Overcoming the Limitations of the Berg Balance Scale (BBS)

Abstract

Research Objectives To increase the sensitivity of the BBS tasks to effectively determine and track the falls risk of individuals. Design The BBS is commonly used to measure falls risk in older adults, but can only be utilized during face-to-face assessments. Due to COVID-19, a virtual health method of assessing falls risk in older adults is necessary. Markerless motion capture was used to provide a quantitative approach to static and dynamic elements of the BBS. This new protocol was dubbed the Enhanced Virtual BBS, or eV-BBS. The eV-BBS provides significantly more objective information than the current BBS, thereby improving its sensitivity and reproducibility. Setting University of Alberta Rehab Robotics Lab, Edmonton, Canada, during the COVID-19 pandemic. Participants A convenience sample of 10 healthy participants were selected. Interventions A test-retest reliability model determined the inter- and intra-participant variability when conducting the sit-to-stand and balance test in the BBS. Main Outcome Measures Novel parameters were created to represent the characteristics of the sit-to-stand and balance components of the BBS, such as rise height, drop height, and root mean square of trunk sway. Results The study revealed significant test-retest reliability (ICC = 0.81 to 0.99) and repeatability (COV < 20%) for the static stability tasks. The sensitivity of the eV-BBS to detect changes between participants was revealed during the analysis of the dynamic stability tasks, which had poor reliability (ICC = 0.10 to 0.60) and repeatability (COV > 20%). Conclusions The results indicate that the current BBS focuses on qualitative measures of sway and task timing. The dynamic and static components (of the sit-to-stand test in particular) are not identified, yet we know these are critical to assessing falling risk. The variability seen in the dynamic data of eV-BBS is likely to be attributable to subtle differences in participant performance of the task. Sensitivity of eV-BBS is high, but the level of sensitivity needed will only become apparent when participants at risk for falling are included in a future study. Author(s) Disclosures The authors have no conflicts of interest to declare. To increase the sensitivity of the BBS tasks to effectively determine and track the falls risk of individuals. The BBS is commonly used to measure falls risk in older adults, but can only be utilized during face-to-face assessments. Due to COVID-19, a virtual health method of assessing falls risk in older adults is necessary. Markerless motion capture was used to provide a quantitative approach to static and dynamic elements of the BBS. This new protocol was dubbed the Enhanced Virtual BBS, or eV-BBS. The eV-BBS provides significantly more objective information than the current BBS, thereby improving its sensitivity and reproducibility. University of Alberta Rehab Robotics Lab, Edmonton, Canada, during the COVID-19 pandemic. A convenience sample of 10 healthy participants were selected. A test-retest reliability model determined the inter- and intra-participant variability when conducting the sit-to-stand and balance test in the BBS. Novel parameters were created to represent the characteristics of the sit-to-stand and balance components of the BBS, such as rise height, drop height, and root mean square of trunk sway. The study revealed significant test-retest reliability (ICC = 0.81 to 0.99) and repeatability (COV < 20%) for the static stability tasks. The sensitivity of the eV-BBS to detect changes between participants was revealed during the analysis of the dynamic stability tasks, which had poor reliability (ICC = 0.10 to 0.60) and repeatability (COV > 20%). The results indicate that the current BBS focuses on qualitative measures of sway and task timing. The dynamic and static components (of the sit-to-stand test in particular) are not identified, yet we know these are critical to assessing falling risk. The variability seen in the dynamic data of eV-BBS is likely to be attributable to subtle differences in participant performance of the task. Sensitivity of eV-BBS is high, but the level of sensitivity needed will only become apparent when participants at risk for falling are included in a future study.