Makindo Medical Notes

About the Berg Balance Scale (BBS)

The Berg Balance Scale is a widely used clinical tool for assessing balance in older adults and individuals with neurological conditions. It evaluates performance on 14 different tasks common to daily living, each designed to measure balance and fall risk. The total score can guide clinicians in determining a person’s level of functional balance and whether they may require additional support or interventions.

Scoring System

Each of the 14 activities is scored from 0 to 4, based on the individual’s ability to complete the task:

• 0 = Unable to complete task
• 1 = Significant difficulty; requires support
• 2 = Moderate difficulty; needs some support
• 3 = Mild difficulty; no support needed
• 4 = Completes task independently with ease

Balance Feature: Score (0–4)

1. Sitting unsupported: Sit with arms folded for 2 minutes without support.
2. Change of position (sitting to standing): Stand up without using hands for support.
3. Change of position (standing to sitting): Sit down under control.
4. Transfers: Move from one chair to another without using hands for support.
5. Standing unsupported: Stand for 2 minutes without holding onto anything.
6. Standing with eyes closed: Stand unsupported with eyes closed for 10 seconds.
7. Standing with feet together: Stand unsupported, feet together for 1 minute.
8. Tandem standing: Stand with one foot in front of the other for 30 seconds.
9. Standing on one leg: Stand on one leg for 10 seconds.
10. Turning trunk (feet fixed): Turn 90° to look over each shoulder without moving feet.
11. Retrieving objects from the floor: Pick up an object from the floor in front of feet.
12. Turning 360°: Turn a full circle in each direction.
13. Stool stepping: Place each foot alternately on a step stool 8 times.
14. Reaching forward while standing: Reach forward as far as possible without taking a step.

Total Score (0–56)

• 0–20: Wheelchair-bound or severely limited; high risk of falls.
• 21–40: Walking with assistance; moderate risk of falls.
• 41–56: Independent; low risk of falls.

Interpretation

The total BBS score helps determine an individual’s risk of falls and assists in planning interventions such as balance training, exercise programs, or environmental modifications. Higher scores indicate better balance and lower fall risk, while lower scores suggest greater impairment and a need for supportive measures or rehabilitation to enhance safety and independence.