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Updated: Aug 30, 2025
Quantitative Static and Dynamic Assessment of Balance Control in Stroke Patients
Published on: May 17, 2020
Development of a Berg Balance Scale Short-Form Using a Machine Learning Approach in Patients With Stroke
Inga Wang1, Pei-Chi Li, Shih-Chieh Lee
1Department of Rehabilitation Sciences & Technology (I.W.), University of Wisconsin-Milwaukee, Milwaukee, Wisconsin; School of Occupational Therapy (P.-C.L., S.-C.L., C.-L.H.), College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Occupational Therapy (S.-C.L.), College of Medicine, National Cheng Kung University, Tainan City, Taiwan; Department of Occupational Therapy (Y.-C.L., C.-L.H.), College of Medical and Health Science, Asia University, Taichung, Taiwan; Institute of Long-Term Care (S.-C.L.), MacKay Medical College, New Taipei City, Taiwan; Department of Physical Therapy (C.-H.W.) and Physical Therapy Room (C.-H.W.), Chung Shan Medical University Hospital, Taichung, Taiwan; and Department of Physical Medicine and Rehabilitation (C.-L.H.), National Taiwan University Hospital, Taipei, Taiwan.
Background And Purpose:
The Berg Balance Scale (BBS) is frequently used in routine clinical care and research settings and has good psychometric properties. This study was conducted to develop a short form of the BBS using a machine learning approach (BBS-ML).
Methods:
Data of 408 individuals poststroke were extracted from a published database. The initial (ie, 4-, 5-, 6-, 7-, and 8-item) versions were constructed by selecting top-ranked items based on the feature selection algorithm in the artificial neural network model. The final version of the BBS-ML was chosen by selecting the short form that used a smaller number of items to achieve a higher predictive power R2 , a lower 95% limit of agreement (LoA), and an adequate possible scoring point (PSP). An independent sample of 226 persons with stroke was used for external validation.
Results:
The R2 values for the initial 4-, 5-, 6-, 7-, and 8-item short forms were 0.93, 0.95, 0.97, 0.97, and 0.97, respectively. The 95% LoAs were 14.2, 12.2, 9.7, 9.6, and 8.9, respectively. The PSPs were 25, 35, 34, 35, and 36, respectively. The 6-item version was selected as the final BBS-ML. Preliminary external validation supported its performance in an independent sample of persons with stroke ( R2 = 0.99, LoA = 10.6, PSP = 37).
Discussion And Conclusions:
The BBS-ML seems to be a promising short-form alternative to improve administrative efficiency. Future research is needed to examine the psychometric properties and clinical usage of the 6-item BBS-ML in various settings and samples.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A402 ).
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