Berg Balance Scale is a Valid Measure for Plan Interventions and for Assessing Changes in Postural Balance in Patients with Stroke

Abstract

Objectives: After confirming the measurement properties of the Berg Balance Scale (BBS) in patients with stroke by conducting a Rasch analysis, this study sought: (i) to generate a keyform as a tool for goal-setting and intervention-planning; and (ii) to determine the appropriate strata for separating patients’ postural balance ability. Design: Methodological analyses of cross-sectional study data. Patients: A pooled sample of 156 patients with stroke: mean (standard deviation) age 74.4 (12.9) years. Methods: This study evaluated the BBS’s rating scale structure, unidimensionality, and measurement accuracy (0: unable to perform or requiring help, to 4: normal performance) and then generated a keyform and strata. Results: The BBS rating scale fulfilled the category functioning criteria. Principal component analysis of standardized residuals confirmed the unidimensionality of the test. All items fit the Rasch analysis. Person ability-item difficulty matching was good. Person reliability was 0.96, and the patients were divided into 9 strata. The keyform for the BBS will enable clinicians and investigators to estimate patients’ postural balance ability and monitor their progress. Conclusion: The BBS has strong measurement properties. This study generated both a keyform that can contribute to clinicians’ decision-making in goalsetting and intervention-planning and strata that can facilitate understanding of patients’ abilities. LAY ABSTRACT People who have had a stroke often have difficulty maintaining postural balance and controlling their posture. The Berg Balance Scale (BBS) measures a person’s ability to maintain postural balance. Several analyses were performed to investigate the measurement properties of the BBS in patients who have had a stroke. Then, a keyform tool was generated and some strata (levels) determined that separate patients according to postural balance ability. A keyform can help therapists to identify items that a patient finds relatively difficult. Use of a keyform can contribute to both rehabilitation goal-setting and planned interventions for patients. The strata can be used to detect and measure changes in a patient’s postural balance ability. The findings of this study demonstrate that the BBS has strong measurement properties and provides an appropriate keyform and 9 strata. Use of these tools can facilitate the rehabilitation of patients with stroke through quantification of a patient’s postural balance ability.

Keywords

• rehabilitation
• postural balance
• Rasch analysis
• outcome measure
• goal-setting
• intervention-planning