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Area of Science:

  • Gerontology
  • Rehabilitation Science
  • Biomedical Engineering

Background:

  • The Berg Balance Scale (BBS) is a standard clinical tool for assessing balance and fall risk.
  • A ceiling effect in the BBS has been observed in older adults with higher physical function.
  • This suggests BBS items may not be challenging enough for individuals with milder balance impairments.

Purpose of the Study:

  • To evaluate the unidimensionality of the BBS.
  • To determine the item difficulty hierarchy and distribution of the BBS.
  • To assess the BBS's utility in community-living older adults (CLOAs).

Main Methods:

  • 112 community-living older adults (mean age 82.4 years) were tested using the BBS.
  • Rasch principal component analysis (PCA) was employed to examine BBS dimensionality.
  • The Rasch rating scale model was used to establish item difficulty and distribution.

Main Results:

  • Rasch PCA confirmed the BBS as a unidimensional balance test.
  • Two items ('sitting unsupported,' 'standing unsupported with eyes closed') did not fit the Rasch model.
  • The most difficult item was 'stand on one leg,' and the easiest was 'sitting unsupported.'

Conclusions:

  • The balance abilities of CLOAs generally surpassed the difficulty of BBS items.
  • The BBS may be less effective for detecting balance deficits and fall risk in this population.
  • More challenging balance assessments or alternative tests are advised for CLOAs.