Effect of Leg Selection on the Berg Balance Scale Scores of Hemiparetic Stroke Survivors: A Cross-Sectional Study

Objective To examine whether selection of the nonparetic or paretic leg as the weight-bearing leg in item 13 (standing unsupported one foot in front) and item 14 (standing on one leg) of the Berg Balance Scale (BBS) influences the item scores, and thus the total score. Design Cross-sectional study. Setting University-based rehabilitation laboratory. Participants Community-dwelling people (N=63, aged ≥50y) with chronic stroke. Interventions Not applicable. Main Outcome Measure BBS. Results The 4 BBS total scores ranged from 48.4 to 50.7. The total score was significantly lower when a participant was asked to step forward with the nonparetic leg in item 13, and stand on the paretic leg in item 14. Fewer participants received a maximum score with the BBS 1 formulation than the others. In addition, the correlations with walking speed and Activities-specific Balance Confidence Scale scores were greatest with the BBS 1 score. Conclusions Our findings suggest that BBS 1 was the most challenging formulation for our participants; this might serve to minimize the ceiling effect of the BBS. These findings provide a rationale for amending the BBS administration guidelines with the BBS 1 formulation.