You are not logged in. Press here to login.

Content

List volumes - List articles in this issue

Original report

How much change is true change? The minimum detectable change of the Berg Balance Scale in elderly people

doi: 10.2340/16501977-0337

Open access

Abstract:

OBJECTIVE: To determine the minimum detectable change at 95% confidence for the Berg Balance Scale in a group of elderly people, undergoing physiotherapy rehabilitation.
DESIGN: Multi-centre, test-retest design.
SUBJECTS: Cross-sectional sample of convenience of people over 65 years (n = 118) without a previous history of stroke, Parkinson’s disease or recent hip arthroplasty.
Raters: Physiotherapists working with elderly people, drawn from the Physiotherapy Research into Older People group, ranging in experience from newly qualified to 39 years qualified.
METHODS: Each participant was assessed using the Berg Balance Scale and again within 48 hours by the same physiotherapist. The minimum detectable change at 95% was established.
RESULTS: A change of 4 points is needed to be 95% confident that true change has occurred if a patient scores within 45–56 initially, 5 points if they score within 35–44, 7 points if they score within 25–34 and, finally, 5 points if their initial score is within 0–24 on the Berg Balance Scale.
CONCLUSION: A clinician with a working knowledge of these minimum detectable change values can be up to 95% confident that a true change or not a true change in a patients’ functional balance has occurred and can therefore alter their interventions accordingly to ensure quality, focused rehabilitation.

Authors:

Declan Donoghue, Physiotherapy Research and Older People (PROP) group , Emma K. Stokes

References

  1. Kay TM, Myers AM, Huijbregts MPJ. How far have we come since 1992? A comparative survey of physiotherapists’ use of outcome measures. Physiother Can 2001; 53: 268–275.
  2. Stokes E, O’Neill D. Use of outcome measures in physiotherapy practice in Ireland from 1998 to 2003 and comparison to Canadian trends. Physiother Can 2008; 60: 109–116.
  3. Berg KO, Wood-Dauphinee SL, Williams JI, Gayton D. Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 1989; 41: 304–311.
  4. Mao HF, Hsueh IP, Tang PF, Sheu CF, Hsieh CL. Analysis and comparison of the psychometric properties of three balance measures for stroke patients. Stroke 2002; 33: 1022–1027.
  5. Brusse KJ, Zimdars S, Zalewski KR, Steffen TM. Testing functional performance in people with Parkinson’s disease. Phys Ther 2005; 85: 134–141.
  6. Whitney S, Wrisley D, Furman J. Concurrent validity of the Berg Balance Scale and the Dynamic Gait Index in people with vestibular dysfunction. Physiother Res Int 2003; 8: 178–186.
  7. Steffen TM, Hacker TA, Mollinger L. Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther 2002; 82: 128–137.
  8. Whitney SL, Poole JL, Cass SP. A review of balance instruments for older adults. Am J Occup Ther 1998; 52: 666–671.
  9. Riddle DL, Stratford PW. Interpreting validity indexes for diagnostic tests: an illustration using the Berg balance test. Phys Ther 1999; 79: 939–948.
  10. Usuda S, Araya K, Umehara K, Endo M, Shumizu T, Endo F. Construct validity of functional balance scale in stroke inpatients. J Phys Ther Sci 1998; 10: 53–56.
  11. Berg K, Wood-Dauphinee S, Williams JI. The Balance Scale: reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med 1995; 27: 27–36.
  12. Halsaa KE, Brovold T, Graver V, Sandvik L, Bergland A. Assessments of interrater reliability and internal consistency of the Norwegian version of the Berg Balance Scale. Arch Phys Med Rehabil 2007; 88: 94–98.
  13. Berg KO, Maki BE, Williams JI, Holliday PJ, Wood-Dauphinee SL. Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil 1992; 73: 1073–1080.
  14. Conradsson M, Lundin-Olsson L, Lindelof N, Littbrand H, Malmqvist L, Gustafson Y, et al. Berg balance scale: intrarater test-retest reliability among older people dependent in activities of daily living and living in residential care facilities. Phys Ther 2007; 87: 1155–1163.
  15. Finch E, Brooks D, Stratford PW, Mayo NE, editors. Physical rehabilitation outcome measures : a guide to enhanced clinical decision making. 2nd edn. Hamilton: Canadian Physiotherapy Association, BC Decker Inc; 2002.
  16. Stratford PW. Getting more from the Literature: estimating the standard error of measurement from reliability studies. Physiother Can 2004; 56: 27–30.
  17. McDowell I, editor. Measuring health: a guide to rating scales and questionnaires. 3rd edn. New York: Oxford University Press; 2006.
  18. Stevenson TJ. Detecting change in patients with stroke using the Berg Balance Scale. Aust J Physiother 2001; 47: 29–38.
  19. Stratford PW, Binkley J, Solomon P, Finch E, Gill C, Moreland J. Defining the minimum level of detectable change for the Roland-Morris questionnaire. Phys Ther 1996; 76: 359–365; discussion 366–368.
  20. van Genderen FR, de Bie RA, Helders PJM, van Meeteren NLU. Reliability research: toward a more clinically relevant approach. Phys Ther Rev 2003; 8: 169–176.
  21. Haley SM, Fragala-Pinkham MA. Interpreting change scores of tests and measures used in physical therapy. Phys Ther 2006; 86: 735–743.
  22. Hauer K, Lamb SE, Jorstad EC, Todd C, Becker C. Systematic review of definitions and methods of measuring falls in randomised controlled fall prevention trials. Age Ageing 2006; 35: 5–10.


Related articles

There are no related articles.


Actions


Abstract

Full text

PDF

Supplementary


There is no supplementary for this article.

Related articles


Click here to show related articles

Print information


Volume 41, Issue 5

DOI: 10.2340/16501977-0337

Pages: 343-346

View at PubMed