School of Medicine and Health Sciences Poster Presentations
Inter-rater Reliability of the Berg Balance Scale with Individuals with Multiple Sclerosis at Risk for Falls
Poster Number
310
Document Type
Poster
Publication Date
3-2016
Abstract
Purpose: The Berg Balance Scale (BBS) is a useful, objective measure to assess balance in persons with Multiple Sclerosis (MS). Each of the 14 items on the scale is scored from 0-4 based on the participant’s level of independence in performing static and dynamic balance tasks. The purpose of this study was to examine the inter-rater reliability of BBS scores between two raters across 29 subjects with MS as part of the Free from Falls study, a collaboration between GW and the National MS Society.
Subjects/Materials/Methods: The BBS was used to assess changes in balance between the experimental group (n = 15), who participated in an 8 week fall prevention program, and control group (n = 14). Each balance assessment was videotaped for scoring. Fifty-four trials were independently rated by two different examiners, which represented pre-tests and post-tests for 29 and 25 subjects respectively. Raters were trained prior to the video analysis to establish a baseline interpretation of the scoring system. Analysis of the reliability of the total BBS score was performed by an independent investigator using intraclass correlation coefficient (ICC) Model 2, and on each individual item using kappa correlation coefficients.
Results: BBS total scores between raters had excellent reliability (Pre-test ICC=0.9695; Post-test ICC=0.9579). In addition, the kappa analysis for individual items on the Berg demonstrated excellent rating (Kappa > 0.75) for Items #1, 2, 3, 6, 7, 8, 11, 13, and good rating (Kappa = 0.4-0.75) for Items #5, 9, 10, 14. Items #4 and #12 had poor reliability (kappa = 0.31).
Conclusions: The BBS total score demonstrated excellent reliability between two raters for this population. Training prior to rating may have contributed to the consistency in scoring between the two raters. Two items emerged from the ratings that showed poor reliability, including the stand-to-sit and the alternating lower extremity toe-taps on a step.
Clinical Relevance: This study suggests that two specific BBS items may be problematic for different raters. Accurate ratings could affect documentation of achieving goals, including the minimal clinical important difference (MCID), for a given patient on an outcome tool.
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Open Access
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Inter-rater Reliability of the Berg Balance Scale with Individuals with Multiple Sclerosis at Risk for Falls
Purpose: The Berg Balance Scale (BBS) is a useful, objective measure to assess balance in persons with Multiple Sclerosis (MS). Each of the 14 items on the scale is scored from 0-4 based on the participant’s level of independence in performing static and dynamic balance tasks. The purpose of this study was to examine the inter-rater reliability of BBS scores between two raters across 29 subjects with MS as part of the Free from Falls study, a collaboration between GW and the National MS Society.
Subjects/Materials/Methods: The BBS was used to assess changes in balance between the experimental group (n = 15), who participated in an 8 week fall prevention program, and control group (n = 14). Each balance assessment was videotaped for scoring. Fifty-four trials were independently rated by two different examiners, which represented pre-tests and post-tests for 29 and 25 subjects respectively. Raters were trained prior to the video analysis to establish a baseline interpretation of the scoring system. Analysis of the reliability of the total BBS score was performed by an independent investigator using intraclass correlation coefficient (ICC) Model 2, and on each individual item using kappa correlation coefficients.
Results: BBS total scores between raters had excellent reliability (Pre-test ICC=0.9695; Post-test ICC=0.9579). In addition, the kappa analysis for individual items on the Berg demonstrated excellent rating (Kappa > 0.75) for Items #1, 2, 3, 6, 7, 8, 11, 13, and good rating (Kappa = 0.4-0.75) for Items #5, 9, 10, 14. Items #4 and #12 had poor reliability (kappa = 0.31).
Conclusions: The BBS total score demonstrated excellent reliability between two raters for this population. Training prior to rating may have contributed to the consistency in scoring between the two raters. Two items emerged from the ratings that showed poor reliability, including the stand-to-sit and the alternating lower extremity toe-taps on a step.
Clinical Relevance: This study suggests that two specific BBS items may be problematic for different raters. Accurate ratings could affect documentation of achieving goals, including the minimal clinical important difference (MCID), for a given patient on an outcome tool.
Comments
Presented at: GW Research Days 2016