Citation

Major MJ, Fatone S, Roth EJ. Arch. Phys. Med. Rehabil. 2013; 94(11): 2194-2202.

Affiliation

Northwestern University Prosthetics-Orthotics Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Electronic address: Matthew-Major@northwestern.edu.

Copyright

(Copyright © 2013, Elsevier Publishing)

DOI

10.1016/j.apmr.2013.07.002

PMID

23856150

Abstract

OBJECTIVE: To evaluate the validity and reliability of the Berg Balance Scale (BBS) for use in people with lower limb amputation. DESIGN: Cross-sectional study. SETTING: Research laboratory. PARTICIPANTS: Thirty individuals (54±12 years; 20 male) with unilateral transtibial (n=13), unilateral transfemoral (n=14), or bilateral (n=3) lower limb amputation of dysvascular (n=7), traumatic (n=14), infectious (n=6), or congenital (n=3) origin. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: BBS, two-minute walk test, L test, Prosthesis Evaluation Questionnaire-Mobility Subscale, Activities-specific Balance Confidence Scale, and Frenchay Activities Index; self-reported descriptors were also collected, including frequency of prosthesis use, number of falls in twelve months prior to visit, fear of falling, and daily mobility aid use. RESULTS: The BBS had high inter-rater reliability (ICC=0.945) and internal consistency (α=0.827). Relationships between the BBS scores and those of other outcome measures were all statistically significant (p≤0.001). Significant group differences in BBS scores were observed for fear of falling (p=0.008) and mobility aid use (p<0.001), but not for multiple (≥2) falls in the previous twelve months (p=0.381). BBS items involving reaching forward, turning 360°, tandem standing, and standing on one leg had relatively greater frequencies of lower scores across participants. CONCLUSIONS: The BBS appears to be a valid and reliable clinical instrument for assessing balance in individuals with lower limb amputation, but may not be able to discriminate between individuals with greater or lesser fall risk. Limitations in prosthetic motion and control may be responsible for the challenges experienced on items of lower performance. Future studies would be useful to assess the responsiveness of the BBS to interventions aimed at improving balance in individuals with lower limb amputation.

Language: en