Berg Balance Scale (BBS)

 

Parameters:

(1) sitting to standing

(2) standing unsupported

(3) sitting unsupported

(4) standing to sitting

(5) transfers

(6) standing unsupported with eyes closed

(7) standing with feet together

(8) reaching forward with an outstretched arm

(9) retrieving an object (a slipper) from the floor

(10) turning to look behind

(11) turning around 360 degrees

(12) placing alternate foot on step of a stool

(13) tandem stance (standing with one foot in front of the other)

(14) standing on one foot

Response for Each	Points
normal	4
slightly abnormal	3
moderately abnormal	2
some impairment	1
significant impairment	0

 

total score =

= SUM(points for all 14 items)

 

Interpretation:

• minimum score: 0 (completely impaired)

• maximums score: 56 (normal balance)

• The higher the score the better the balance.

• A cutoff of 45 points may be used to identify a patient at risk for falling (>= 45 low risk of falling, < 45 higher risk).

• The 2 most difficult items for patients to pass were standing on one leg and tandem walking.

 

Statements

 

Sitting to standing:

(4) without using hand and stabilized independently

(3) needs to use hands

(2) uses hands and needs several tries

(1) needs minimal aid to stand or to stabilize

(0) needs moderate or maximal assistance to stand

 

Standing unsupported:

(4) safely for 2 minutes

(3) for 2 minutes with supervision

(2) for 30 seconds unsupported

(1) needs several tries but can eventually stand 30 seconds unsupported

(0) unable to stand for 30 seconds unsupported

 

Sitting unsupported:

(4) safely and securely for 2 minutes

(3) needs supervision to sit for 2 minutes

(2) able to sit for 30 seconds

(1) able to sit for 10 seconds

(0) unable to sit without support for 10 seconds

 

Standing to sitting:

(4) with minimal use of hands

(3) controls descent with hands

(2) use back of legs against the chair to control descent

(1) sits independently but descent uncontrolled

(0) needs assistance to sit

 

Transfers:

(4) with minor use of hands

(3) with definite use of hands

(2) needs verbal cueing and/or supervision

(1) needs 1 person to assist

(0) needs 2 people to assist or supervise

 

Standing unsupported with eyes closed:

(4) for 10 seconds safely

(3) for 10 seconds with supervision

(2) for 3 seconds

(1) unable to keep eyes closed for 3 seconds but stays steady

(0) needs help to keep from falling

 

Standing unsupported with feet together:

(4) gets into position independently, can stand 1 minute safely

(3) gets into position independently, can stand for 1 minute with supervision

(2) gets into position independently, unable to hold for 30 seconds

(1) needs help to get into position, unable to stand for 15 seconds with feet together

(0) needs help to get into position, unable to stand for 15 seconds

 

Reaching forward with outstretched arm:

(4) can reach forward > 25 cm

(3) can reach forward 13 to 25 cm

(2) can reach forward 6 to 12 cm

(1) reaches forward but needs supervision

(0) loses balance and needs external support

 

Picking up object (slipper) from floor:

(4) able to do so safely and easily

(3) able to pick up but needs supervision

(2) unable to pick up object; gets within 2-5 cm, keeps balance

(1) unable to pick up; needs supervision while trying

(0) needs assistance to keep from losing balance or falling

 

Turning to look behind:

(4) from both sides and weight shifts well

(3) well on one side only; other side shows less weight shift

(2) turns sideways only; maintains balance

(1) needs supervision when turning

(0) needs assistance to keep from losing balance or falling

 

Turning around 360 degrees:

(4) turns around safely to either side in 4 seconds or less

(3) can turn around safely to one side only in 4 seconds or less

(2) can turn around but slowly

(1) needs close supervision or visual cueing

(0) needs assistance

 

Placing alternate foot on step of stool:

(4) stands independently; completes 8 steps in 20 seconds or less

(3) stands independently; completes 8 steps in more than 20 seconds

(2) completes 4 steps without aid

(1) able to take > 2 steps with minimal assistance

(0) needs assistance to keep from falling, or unable to try

 

Tandem stance:

(4) feet placed in tandem independently; can hold for 30 seconds

(3) one foot ahead of other independently, can hold for 30 seconds

(2) able to take small step independently; can hold for 30 seconds

(1) needs help to step; can hold for 15 seconds

(0) loses balance while stepping or standing

 

Standing on one leg:

(4) independently and hold > 10 seconds

(3) independently and hold 5 to 10 seconds

(2) independently and hold >= 3 seconds

(1) independently but unable to hold for 3 seconds

(0) unable to try OR needs assistance to keep from falling