Validity and Reliability of the Berg Balance Scale in Different Tele-Assessment Methods in Patients With Stroke

Balance evaluation is essential for determining treatment and its effectiveness in stroke patients. Considering the widespread use of telehealth services, it is important to evaluate the applicability of balance scales for teleassessment. The aim in this study was to investigate the reliability and validity of the Berg Balance Scale (BBS) applied using synchronous and asynchronous teleassessment methods.

Teleassessments were performed by two physiotherapists. Synchronous assessments were conducted online in real time using the application Zoom, while asynchronous assessments involved patients recording videos according to a reference evaluation video sent to them. All tests were repeated 10 days later to assess intrarater reliability.

Thirty-six stroke patients (mean age 55.9 ± 9.5 years) participated in the study. Both synchronous and asynchronous teleassessments of the Berg Balance Scale (BBS) demonstrated excellent interrater reliability, with ICC values of 0.989 for synchronous and 0.997 for asynchronous assessments. Intrarater reliability was also high, with ICCs ranging from 0.982 to 0.997 across raters and methods. Regarding concurrent validity, synchronous teleassessment BBS scores showed a strong correlation with face-to-face BBS (r = 0.970) and Timed Balance Test (TBT) scores (r = 0.901), while asynchronous assessments also demonstrated strong correlations (BBS: r = 0.945; TBT: r = 0.885). Correlations with postural sway parameters were moderate, ranging from r =-0.40 to -0.54.

Our findings suggest that synchronous and asynchronous teleassessment of the BBS may be a viable alternative to face-to-face assessments. However, further research with larger samples is needed to support these findings and increase their generalizability.

ClinicalTrials.gov identifier: NCT05263063.