Intro. to FallProof Balance Tests - California State University, Fullerton

Introduction to TM FallProof Balance Tests

Debbie Rose, Ph.D. Co-Director, Center for Successful Aging California State University, Fullerton

FallProofTM Screening and Assessment Tools  Fall Risk • 8 Foot Up and Go  Functional Limitations • Fullerton Advanced Balance (FAB) Scale • Berg Balance Scale (BBS) • 50 Foot Walk at Preferred and Fast Speed • “Walkie-Talkie” Test

FallProofTM Screening and Assessment Tools  Sensory

Impairments

• Modified version of the Clinical Test of Sensory

Interaction in Balance (M-CTSIB)

 Motor

Impairments

• Multidirectional Reach Test

FallProofTM Screening and Assessment Tools  Physical Impairments • Senior Fitness Test Items – Chair Stand; Arm Curl; Chair Sit-and-Reach; Scratch Test; 2Minute Step  Fear-of-Falling • Health/Activity Questionnaire • Balance Efficacy Scale (Optional)

Fullerton Advanced Balance Scale  

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Developed by Rose & Lucchese (2003). Test demonstrates high test-retest reliability (.95) Inter-rater reliability is also high, ranging from .94 to .97 when administered by experienced clinicians. Scale is comprised of 10 items designed to measure multiple dimensions of balance. Recommended for use with higher functioning community-dwelling older adults only.

Fullerton Advanced Balance Scale Test requires little equipment  Can be administered within 8 to 10 minutes  Has operational definitions by which to score each test item  Assesses more dimensions of balance when compared to the Berg Balance Scale  Expect to be less prone to ceiling effects 

Fullerton Advanced Balance Scale  Test

Items include:

• Standing with feet together, eyes closed

• Reaching forward to grasp object • Turn 360 degrees • Stepping over an obstacle • Walking with feet in tandem position • Standing on one foot

Fullerton Advanced Balance Scale  Test

Items include:

• Standing on foam, eyes closed.

• Two-footed Jump for Distance • Walk with Head Turns • Backward Perturbation  Total

Score Possible: 40 Points

Balance Dimensions  Sensory

reception and integration

• Items 1; 3; 7; 9  Motor

coordination

• Items 2; 4; 5; 6; 8; 10  Musculoskeletal

Integrity

• Items 4; 5; 6; 7; 8

Interpretation of Item Scores  Possible

underlying Impairments?

• Item 1- Standing with feet together and

eyes closed. Weak hip abductor/adductor muscles Poor use of somatosensory Cues Poor Center of Gravity Control

Interpretation of Item Scores  Possible

underlying Impairments?

• Item 8 – Two-footed jump for

distance. Lower body muscle weakness Poor Center of Gravity Control Poor upper and lower body coordination

Interpretation of Item Scores  Possible

underlying Impairments?

• Item 9- Walk with Head Turns

Possible vestibular impairment? Poor use of vision Poor dynamic COG control

Interpretation of Item Scores  Possible

underlying Impairments?

• Item 10 – Unexpected Backward Release

Absent or ineffective use of step strategy Lower body weakness (reduced power) Poor Center of Gravity Control

Berg Balance Scale (BBS) Developed by Berg in 1989  Test comprised of 14 performance items  High validity, test-retest and rater reliability  Requires approximately 15 to 20 minutes to administer  Prone to ceiling effects when used with community-dwelling older adults. 

Berg Balance Scale  Test

Items Include:

• Rising from a chair • Standing independently for two minutes • Seated balance (if unable to stand

independently) • Sitting down in a chair • Transfers between chairs • Standing with eyes closed

Berg Balance Scale 

Test Items Include: • Standing with feet together • Leaning forward • Picking object up from floor

• Turn to look over shoulders • 360 degree turn • Dynamic toe touching

• Tandem Stance • Standing on one leg

Modified Version of BBS  In

modified version of the test, the first 5 test items are deleted (Daschle et al., 1987)  High reliability and validity retained with modified version.  Total score reduced from 56 to 36 points

Interpretation of Item Scores Possible impairments associated with low Scores: • Item 1 – lower and upper body weakness; poor

dynamic COG control; Abnormal weight distribution. • Item 2 – Poor gaze stabilization; lower body weakness; abnormal weight distribution in standing. • Item 6 – Poor use of somatosensory inputs; Visual dependency and/or fear-of-falling; Lower body weakness.