Developing a short form of the Berg Balance Scale for people with stroke

BACKGROUND AND PURPOSE: To improve the utility of the Berg Balance Scale (BBS), the aim of this study was to develop a short form of the BBS (SFBBS) that was psychometrically similar (including test reliability, validity, and responsiveness) to the original BBS for people with stroke. SUBJECTS AND METHODS: A total of 226 subjects with stroke participated in this prospective study at 14 days after their stroke; 167 of these subjects also were examined at 90 days after their stroke. The BBS, Barthel Index, and Fugl-Meyer Motor Test were administered at these 2 time points. By reducing the number of tested items by more than half the number of items in the original BBS (ie, making 4-, 5-, 6-, and 7-item tests) and simplifying the scoring system of the original BBS (ie, collapsing the 5-level scale into a 3-level scale [BBS-3P]), we generated a total of 8 SFBBSs. RESULTS: The distributions of scores for all 8 SFBBSs were acceptable but featured notable floor effects. The 4-item BBS, 5-item BBS, 5-item BBS-3P, and 7-item BBS-3P demonstrated good reliability. The subjects' scores on the 6-item BBS, 6-item BBS-3P, 7-item BBS, and 7-item BBS-3P showed excellent agreement with those on the original BBS. The 6-item BBS-3P and 7-item BBS-3P exhibited great responsiveness. Only the 7-item BBS-3P demonstrated both satisfactory and psychometric properties similar to those of the original BBS. DISCUSSION AND CONCLUSION: The 7-item BBS-3P was found to be psychometrically similar to the original BBS. The 7-item BBS-3P, compared with the original BBS, is simpler and faster to complete in either a clinical or a research setting and is recommended.