Berg Balance Scale Assessment Quiz
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Questions and Answers

What is the maximum score for a participant who can stand without using their hands and stabilizes independently?

  • 1
  • 5
  • 3
  • 4 (correct)

During the standing on one leg task, what is the requirement for the lifted leg?

  • It must be held in a bent position.
  • It must remain in contact with the standing leg.
  • It cannot touch the standing leg at any time. (correct)
  • It can touch the ground for balance.

For scoring purposes, what happens if a subject is unable to stand unsupported for 2 minutes?

  • They may get half points for sitting unsupported.
  • They qualify for alternative scoring methods.
  • They receive a full score for sitting unsupported.
  • They score zero points for both sitting and standing unsupported. (correct)

What would be a possible score for an individual who needs minimal aid to stand?

<p>1 (B)</p> Signup and view all the answers

How is the overall score calculated for the assessments mentioned?

<p>By summing the scores from all items. (D)</p> Signup and view all the answers

What is the primary purpose of the examiner standing close to the patient during the alternate foot placement test?

<p>To ensure patient safety by providing assistance if needed (A)</p> Signup and view all the answers

In the standing unsupported test, what is the minimum duration for which the patient must hold their position?

<p>2 minutes (D)</p> Signup and view all the answers

What is a critical instruction given during the sitting to standing test?

<p>Try not to use your hands for support (D)</p> Signup and view all the answers

How is the execution of the 360-degree turn assessed?

<p>By measuring the time taken to complete the turn (B)</p> Signup and view all the answers

Which item requires the patient to close their eyes while maintaining balance?

<p>Standing with eyes closed (B)</p> Signup and view all the answers

What does the reaching forward test require from the patient during the execution?

<p>Lift their arm to 90 degrees without any body movement (B)</p> Signup and view all the answers

What is the expected behavior from the patient during the standing on one leg test?

<p>To remain still without moving either leg (C)</p> Signup and view all the answers

During what task is a stool height of 7¾ - 9 inches specifically mentioned?

<p>Placing alternate foot on step or stool while standing unsupported (B)</p> Signup and view all the answers

What is the main objective when measuring the forward reach of a patient?

<p>To gauge the patient's balance without trunk rotation (D)</p> Signup and view all the answers

Which method is used to ensure the patient does not rely on their legs to assist in picking up an object from the floor?

<p>Positioning the object directly at the feet (B)</p> Signup and view all the answers

When instructing a patient to turn and look over their shoulders, what is emphasized for proper assessment?

<p>Trunk rotation and weight shift (B)</p> Signup and view all the answers

What is the purpose of asking a patient to turn completely around in a full circle?

<p>To measure the time taken for movement (C)</p> Signup and view all the answers

What is indicated by assessing how well a patient can alternate placing their feet on a step or stool while standing unsupported?

<p>Balance and coordination (A)</p> Signup and view all the answers

Which cueing strategy might be necessary for a patient who is using one arm during the forward reach?

<p>Verbal cues to limit trunk rotation (B)</p> Signup and view all the answers

What action should the examiner take to enhance a patient's twist turn when looking behind them?

<p>Hold an object for them to focus on (C)</p> Signup and view all the answers

Which factor is crucial during the assessment of the forward reach to ensure accuracy?

<p>Trunk rotation must be limited (C)</p> Signup and view all the answers

What is the appropriate action if an assistive device is utilized during a balance test?

<p>Exclude the score from the data analysis. (D)</p> Signup and view all the answers

When using a hospital bed or mat table during the BBS, what height should be preserved?

<p>18-20 inches (A)</p> Signup and view all the answers

If a patient cannot attain the start position in the test, what should they be instructed to do?

<p>Place heels and toes as close together as possible. (C)</p> Signup and view all the answers

What is the guideline regarding using objects shorter or taller than a slipper during the test?

<p>Do not substitute with objects shorter or taller than a slipper. (C)</p> Signup and view all the answers

In a scenario where trunk rotation is limited post-surgery, what score should the patient receive?

<p>Score 0 for inability to rotate. (D)</p> Signup and view all the answers

What is the maximum height for a step or stool recommended for testing?

<p>9 inches (A), 7¾ inches (C)</p> Signup and view all the answers

Which leg position is important when assessing single-leg stance?

<p>Leg positioning does not matter. (A)</p> Signup and view all the answers

What should be done if the patient has hemiparesis during the test?

<p>Use the intact arm but avoid trunk rotation. (C)</p> Signup and view all the answers

When a patient has unilateral impairment, which limb should be tested during the single leg stance (SLS)?

<p>The involved limb (A)</p> Signup and view all the answers

What should a tester do if a patient cannot hold full tandem stance?

<p>Provide a demonstration of an alternate position (A)</p> Signup and view all the answers

What is the primary purpose of demonstrating the tandem stance and foot-ahead stance to a patient?

<p>To ensure the patient understands the required postures (A)</p> Signup and view all the answers

Which statement is true regarding scoring for item 13 if the patient loses balance in tandem stance?

<p>The tester may need to adjust the scoring based on patient attempts (A)</p> Signup and view all the answers

If a patient is recommended to take a forward step with the uninvolved limb, which stance are they likely undergoing?

<p>Tandem stance with the uninvolved limb (A)</p> Signup and view all the answers

Which alternative position is suggested if the patient cannot achieve the tandem stance?

<p>Foot-ahead stance (D)</p> Signup and view all the answers

In assessing balance, what is considered crucial for ensuring accurate scoring?

<p>Providing clear instructions and demonstrations (C)</p> Signup and view all the answers

What must a tester consider if a patient is unable to hold the tandem stance?

<p>The option for alternate positions and additional support (A)</p> Signup and view all the answers

What is the highest score for standing unsupported for 2 minutes?

<p>4 (C)</p> Signup and view all the answers

Which of the following indicates the least ability to stand unsupported with eyes closed?

<p>needs help to keep from falling (B)</p> Signup and view all the answers

What is the ability level for someone who can sit unsupported for 10 seconds?

<p>1 (C)</p> Signup and view all the answers

What does a score of 4 represent when picking up an object from the floor?

<p>Can pick up the slipper safely and easily (C)</p> Signup and view all the answers

What is the criterion for a score of 2 in the standing on one leg assessment?

<p>Able to lift leg and hold ≥3 seconds (D)</p> Signup and view all the answers

How long should a participant be able to sit unsupported to attain the highest score of 4?

<p>2 minutes (A)</p> Signup and view all the answers

Which assessment measure corresponds with needing supervision to control descent while sitting?

<p>3 (A)</p> Signup and view all the answers

What is necessary for someone to achieve a score of 1 on the transfers assessment?

<p>Requires one person assist (B)</p> Signup and view all the answers

What does a score of 3 indicate when assessing the ability to turn 360 degrees?

<p>Able to turn safely one side only (D)</p> Signup and view all the answers

What signifies a score of 0 when reaching forward with an outstretched arm while standing?

<p>Loses balance and requires support (B)</p> Signup and view all the answers

Which score corresponds to the ability to turn sideways while maintaining balance?

<p>2 (B)</p> Signup and view all the answers

What indicates the greatest level of independence in 'standing unsupported with feet together'?

<p>Stands independently for 1 minute (C)</p> Signup and view all the answers

What's the least possible score for placing alternate foot on a step stool while standing unsupported?

<p>0 (A)</p> Signup and view all the answers

What is the minimum number of times this measure should be administered to track change effectively?

<p>Two times (C)</p> Signup and view all the answers

Flashcards

Standing unsupported

Patient stands for 2 minutes without support.

Sitting without back support

Patient sits with arms folded for 2 minutes.

360-degree turn

Patient completes a full rotation.

Alternating foot steps

Patient places each foot on a step/stool while standing.

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One-leg stand

Patient stands on one leg.

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Standing, one foot in front

Patient stands with one foot in front of the other unsupported..

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Turning assessment

Assessing patient turning ability (left/right).

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Transfers

Patient moves between chairs (with/without armrests).

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Forward reach test

Assessment of upper body flexibility and range of motion.

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Heel Placement

During the 'Standing, one foot in front' task, the heel of the forward foot must be ahead of the toes of the other foot.

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Unsupported Standing Score

If a participant can stand unsupported for 2 minutes, they automatically receive full points for 'Sitting unsupported'.

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Object pick-up test

Evaluates lower body flexibility and balance.

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Turning test

Assesses trunk rotation and weight shift.

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360-degree turn test

Measures speed and coordination in full rotations.

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Sitting to Standing Scale

This scale evaluates how the participant stands up, ranging from needing maximal assistance to standing independently, using hands or not. Score 0 to 4.

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Step/stool test

Assesses lower body strength and balance.

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Trunk rotation

The ability of the body to rotate around its central axis.

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Forward lean

Body posture with the torso angled forward while standing.

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Balance

Maintaining a stable posture and position.

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Assistive Devices and Balance Scores

If a patient uses an assistive device during a balance test, their score should be excluded from data analysis.

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Hospital Bed or Mat Table as Seating?

A hospital bed or mat table can be used as a seating surface for the BBS, but the height should be standardized to 18-20 inches if possible.

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Start Position Difficulty

If a patient cannot stand with feet together, instruct them to place their feet as close together as possible.

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Slipper/Shoe Substitutes

Do not substitute slippers or shoes with objects of different heights. This could affect the patient's ability to bend or reach.

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Reaching Forward Arm

Ideally, both arms should be used for forward reach, but the intact arm can be used if one arm is impaired.

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Trunk Rotation Assessment for Spinal Precautions

Patients with post-operative spinal precautions who cannot rotate their trunk will receive a score of 0 for trunk rotation.

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Step/Stool Height for Balance Test

The step/stool used in the balance test should be between 7¾ and 9 inches high.

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Leg Preference for One-Leg Stand and Tandem Stance

The choice of leg for the one-leg stand and tandem stance does not affect the scoring.

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Self-selection of limb

The BBS allows patients to choose which leg they stand on during specific tasks, promoting patient comfort and tailored assessment.

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Unilateral Impairment Testing

For patients with weakness on one side, the BBS recommends testing the affected limb (SLS) while standing on it and taking a step forward with the unaffected limb (tandem).

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Tandem Stance

A specific position in the BBS where one foot is placed directly behind the other, testing balance and coordination.

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Foot-Ahead Stance

An alternative to tandem stance in the BBS, allowing patients struggling with tandem to achieve a score with one foot slightly in front of the other.

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Cueing

The tester can guide the patient towards success by demonstrating alternative stances or positions during the BBS, ensuring a fair assessment.

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Balance Loss During Tandem

If a patient loses balance trying to achieve tandem stance, the tester can cue them to attempt an alternate position (foot-ahead) for scoring.

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Demonstration

Test instructions highlight the importance of demonstrating proper tandem and foot-ahead stances to the patient before scoring.

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Alternate Position

During the BBS, if a patient cannot perform tandem, the tester can offer an alternate position (foot-ahead) to allow the patient to score.

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Safe Standing

The ability to stand unsupported for 2 minutes without assistance.

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Supervised Standing

The ability to stand unsupported for 2 minutes, but requiring supervision for safety.

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Short Standing

The ability to stand for 30 seconds without support.

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Assisted Standing

The ability to stand for 30 seconds, but needing multiple attempts with assistance.

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Unable to Stand

Inability to stand for 30 seconds without support.

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Safe Sitting

The ability to sit unsupported for 2 minutes without assistance.

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Supervised Sitting

The ability to sit for 2 minutes, but requiring supervision for safety.

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Short Sitting

The ability to sit for 30 seconds without support.

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Brief Sitting

The ability to sit for 10 seconds without support.

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Supported Sitting

Inability to sit without back support for 10 seconds.

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Independent Sitting

The ability to sit safely from a standing position with minimal use of hands.

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Assisted Descent

The ability to sit down from a standing position, but needing to use hands to control the movement.

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Leaning Back

The ability to sit down, but using the back of their legs against the chair to control the descent.

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Uncontrolled Descent

The ability to sit down independently, but lacking control over the movement.

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Assisted Sitting

The need for assistance to sit down from a standing position.

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Study Notes

Core Measure: Berg Balance Scale (BBS)

  • The BBS is a clinician-rated scale for assessing sitting and standing balance, both static and dynamic.
  • The scale consists of 14 functional balance items.
  • Each item is scored on a 5-point ordinal scale (0-4).
  • A score of 0 indicates inability to complete the task, and 4 indicates successful completion.
  • Items are scored based on time, independence, and supervision needed.
  • Supervision may be needed if excessive sway or safety concerns arise.

Equipment

  • Stopwatch
  • Standard height chair (18-20 inches) with armrests
  • Standard height chair (18-20 inches) without armrests
  • Step stool (7¼-9 inch)
  • Ruler
  • Slippers or shoes

Time

  • New clinician: Less than 20 minutes
  • Experienced clinician: Less than 20 minutes

Cost

  • Equipment only

Logistics/Setup

  • Item 1: Sitting to Standing
    • Patient sits in a standard height chair with armrests (18-20 inches).
  • Item 2: Standing Unsupported
    • Patient stands with feet shoulder-width apart on a solid surface.
  • Item 3: Sitting with Back Unsupported
    • Patient sits with back unsupported, feet supported on the floor or a stool.
  • Item 4: Standing to Sitting
    • Patient stands in front of a chair with armrests.
  • Item 5: Transfers
    • Two chairs (one with armrests, one without) or a bed and chair are used for pivot transfers.

Additional Items (Page 2)

  • Item 6: Standing Unsupported with Eyes Closed
  • Item 7: Standing Unsupported with Feet Together
  • Item 8: Reaching Forward with Outstretched Arm While Standing
  • Item 9: Picking Up Object From the Floor From a Standing Position
  • Item 10: Turning to Look Behind
  • Item 11: Turning 360 Degrees
  • Item 12: Placing Alternate Foot on Step or Stool While Standing Unsupported
  • Item 13: Standing Unsupported One Foot in Front
  • Item 14: Standing on One Leg

Logistics - Administration (Page 3)

  • Detailed instructions for each item, including specific instructions (e.g., time limits, support allowed).
  • Includes variations (e.g., how to handle patients who cannot stand; assistive devices; different seating).

Logistics - Scoring (Page 4,5)

  • Scoring criteria for each item, including scoring for success or failure, time limits, and need for supervision.

Additional Recommendations (Page 6)

  • Frequency of administration:
    • At least two times, preferably at admission and discharge; preferably, more test administrations if feasible between these periods under identical conditions.
  • Consistency:
    • Review annual basis to ensure consistency within and amongst raters using this tool.

Common Questions and Variations (Page 7,8)

  • Addressing potential issues and variations in administering the test to different patient populations.

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Related Documents

Berg Balance Scale Protocol PDF

Description

This quiz evaluates your understanding of the Berg Balance Scale (BBS), a critical tool for assessing patients' balance abilities. It covers the scoring system, equipment needed, and logistics of administering the test. Perfect for clinicians wanting to ensure they follow best practices in balance assessment.

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