Validating the Berg Balance Scale for patients with Parkinson's disease: A key to rehabilitation evaluation

Objective: To assess the criterion-related validity of the Berg Balance Scale (BBS) in subjects with Parkinson's disease (PD). Design: Prospective, correlational analysis between the BBS and accepted measures of PD motor and functional impairment. Setting: The federally funded PD research center, an interdisciplinary center of excellence for people with PD within a Veterans Affairs medical center. Participants: Thirty-eight men (average - standard deviation, 71.1 +/- 10.5y) with confirmed PD. Their initial diagnosis had been made on average 5.8 +/- 3.6 years earlier. All could stand or walk unassisted and had mild to moderate disability. Patients who could not ambulate Without assistive devices were excluded. Interventions: Not applicable. Main Outcome Measures: Correlational analyses between the BBS and the Unified Parkinson's Disease Rating Scale (UPDRS) motor scale. Modified Hoehn and Yahr Staging (Hoehn and Yahr) Scale, and the Modified Schwab and England Capacity for Daily Living Scale (SME ADL Scale). Results: BBS score showed significant correlations with indicators of motor functioning, stage of disease, and daily living capacity. BBS score was inversely associated with the UPDRS motor score (-.58, P < .005), Hoehn and Yahr Scale staging (-.45. P < .005), and SRE ADL Scale rating (.55, P < .005). In all 3 correlations, lower scores on the BBS (indicating greater balance deficits) correlated with higher UPDRS scores (indicating greater motoric or functional impairment). Conclusions: Results Support the criterion-related validity of the BBS. Its utility in other balance conditions of older adults has been established. Rehabilitation interventions have been shown to improve the balance deficits associated with PD. Early referral and periodic reassessment is vital to achieving and maintaining improvements. Our research results agree with other published research in suggesting that the BBS may be used as a screening tool and ongoing assessment tool for patients with PD. (c) 2005 by American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation