Berg Balance Scale(BBS)

Administration.

Standardized instructions for 14 items: sit-to-stand, standing unsupported, sitting unsupported, stand-to-sit, transfers, standing with eyes closed, standing with feet together, reaching forward, retrieving object from floor, turning to look behind, turning 360°, alternating foot on stool, tandem stance, single-leg stance. Equipment: chair with armrests, ruler, stopwatch, step, second chair. Time: 15–20 minutes. Touching assistance during balance items results in the lower applicable score.

Scoring.

Sum across 14 items (0–56). Patients who cannot perform an item score 0 per Core Set CPG conventions.

MDC and MCID, stroke-specific.

• MDC acute stroke = 7 points (Stevenson TJ. *Aust J Physiother*. 2001;47:29–38).
• MDC chronic stroke = 4.66 (Hiengkaew V et al. *Arch Phys Med Rehabil*. 2012;93:1201–1208) to 6.7 (Liaw LJ et al. *Disabil Rehabil*. 2008;30:656–661).
• MCID early subacute stroke, assisted-walking subgroup = 5 points (Tamura S, Miyata K et al. *Disabil Rehabil*. 2022); the same study reported a lower-quality estimate of 4 points in the unassisted-walking subgroup with reduced discriminative accuracy.

Cut-points.

Older adults: <45 elevated fall risk (Shumway-Cook 1997). Stroke: ≥49/56 walks without aid; ≥43/56 walks without four-wheeled walker. Acute stroke admission Berg predicts discharge destination (Wee J et al. *Arch Phys Med Rehabil*. 2003;84:731–735).

What it measures.

Static and dynamic standing and sitting balance through 14 functional tasks scored 0–4, total 0–56. Higher = better balance.

History.

Developed by Katherine Berg and colleagues for the elderly (Berg KO, Wood-Dauphinée SL, Williams JI, Maki B. *Can J Public Health*. 1992;83(Suppl 2):S7–S11). Subsequently validated in stroke (Berg K et al. *Scand J Rehabil Med*. 1995). The Core Set CPG (Moore 2018) gives a strong recommendation (Level I) for assessing static and dynamic standing balance across adults with neurologic conditions who have balance goals.

When to use.

Adults with neurologic conditions across acute, subacute, and chronic stages who have goals to improve static or dynamic standing balance.

When not to use.

No goals or capacity for sitting/standing balance change. High-functioning patients near 51–56 (ceiling effect — switch to mini-BESTest or FGA).