The Berg Balance Scale (BBS) is a valid and reliable clinical tool for assessing balance in individuals with lower limb amputation, according to a study published in Archives of Physical Medicine and Rehabilitation.
The study was conducted by researchers at Northwestern University Prosthetics-Orthotics Center and included 30 participants: 13 unilateral transtibial amputees, 14 unilateral transfemoral amputees and 3 bilateral amputees.
The researchers evaluated results from the BBS, 2-minute walk test, L test, Prosthesis Evaluation Questionnaire-Mobility Subscale, Activities-specific Balance Confidence Scale and Frenchay Activities Index, as well as self-reported descriptors including frequency of prosthesis use, number of falls in 12 months prior to visit, fear of falling and daily mobility aid use.
They found that the BBS had high inter-rater reliability and internal consistency and relationships between the BBS scores and those of other outcome measures were all statistically significant. They also noted significant group differences in BBS scores for fear of falling and mobility aid use, but not for multiple falls in the previous 12 months. BBS items involving reaching forward, turning 360°, tandem standing and standing on one leg also had relatively greater frequencies of lower scores across participants.
“The BBS appears to be a valid and reliable clinical instrument for assessing balance in individuals with lower limb amputation, but may not be able to discriminate between individuals with greater or lesser fall risk,” the authors wrote in the study abstract. “Limitations in prosthetic motion and control may be responsible for the challenges experienced on items of lower performance. Future studies would be useful to assess the responsiveness of the BBS to interventions aimed at improving balance in individuals with lower limb amputation.”
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