BERG BALANCE
SCALE (BBS)
Instructions:1-6
• There are standardized instructions
for each item of the BBS.
•Please refer to the protocol for
standardized administration of the
BBS, including instructions for each
item. http://neuropt.org/practice-re-
sources/anpt-clinical-practice-guide-
lines/core-outcome-measures-cpg
Equipment Needed:1-6
•Stopwatch
• Standard height chair (18-20 in.)
with arm rests
• Standard height chair (18-20 in.)
without arm rests
• Step or stool of average height
(7 ¾ - 9 in.)
• Ruler
• Slipper or shoe
Scoring:1-6
• Items are scored on a 5 point ordinal scale.
• Points are deducted for requiring
supervision, assistance and/or taking
more than the allotted time to
complete the task.
• The lowest category that applies
should be marked.
• Please refer to the standardized
administration of the BBS for
item-by-item scoring. This can be
found at: http://neuropt.org/
practice-resources/anpt-clinical-p
ractice-guidelines/core-out-
come-measures.cpg
What Does My Patient’s Score Mean?
Cut-off scores may be used in conjunction
with a complete evaluation to interpret the
meaning of a patient’s score on the BBS
• Non-Specific/Older Adults
¡Cutoff Score: ≤40 almost
100% fall risk7
¡Cutoff Score: ≤50 fall risk8
Considerations:
•Assistive devices should not be
used when performing the BBS.
Orange text indicates that the reference was also critically appraised and cited in the publication “A Core Set of
Outcome Measures for Adults with Neurologic Conditions Undergoing Rehabilitation: A Clinical Practice Guideline”.
Journal of Neurologic Physical Therapy 2018; 42(2):174-220.
What Constitutes a Change in Berg Score?
Change can be determined using values of Minimal Detectable Change (MDC) and
Minimal Clinically Important Difference (MCID). MDC is the minimal change required to
ensure the change is not the result of measurement error. MCID is the minimal change
required for the patient to also feel an improvement in the construct being measured.
•Stroke
¡MDC (acute): 6-7 points2
¡MDC (chronic): 4.66 points (superscript 2) to 6.7 points10
• Parkinson’s Disease (Hoehn & Yahr stages 1-4)
¡MDC: 5 points3
• Huntington’s Disease
¡MDC (premanifest HD): 1 point11
¡MDC (early-stage HD): 4 points11
¡MDC (middle and late-stage): 5 points11
