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Measurement Characteristics and Clinical Utility of the Berg Balance Scale Among Individuals With Stroke

      Balance impairments that result from stroke have been associated with fall risk and limited independence in activities of daily living and walking ability.1. 2. Approximately 50% to 70% of individuals fall within the first year after having a stroke, which frequently results in a hip fracture.1. 3. Because balance has a substantial impact on function for individuals poststroke, it is frequently assessed and treated during stroke rehabilitation. The Berg Balance Scale (BBS) is one of the most commonly used instruments to assess balance deficits during stroke rehabilitation; it assists in identifying individuals who are at risk for falls.4 This 14-item, public-domain test can be administered in less than 20 minutes using items commonly available in rehabilitation clinics. The BBS has excellent reliability and validity in acute and chronic stroke, and is feasible to administer in clinical settings. Minimal detectable change scores can assist clinicians in measuring improvements in balance as the result of treatment.
      This Rehabilitation Measures Database summary provides a review of the psychometric properties of the BBS in the stroke population, including reliability, validity, standard error of measurement, minimum detectable change, and interpretation of the results. A full review of the BBS and reviews of over 100 other instruments can be found at www.rehabmeasures.org.
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        Ramnemark A, Nyberg L, Borssen B, Olsson T, Gustafson Y. Fractures after stroke. Osteoporos Int 1998;8:92-5.
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        Korner-Bitensky N, Wood-Dauphine S, Teasell R. Best versus actual practices in stroke rehabilitation: results of the Canadian National Survey [abstract]. Stroke 2006;37:631.
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        Mao H, Hsueh I. Analysis and comparison of the psychometric properties of three balance measures for stroke patients. Stroke 2002;33:1022.
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        Wee JY, Bagg SD, Palepu A. The Berg balance scale as a predictor of length of stay and discharge destination in an acute stroke rehabilitation setting. Arch Phys Med Rehabil 1999;80:448-52.
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        Liston R, Brouwer B. Reliability and validity of measures obtained from stroke patients using the balance master. Arch Phys Med Rehabil 1996;77:425-30.
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        Berg K, Wood-Dauphinee S, Williams J. The Balance Scale: reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med 1995;27:27.
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        Chou CY, Chien CW, Hsueh IP, Sheu CF, Wang CH, Hsieh CL. Developing a short form of the Berg Balance Scale for people with stroke. Phys Ther 2006;86:195-204.
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        Salbach N, Mayo N, Higgins J, Ahmed S, Finch L, Richards C. Responsiveness and predictability of gait speed and other disability measures in acute stroke. Arch Phys Med Rehabil 2001;82:1204-12.
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        Stevenson TJ. Detecting change in patients with stroke using the Berg Balance Scale. Aust J Physiother 2001;47:29-38.
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        Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Public Health 1992;83(Suppl 2):S7-11.
      This instrument summary is designed to facilitate the selection of outcome measures by trained clinicians. The information contained in this summary represents a sample of the peer-reviewed research available at the time of this summary's publication. The information contained in this summary does not constitute an endorsement of this instrument for clinical practice. The views expressed are those of the summary authors and do not represent those of authors' employers, instrument owner(s), the Archives of Physical Medicine and Rehabilitation, the Rehabilitation Measures Database, or the United States Department of Education. This instrument summary has not been subjected to peer review.
      The Rehabilitation Measures Database and Instrument Summary Tear-sheets are funded by the National Institute on Disability and Rehabilitation Research, United States Department of Education through the Rehabilitation Research and Training Center on Improving Measurement of Medical Rehabilitation Outcomes (H133B090024).