Berg Balance Scale May Be Useful to Assess Balance in Amputees

  Matthew J. Major
  Matthew J. Major

ATLANTA — For lower limb amputees, maintaining upright balance helps minimize the risk of falls, according to a presenter from Northwestern University Orthotics-Prosthetics Center.

“However, there is not currently a standardized clinical instrument to quantify functional balance in these individuals,” Matthew J. Major, PhD, a post-doctoral research fellow at Northwestern University, said at the American Academy of Orthotists and Prosthetists Annual Meeting, here.

Major’s study looked at the feasibility, validity and reliability of using the Berg Balance Scale (BBS), an established clinical outcome measure that assesses balance in the geriatric population, in lower limb amputees. The Berg scale looks at 14 performance tasks, is inexpensive and takes 15 to 20 minutes to administer. It has shown good validity and reliability in association with fall history in patients with stroke and neurological diseases, he said.

Four participants in the pilot study were unilateral or bilateral lower limb amputees with residuum and amputated side in good condition, and wore prostheses. They were administered three random questionnaires (Activities-specific Balance Confidence (ABC) Scale; the Prosthesis Evaluation Questionnaire-Mobility Subscale (PEQ-MS); and the Frenchay Activities Index (FAI) and three performance exams, including the Berg Balance Scale; L test of functional mobility, and a 2-minute walk test.

Regarding feasibility, all participants completed the protocol and all items on the BBS scale. Median score was 50.3 with a range of 41-56 out of 56 total). As for validity and reliability of the Berg Balance Scale, there was a positive relationship of the Berg scale with the 2-minute walk test, the FAI and the PEQ-MS.

“The scores for the Berg Balance Scale indicated a greater capability for balance,” Major said. “Overall the BBS is a promising instrument to discriminate fear of falling and fall incidence and shows high reliability comparable to other populations.” Although this was a pilot study with a limited number of active individuals, “it appears it could be useful clinical instrument in assessing balance in this population and may provide additional insight into specific balance deficits.”

Major M. A pilot study: Feasibility of using the Berg Balance Scale in lower limb prosthesis users. Presented at the American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium. March 21-24. Atlanta.

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