null, "name": "q11", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Needs assistance while turning", "value": 0 }, { "label": "Needs close supervision or verbal cueing", "value": 1 }, { "label": "Able to turn 360 degrees safely but slowly", "value": 2 }, { "label": "Able to turn 360 degrees safely on one side only in 4 seconds or less", "value": 3 }, { "label": "Able to turn 360 degrees safely in 4 seconds or less", "value": 4 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 4, "label_en": "<p>Placing alternate foot on step or stool while standing unsupported</p>", "mdcalc_info_concept": null, "name": "q12", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Needs assistance to keep from falling/unable to try", "value": 0 }, { "label": "Able to complete >2 steps, needs minimal assist ", "value": 1 }, { "label": "Able to complete 4 steps without aid, with supervision", "value": 2 }, { "label": "Able to stand independently, and complete 8 steps in >20 seconds", "value": 3 }, { "label": "Able to stand independently and safely, and complete 8 steps in 20 seconds", "value": 4 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 4, "label_en": "<p>Standing unsupported one foot in front</p>", "mdcalc_info_concept": null, "name": "q13", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Loses balance while stepping or standing", "value": 0 }, { "label": "Needs help to step but can hold 15 seconds", "value": 1 }, { "label": "Able to take small step independently and hold 30 seconds", "value": 2 }, { "label": "Able to place foot ahead of other independently and hold 30 seconds<ul><li>Foot must completely pass the other foot</li><li>Step width should be no wider than shoulders</li></ul>", "value": 3 }, { "label": "Able to place foot tandem independently and hold 30 seconds", "value": 4 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 4, "label_en": "<p>Standing on one leg</p>", "mdcalc_info_concept": null, "name": "q14", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Unable to try or needs assist to prevent fall", "value": 0 }, { "label": "Tries to lift leg, unable to hold 3 seconds but remains standing independently", "value": 1 }, { "label": "Able to lift leg independently and hold ≥3 seconds", "value": 2 }, { "label": "Able to lift leg independently and hold 5-10 seconds", "value": 3 }, { "label": "Able to lift leg independently and hold >10 seconds", "value": 4 } ], "show_points": true, "tips_en": "", "type": "radio" } ]

instructions

Equipment required for this tool:

• Stopwatch.
• Two standard-height chairs (one with armrests, the other without).
• Step or footstool.
• Ruler.
• Shoe or slipper.

published

2024-09-09T14:16:49.512Z

purpose

[ "Prognosis" ]

search_terms

[ "Berg Balance Scale (BBS)", "BBS", "balance", "fall", "fall risk", "neurologic disorders", "postural balance", "psychometrics", "rehabilitation", "balance in elderly", "stroke", "Parkinson’s disease", "multiple sclerosis", "MS", "traumatic brain injury", "peripheral neuropathies", "elderly fall", "functional balance", "automatic postural response", "impaired balance" ]

seo

{ "keywords_en": "Berg Balance Scale (BBS), BBS, balance, fall, fall risk, neurologic disorders, postural balance, psychometrics, rehabilitation, balance in elderly, stroke, Parkinson’s disease, multiple sclerosis, MS, traumatic brain injury, peripheral neuropathies, elderly fall, functional balance, automatic postural response, impaired balance", "meta_description_en": "The Berg Balance Scale (BBS) assesses balance and risk for falls in older community-dwelling adults." }

specialty

[ "Family Practice", "Geriatrics", "Hospitalist Medicine", "Internal Medicine", "Neurology", "Neurosurgery", "Orthopedics", "Palliative Care/Hospice", "Primary Care", "Rehabilitation Medicine", "Rheumatology" ]

departments

[ "Musculoskeletal", "Neurologic", "Rheumatologic" ]

tags

[]

version_number

1

versions

[]

related

[ { "calcId": 10589, "short_title_en": "Infant Scalp Score", "slug": "infant-scalp-score" }, { "calcId": 10432, "short_title_en": "mBIG", "slug": "modified-brain-injury-guideline-mbig" }, { "calcId": 10532, "short_title_en": "NDI", "slug": "neck-disability-index-ndi" } ]

ismed

false

section

[ "whenToUseViewed", "pearlsPitfallsViewed", "whyUseViewed", "nextStepsViewed", "evidenceViewed" ]

cleaned_departments

[ "orthopedics", "neurology", "rheumatology" ]

cleaned_use

[ "Use to assess balance and the fall risk in older adult patients, those recovering from stroke, or individuals with potential balance impairment due to neurological disorders.", "Useful for both initial assessments and ongoing monitoring to evaluate changes in balance over time.", "May be used in rehabilitation settings to gauge a patient’s balance capabilities and tailor appropriate balance exercises and therapy." ]

pub

false