Introduction toFallProofTM 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; 2-Minute Step • Fear-of-Falling • Health/Activity Questionnaire • Balance Efficacy Scale (Optional)
Fullerton Advanced Balance Scale • 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.