Introduction to FallProofTM Balance Tests

1
Introduction toFallProofTM Balance Tests

• Debbie Rose, Ph.D.
• Co-Director, Center for Successful Aging
• California State University, Fullerton

2
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

3
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

4
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)

5
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.

6
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

7
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

8
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

9
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

10
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

11
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

12
Interpretation of Item Scores

• Possible underlying Impairments?
• Item 9- Walk with Head Turns
• Possible vestibular
• impairment?
• Poor use of vision
• Poor dynamic COG control

13
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

14
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.

15
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

16
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

17
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

18
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.