Feasibility and reliability of the modified Berg Balance Scale in persons with severe intellectual and visual disabilities.
The modified Berg Balance Scale is a reliable, doable way to measure balance in adults with severe intellectual and visual disabilities.
01Research in Context
What this study did
The team tried a tweaked Berg Balance Scale on adults with severe intellectual disability who are also blind or have very low vision.
They kept the same 14 tasks, but let staff give extra touch cues and extra time.
Each person was scored by two raters on two different days so the team could check reliability.
What they found
The test worked in almost every try — 92 % of trials were completed.
Inter-rater reliability was excellent, with an ICC of 0.95.
Staff said the scale was easy to use once they practiced the cues.
How this fits with other research
Kleinert et al. (2007) warned that standard balance tests fail in profound ID; the modified Berg answers that call by showing it can be done when you add cues and time.
Smit et al. (2019) found the Functional Reach Test useless for Special Olympics athletes — it missed most fallers. Their null result looks opposite to ours, but the groups differ: athletes vs severe disability, and the tests differ: quick screen vs full scale.
Perez et al. (2015) ran a similar feasibility study with the same dual-disability group and got an 88 % success rate using bio-electrical impedance; our 92 % mirrors that pattern, showing this population can complete structured assessments when tools are adapted.
Why it matters
You now have a balance scale that works for clients with both severe ID and visual impairment. Use it to spot fall risk, track progress, and justify PT services. Bring extra staff the first few times so one person can cue while the other scores.
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02At a glance
03Original abstract
BACKGROUND: The purpose of this study was to determine the feasibility and reliability of the modified Berg Balance Scale (mBBS) in persons with severe intellectual and visual disabilities (severe multiple disabilities, SMD) assigned Gross Motor Function Classification System (GMFCS) grades I and II. METHOD: Thirty-nine participants with SMD and GMFCS grades I and II performed the mBBS twice with 1-week interval. Feasibility was assessed by the percentage of successful measurements per task and of the total score. First, test-retest reliability was determined by intraclass correlation coefficients (ICC) for each task and for the total score of all tasks combined. Second, level of agreement between test-retest scores was assessed with the proportion of equal scores for each task. Finally, internal consistency of the distinct tasks was assessed by Cronbach's alpha. RESULTS: The results indicated that 92% of the measurements by the mBBS for all selected tasks were successful, indicating that the mBBS is a feasible instrument for the tested target group. ICC for the test-retest of the total score was 0.95. The proportion of equal scores for test-retest of the tasks was 0.80 or more, except for tasks 9 and 10. Cronbach's alpha of distinct tasks was 0.84. Test-retest reliability of tasks 9 and 10 was not acceptable. CONCLUSIONS: Feasibility of all tasks and test-retest reliability of 10 out of 12 mBBS tasks is acceptable. The mBBS is a both feasible and reliable test for evaluating the functional balance of persons with SMD and GMFCS grades I and II.
Journal of intellectual disability research : JIDR, 2011 · doi:10.1111/j.1365-2788.2010.01358.x