Feasibility and outcomes of the Berg Balance Scale in older adults with intellectual disabilities.
Expect Berg scores 20 years below age norms in older adults with ID and use that to trigger fall-prevention plans.
01Research in Context
What this study did
Oppewal et al. (2013) gave the Berg Balance Scale to over 1,000 older adults with intellectual disability. They wanted to see if the test could be done and what scores looked like in this group.
Staff scored 14 everyday moves like standing on one foot or turning around. If someone could not finish the full list, they noted which parts still worked.
What they found
Average scores were around 47, a level typical of adults 20 years older. Many people needed the short form because the full test was too hard.
The scale could be given in most day centers, so it is practical for routine checks.
How this fits with other research
Dijkhuizen et al. (2017) tried a modified Berg in adults who also had visual impairment. They found the scores did not predict future falls, a result that sounds opposite to Alyt et al. The difference is vision loss: when people cannot see, balance items lose meaning, so the scale stops forecasting risk.
Robertson et al. (2013) counted falls in the same age group and reported one fall per person each year. Alyt’s low balance scores help explain why that rate is high.
Gandhi et al. (2022) showed another movement screen, the FMS, is also doable in adults with ID but gives lower scores. Together these papers say: pick one quick motor test, expect below-average numbers, and plan care from there.
Why it matters
You can add the Berg Balance Scale to annual reviews for any adult with ID over 45. Score below 45 means fall risk is high, so start strength drills, clear trip hazards, and request physio. If the person also has poor vision, skip the full Berg and watch real-world mobility instead.
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02At a glance
03Original abstract
High incidence of falls and increased risk of fall-related injuries are seen in individuals with intellectual disabilities (ID). The Berg Balance Scale (BBS) is a reliable instrument for balance assessment in the population of (older) adults with ID. The aims of this study were to assess the balance capacities of a large group of older adults with ID with the BBS and look for gender and age effects, as well as reasons for drop-out on separate items, and to identify feasible subtests for subgroups in which the complete BBS is not feasible. The balance capacities of 1050 older clients with borderline to profound ID of three Dutch care-provider services (mean age 61.6 [sd=8.0]) were assessed with the BBS. The participants who completed all items of the BBS (n=508) were the functionally more able part of the study sample. Results showed that even this functionally more able part had poor balance capacities, with a mean BBS score of 47.2, 95% CI [46.3, 48.0], similar to adults in the general population aged around 20 years older. Balance capacities decreased with increasing age and females had poorer balance capacities than males. Difficulties understanding the task and physical limitations were most often the reasons for drop-out. Feasible subtests were identified for the subgroups with very low cognitive levels and wheelchair users. Low balance capacities of older adults with ID show the need for regular screening and the urge for fall prevention programs for individuals with ID.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.05.040