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Validating the Berg Balance Scale for patients with Parkinson’s disease: A key to rehabilitation evaluation

https://doi.org/10.1016/j.apmr.2004.11.005Get rights and content

Abstract

Qutubuddin AA, Pegg PO, Cifu DX, Brown R, McNamee S, Carne W. Validating the Berg Balance Scale for patients with Parkinson’s disease: a key to rehabilitation evaluation. Arch Phys Med Rehabil 2005;86:789–92.

Objective

To assess the criterion-related validity of the Berg Balance Scale (BBS) in subjects with Parkinson’s disease (PD).

Design

Prospective, correlational analysis between the BBS and accepted measures of PD motor and functional impairment.

Setting

The federally funded PD research center, an interdisciplinary center of excellence for people with PD within a Veterans Affairs medical center.

Participants

Thirty-eight men (average ± standard deviation, 71.1±10.5y) with confirmed PD. Their initial diagnosis had been made on average 5.8±3.6 years earlier. All could stand or walk unassisted and had mild to moderate disability. Patients who could not ambulate without assistive devices were excluded.

Interventions

Not applicable.

Main outcome measures

Correlational analyses between the BBS and the Unified Parkinson’s Disease Rating Scale (UPDRS) motor scale, Modified Hoehn and Yahr Staging (Hoehn and Yahr) Scale, and the Modified Schwab and England Capacity for Daily Living Scale (S&E ADL Scale).

Results

BBS score showed significant correlations with indicators of motor functioning, stage of disease, and daily living capacity. BBS score was inversely associated with the UPDRS motor score (–.58, P<.005), Hoehn and Yahr Scale staging (–.45, P<.005), and S&E ADL Scale rating (.55, P<.005). In all 3 correlations, lower scores on the BBS (indicating greater balance deficits) correlated with higher UPDRS scores (indicating greater motoric or functional impairment).

Conclusions

Results support the criterion-related validity of the BBS. Its utility in other balance conditions of older adults has been established. Rehabilitation interventions have been shown to improve the balance deficits associated with PD. Early referral and periodic reassessment is vital to achieving and maintaining improvements. Our research results agree with other published research in suggesting that the BBS may be used as a screening tool and ongoing assessment tool for patients with PD.

Section snippets

Methods

The Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, VA, is 1 of 6 Veterans Health System centers of excellence for the treatment of PD. Patients referred to Parkinson’s Disease Research, Education, and Clinical Center (PADRECC) undergo a comprehensive interdisciplinary evaluation that includes examinations by a neurologist, neuropsychologist, and physiatrist. Eligible participants in this study were consecutively evaluated by the PADRECC physiatrist between August 2003 and

Demographic data

Participants were 38 male patients at the PADRECC clinic. Thirty (77%) identified themselves as white and the remainder as African American. Thirty patients (77%) lived with their wives only or with their families, while 3 lived alone, 2 lived with a nonfamily member, 1 lived in a nursing home, and the living arrangements of 2 participants were not reported. For the 27 patients who had complete information about how long since they were diagnosed with PD, the average time was 5.4±3.58 years

Discussion

Intact balance is a key building block for all functional activities, from upright sitting tasks to transfer skills to ambulation. Although a range of rehabilitation interventions have improved motor skills that affect activities of daily living and ambulation in people with PD,22, 23 specific improvements in PD-related balance have been less well demonstrated. A key factor accounting for this is the lack of a well-accepted, standardized balance measure for people with PD. Although such a

Conclusions

The consistent correlations found in this study support the clinical validity of the BBS in the PD population. Its increased use in this subpopulation of older adults may serve as both a useful screening test for balance deficits and a sensitive measure of changes in balance skills. This may provide for a better understanding of the specific effects of therapeutic interventions (eg, medications, deep brain stimulation, rehabilitation) on balance deficits in people with PD. The prospective,

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    Supported by the Veterans Health Administration Southeastern Parkinson’s Disease Research, Education, and Clinical Center (PADRECC) and the Veterans Health Administration Defense and Veterans Brain Injury Center (DVBIC). The content of this article is solely the responsibility of the authors and does not represent the official views of PADRECC or DVBIC.

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors(s) or upon any organization with which the author(s) is/are associated.

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