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Berg Balance Scale

 Berg Balance Scale

Berg Balance Scale has 14 items scale that was developed to measure balance among older people with impairment in balance function by assessing the performance of functional tasks.

The Berg Balance Scale score is ranging from 0 to 56 points.

The requirement tools for this scale are: a stopwatch, a ruler or a measuring tape, a chair, a step, and an object that can be picked up.

See Also: Thomas Test Hip

Berg Balance Scale Items

Berg Balance Scale consists of 14 items that the patient is asked to perform to check for balance.

ItemDescription
B1Sitting to standing
B2Standing unsupported
B3Sitting unsupported
B4Standing to sitting
B5Transfers
B6Standing with the eyes closed
B7Standing with the feet together
B8Reaching forward with outstretched arm
B9Retrieving object from floor
B10Turning to look behind
B11Turning 360 degrees
B12Placing alternate foot on stool
B13Standing with one foot in front
B14Standing on one foot

B1 – Sitting To Standing

The examiner asks the patient to stand up and try not to use the hand for support.

Patient ResponseScore
Patient is able to stand without using hands and stabilize independently4
Patient is able to stand independently using hands3
Patient is able to stand using hands after several tries2
Patient needs minimal aid to stand or stabilize1
Patient is needs moderate or maximal assist to stand0
Berg Balance Scale - Sitting To Standing
Sitting To Standing

B2 – Standing Unsupported

The examiner asks the patient to stand for two minutes without holding on.

Patient ResponseScore
Patient is able to stand safely for 2 minutes4
Patient is able to stand 2 minutes with supervision3
Patient is able to stand 30 seconds unsupported2
Patient needs several tries to stand 30 seconds unsupported1
Patient is unable to stand 30 seconds unsupported0

If the patient is able to stand 2 minutes unsupported, score full points for sitting unsupported and proceed to item 4 (Standing to sitting).

B3 – Sitting unsupported

Sitting With Back Unsupported But Feet Supported On Floor Or On A Stool. The examiner asks the patient to sit with arms folded for 2 minutes.

Patient ResponseScore
Patient is able to sit safely and securely for 2 minutes4
Patient is able to sit 2 minutes under supervision3
Patient is able to able to sit 30 seconds2
Patient is able to sit 10 seconds1
Patient is unable to sit without support 10 seconds0

B4 – Standing To Sitting

The examiner asks the patient to sit down.

Patient ResponseScore
Patient sits safely with minimal use of hands4
Patient controls descent by using hands3
Patient uses back of legs against chair to control descent2
Patient sits independently but has uncontrolled descent1
Patient needs assist to sit0
Berg Balance Scale- Standing To Sitting
Standing To Sitting

B5 – Transfers

Arrange chair(s) for pivot transfer. The examiner ask the patient to transfer one way toward a seat with armrests and one way toward a seat without armrests.

Two chairs (one with and one without armrests) or a bed and a chair may be used.

Patient ResponseScore
Patient is able to transfer safely with minor use of hands4
Patient is able to transfer safely definite need of hands3
Patient is able to transfer with verbal cuing and/or supervision2
Patient needs one person to assist1
Patient needs two people to assist or supervise to be safe0

B6 – Standing Unsupported With Eyes Closed

The examiner asks the patient to close the eyes and stand still for 10 seconds.

Patient ResponseScore
Patient is able to stand 10 seconds safely4
Patient is able to stand 10 seconds with supervision3
Patient is able to stand 3 seconds2
Patient is unable to keep eyes closed 3 seconds but stays safely1
Patient needs help to keep from falling0
Berg Balance Scale- Standing Unsupported With Eyes Closed
Standing Unsupported With Eyes Closed

B7 – Standing Unsupported With Feet Together

The examiner asks the patient to place his feet together and stand without holding on.

Patient ResponseScore
Patient is able to place feet together independently and stand 1 minute safely4
Patient is able to place feet together independently and stand 1 minute with supervision3
Patient is able to place feet together independently but unable to hold for 30 seconds2
Patient needs help to attain position but able to stand 15 seconds feet together1
Patient needs help to attain position and unable to hold for 15 seconds0

B8 – Reaching forward with outstretched arm

The examiner asks the patient to lift arm to 90 degrees and stretch out the fingers and reach forward as far as he can.

The examiner places a ruler at the end of fingertips when arm is at 90 degrees. Fingers should not touch the ruler while reaching forward. The recorded measure is the distance forward that the fingers reach while the subject is in the most forward lean position. When possible, the patient is asked to use both arms when reaching to avoid rotation of the trunk.

Patient ResponseScore
Patient can reach forward confidently 25 cm (10 inches)4
Patient can reach forward 12 cm (5 inches)3
Patient can reach forward 5 cm (2 inches)2
Patient reaches forward but needs supervision1
Patient loses balance while trying/requires external support0
Berg Balance Scale- Reaching forward with outstretched arm
Reaching forward with outstretched arm

B9 – Pick Up Object From The Floor From A Standing Position

The examiner asks the patient to pick up the shoe/slipper, which is placed in front of the patient’s feet.

Patient ResponseScore
Patient is able to pick up slipper safely and easily4
Patient is able to pick up slipper but needs supervision3
Patient is unable to pick up but reaches 2-5 cm (1-2 inches) from slipper and keeps balance independently.2
Patient is unable to pick up and needs supervision while trying1
Patient is unable to try/needs assist to keep from losing balance or falling0

B10 – Turning to look behind

Turning To Look Behind Over Left And Right Shoulders While Standing:

The patient is asked to turn to look directly behind over toward the left shoulder, repeat to the right. The Examiner may pick an object to look at directly behind the patient to encourage a better twist turn.

Patient ResponseScore
Patient looks behind from both sides and weight shifts well4
Patient looks behind one side only other side shows less weight shift3
Patient turns sideways only but maintains balance2
Patient needs supervision when turning1
Patient needs assist to keep from losing balance or falling0
Berg Balance Scale- Turning to look behind
Turning to look behind

B11 – Turn 360 Degrees

The patient is asked to turn completely around in a full circle. Pause. Then turn a full circle in the other direction.

Patient ResponseScore
Patient is able to turn 360 degrees safely in 4 seconds or less4
Patient is able to turn 360 degrees safely one side only 4 seconds or less3
Patient is able to turn 360 degrees safely but slowly2
Patient needs close supervision or verbal cuing1
Patient needs assistance while turning0

B12 – Placing alternate foot on stool

Place Alternate Foot On Step Or Stool While Standing Unsupported:

The examiner asks the patient to place each foot alternately on the step/stool. Continue until each fool has touch the step/stool four times.

Patient ResponseScore
Patient is able to stand independently and safely and complete 8 steps in 20 seconds4
Patient is able to stand independently and complete 8 steps in > 20 seconds3
Patient is able to complete 4 steps without aid with supervision2
Patient is able to complete > 2 steps needs minimal assist1
Patient needs assistance to keep from falling/unable to try0
Berg Balance Scale- Placing alternate foot on stool
Placing alternate foot on stool

B13 – Standing Unsupported One Foot In Front

The patient is asked to place one foot directly in front of the other. If the patient feels that he cannot place the foot directly in front, he tries to step far enough ahead that the heel forward foot is ahead of the toes of the other foot.

To score 3 points, the length of the step should exceed the length of the other foot and the width of the stance should approximate the patient’s normal stride width.

Patient ResponseScore
Patient is able to place foot tandem independently and hold 30 seconds4
Patient is able to place foot ahead independently and hold 30 seconds3
Patient is able to take small step independently and hold 30 seconds2
Patient needs help to step but can hold 15 seconds1
Patient loses balance while stepping or standing0
Berg Balance Scale - Standing Unsupported One Foot In Front
Standing Unsupported One Foot In Front

B14 – Standing On One Leg

The patient is asked to stand on one leg as long as he can without holding on.

Patient ResponseScore
Patient is able to lift leg independently and hold > 10 seconds4
Patient is able to lift leg independently and hold 5-10 seconds3
Patient is able to lift leg independently and hold > 3 seconds2
Patient is tries to lift leg unable to hold 3 seconds but remains standing independently.1
Patient is unable to try of needs assist to prevent fall0
Berg Balance Scale- Standing On One Leg
Standing On One Leg

Clinical Importance of Berg Balance Test

The clinical importance of Berg Balance Scale is to predict risk of falls and assess the need for an assistive device for ambulation, such as a cane, walker, or wheelchair.

As with neurological conditions, studies have supported using the Berg Balance Scale for lower extremity amputees.

Falls Risk:

Need for an Assistive Device:

References


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