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Balance in Personal Care Home Residents: A Comparison of the Berg Balance Scale, the Multi-Directional Reach Test, and the Activities-Specific Balance Confidence Scale

Holbein-Jenny, Mary Ann PhD, DPT1; Billek-Sawhney, Barbara PT, EdD1; Beckman, Elizabeth DPT2; Smith, Trina DPT2

Journal of Geriatric Physical Therapy: August 2005 - Volume 28 - Issue 2 - p 48–53

Purpose: This study used the Berg Balance Scale (BBS), the Multi-Directional Reach Test (MDRT), and the Activitiesspecific Balance Confidence Scale (ABC) to quantify balance of elderly residents of a personal care home. The reliability and construct validity of these measures were also examined.

Methods: Twenty-one females and 5 males, 74 to 92 years old, participated. Participants completed each balance test once, during 2 testing sessions. Reliability was quantified using intraclass correlation coefficients (ICCs). Construct validity was quantified using Pearson's correlation coefficients (r) and Cronbach's alpha.

Results: The mean (± sd) scores were: BBS = 41.3 ± 9.0, MDRT (forward = 5.6 ± 3.0 in, backward = 2.9 ± 2.2 in, right = 3.3 ± 2.5 in, left = 3.7 ± 3.1 in), and ABC = 54.0 ± 24.9%. Inter-rater reliability was good for the BBS and MDRT (ICC = 0.88–0.98). Test-retest reliability was moderate to good for all 3 balance tests (ICC = 0.66–0.83). Pearson's correlations between the BBS and MDRT were moderate to good (r = 0.53–0.78), and correlations involving the ABC were fair to moderate (r = 0.41–0.59). Cronbach's alpha was strong (0.80) when only the MDRT and BBS were included.

Conclusions: Results indicate residents of personal care homes are at high fall risk. The balance tests showed moderate to good reliability for this population. The BBS and MDRT appear to be valid measures of motor ability to maintain balance, while the self-report ABC appears to measure a different component of the balance construct in this population.

1Associate Professor, Slippery Rock University, School of Physical Therapy, Slippery Rock, PA

2Student in DPT program at Slippery Rock University when study was conducted, Slippery Rock, PA

Address correspondence to: Mary Ann Holbein-Jenny, Slippery Rock University, Graduate School of Physical Therapy, 1 Morrow Way, Slippery Rock, PA 16057, Ph: 724–738–2907, Fax: 724–738–2113 (

© 2005 Lippincott Williams & Wilkins, Inc.
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