A comparison of three balance-assessment scales for patients after stroke with various levels of balance disorder

Int J Rehabil Res. 2020 Dec;43(4):337-341. doi: 10.1097/MRR.0000000000000431.

Abstract

It is often difficult for the clinician to choose the most appropriate balance-assessment measure. We wanted to facilitate this decision based on the stroke patient's functional abilities. The aim of our study was to compare three established scales [Berg Balance Scale (BBS), mini-BESTest (MBT) and Functional Gait Assessment (FGA)] in terms of responsiveness, floor and ceiling effects at different levels of ambulation as defined by the Functional Ambulation Classification (FAC). The 18-month prospective study included 88 patients after cerebral stroke, who were able to walk independently or with assistance of one person (FAC 2-6). BBS showed the highest relative gain in the FAC 2-3 group (17% of maximum scale score); in the other two groups (FAC 4-5 and FAC 6), MBT showed the highest relative gain (16 and 13%, respectively), followed by FGA (11 and 10%, respectively). Among the patients with initial FAC 2-3, a floor effect occurred with FGA, while a ceiling effect occurred with BBS among patients with initial FAC 6. Gain in FGA correlated slightly more with improvement detected by MBT (r = 0.60) than with BBS (r = 0.50). We can conclude that BBS seems to be suitable for stroke patients with initial FAC 2-5, whereas MBT and FGA for those with FAC 4-6.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Disability Evaluation*
  • Female
  • Gait Disorders, Neurologic / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Postural Balance / physiology*
  • Prospective Studies
  • Stroke / physiopathology*