Berg Balance Scale -- NeurologyToolKit
The Berg Balance Scale was originally published in 1989 in the journal Physiotherapy Canada. The Berg Balance Scale is designed to provide a functional measure of balance performance. The wBerg Balance Scale consists of 14 items, each corresponding to a balance-related task. Items are scored from 0 to 4 points. 0 represents the lowest performance level and 4 the highest performance level for the 14 tasks. The total score is calculated out of 56, with 56 representing the best balance-related performance and 0 representing the worst balance-related performance. The Berg Balance Scale is also available in a short form version. The short form Berg Scale offers a comparable estimate of balance-related performance to the original Berg Balance Scale yet is easier for the healthcare provider and patient to complete.
Original Literature:Berg, Katherine, et al. "Measuring balance in the elderly: preliminary development of an instrument." Physiotherapy Canada 41.6 (1989): 304-311. Validation Literature:Berg, Katherine O., et al. "Measuring balance in the elderly: validation of an instrument." Canadian journal of public health= Revue canadienne de sante publique 83 (1992): S7-11. Additional Literature:Blum, Lisa, and Nicol Korner-Bitensky. "Usefulness of the Berg Balance Scale in stroke rehabilitation: a systematic review." Physical therapy 88.5 (2008): 559-566. Steffen, Teresa M., Timothy A. Hacker, and Louise Mollinger. "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 82.2 (2002): 128-137.
The Berg Balance Scale was developed by a team led by Dr. Katherine Berg, who is Associate Professor Emeritus in the Department of Physical Therapy at the University of Toronto. Her clinical care is focused on geriatric patients. Her research interests include quality of care and healthcare outcomes, as well as fall prevention and disability prevention.To view her publications, please visit PubMed.
Berg Balance Score: 56 / 56 = 100.0 %Graphical Berg Balance Score: (%)
Please document each task and/or give instructions as written. When scoring, please record the lowest response category that applies for each item.
1. SITTING TO STANDING:
Please stand up. Try not to use your hand for support.
1. SITTING TO STANDING:
Please stand up. Try not to use your hand for support.
2. STANDING UNSUPPORTED:
Please stand for two minutes without holding on.
2. STANDING UNSUPPORTED:
Please stand for two minutes without holding on.
3. SITTING WITH BACK UNSUPPORTED BUT FEET SUPPORTED ON FLOOR OR ON A STOOL:
Please sit with arms folded for 2 minutes.
3. SITTING WITH BACK UNSUPPORTED BUT FEET SUPPORTED ON FLOOR OR ON A STOOL:
Please sit with arms folded for 2 minutes.
4. STANDING TO SITTING:
Please sit down.
4. STANDING TO SITTING:
Please sit down.
5. TRANSFERS:
Arrange chair(s) for pivot transfer. Ask subject to transfer one way toward a seat with armrests and one way toward a seat without armrests. You may use two chairs (one with and one without armrests) or a bed and a chair.
5. TRANSFERS:
Arrange chair(s) for pivot transfer. Ask subject to transfer one way toward a seat with armrests and one way toward a seat without armrests. You may use two chairs (one with and one without armrests) or a bed and a chair.
6. STANDING UNSUPPORTED WITH EYES CLOSED:
Please close your eyes and stand still for 10 seconds.
6. STANDING UNSUPPORTED WITH EYES CLOSED:
Please close your eyes and stand still for 10 seconds.
7. STANDING UNSUPPORTED WITH FEET TOGETHER:
Place your feet together and stand without holding on.
7. STANDING UNSUPPORTED WITH FEET TOGETHER:
Place your feet together and stand without holding on.
8. REACHING FORWARD WITH OUTSTRETCHED ARM WHILE STANDING:
Lift arm to 90 degrees. Stretch out your fingers and reach forward as far as you can. (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, ask subject to use both arms when reaching to avoid rotation of the trunk.)
8. REACHING FORWARD WITH OUTSTRETCHED ARM WHILE STANDING:
Lift arm to 90 degrees. Stretch out your fingers and reach forward as far as you can. (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, ask subject to use both arms when reaching to avoid rotation of the trunk.)
9. PICK UP OBJECT FROM THE FLOOR FROM A STANDING POSITION:
Pick up the shoe/slipper, which is place in front of your feet.
9. PICK UP OBJECT FROM THE FLOOR FROM A STANDING POSITION:
Pick up the shoe/slipper, which is place in front of your feet.
10. TURNING TO LOOK BEHIND OVER LEFT AND RIGHT SHOULDERS WHILE STANDING:
Turn to look directly behind you over toward the left shoulder. Repeat to the right. Examiner may pick an object to look at directly behind the subject to encourage a better twist turn.
10. TURNING TO LOOK BEHIND OVER LEFT AND RIGHT SHOULDERS WHILE STANDING:
Turn to look directly behind you over toward the left shoulder. Repeat to the right. Examiner may pick an object to look at directly behind the subject to encourage a better twist turn.
11. TURN 360 DEGREES:
Turn completely around in a full circle. Pause. Then turn a full circle in the other direction.
11. TURN 360 DEGREES:
Turn completely around in a full circle. Pause. Then turn a full circle in the other direction.
12. PLACE ALTERNATE FOOT ON STEP OR STOOL WHILE STANDING UNSUPPORTED:
Place each foot alternately on the step/stool. Continue until each foot has touch the step/stool four times.
12. PLACE ALTERNATE FOOT ON STEP OR STOOL WHILE STANDING UNSUPPORTED:
Place each foot alternately on the step/stool. Continue until each foot has touch the step/stool four times.
13. STANDING UNSUPPORTED ONE FOOT IN FRONT:
(DEMONSTRATE TO SUBJECT) Place one foot directly in front of the other. If you feel that you cannot place your foot directly in front, try to step far enough ahead that the heel of your 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 subject’s normal stride width.)
13. STANDING UNSUPPORTED ONE FOOT IN FRONT:
(DEMONSTRATE TO SUBJECT) Place one foot directly in front of the other. If you feel that you cannot place your foot directly in front, try to step far enough ahead that the heel of your 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 subject’s normal stride width.)
14. STANDING ON ONE LEG:
Stand on one leg as long as you can without holding on.
14. STANDING ON ONE LEG:
Stand on one leg as long as you can without holding on.
Berg Balance Score: 56 / 56 = 100.0 %
Graphical Berg Balance Score: (%)Pertinent Positives:
Pertinent Negatives:
Sit to stand w/o use of hands, stabilizes independently; Able to stand safely for 2 minutes; Able to sit safely and securely for 2 minutes; Sits safely with minimal use of hands; Able to transfer safely with minor use of hands; Able to stand 10 seconds safely (eyes closed); Able to place feet together independently and stand 1 minute safely; Can reach forward confidently 25 cm (10 inches); Able to pick up slipper safely and easily; Looks behind shoulder from both sides and weight shifts well; Able to turn 360 degrees safely in 4 seconds or less; Able to stand independently and safely and complete 8 steps on stool in 20 seconds; Able to place foot tandem independently and hold 30 seconds; Able to lift leg independently and hold > 10 seconds;