Performance-based assessment of balance and fall risk in older adults.
Berg Balance Scale (BBS)
Sitting to standing
Standing unsupported (no aid, feet together, up to 2 minutes)
Sitting unsupported, back unaided, feet on floor (up to 2 minutes)
Standing to sitting, in a controlled manner
Transferring between two chairs (with or without armrests)
Standing unsupported with eyes closed
Standing unsupported with feet together
Reaching forward with an outstretched arm while standing
Picking up an object from the floor from a standing position
Turning to look behind over each shoulder while standing
Turning a full 360 degrees
Placing alternate feet on a step/stool while standing unsupported
Standing unsupported with one foot directly in front of the other
Standing unsupported on one leg
Result0/56
Consistent with high fall risk (wheelchair-bound level of function).
Total score
0/56
When to use
Quantifying balance impairment and fall risk in older adults or after neurological injury.
Tracking functional change over time or with rehabilitation.
Formula
Sum of 14 balance tasks, each scored 0 (unable) to 4 (normal, independent). Range 0-56: 0-20 high fall risk, 21-40 medium fall risk, 41-56 low fall risk.
Pearls and pitfalls
A ceiling effect can occur in higher-functioning individuals who score near the maximum.
Some studies use a cut-off around 45 to flag increased fall risk in community-dwelling older adults.