THE BERG BALANCE SCALE AS A SCREENING TEST TO PREDICT FALLS IN OLDER ADULTS: A SYSTEMATIC REVIEW

Abstract

Although the Berg Balance Scale (BBS) is widely used in daily practice, there is no consensus about its value to predict falls. This systematic review aims to verify the BBS ability to predict fall risk in older adults through the analysis of prospective studies. Manual and electronic searches (Medline, EMBASE, CINAHL, Ageline, Lilacs, Web of Science, Cochrane and PEDro) were conducted without language restriction and with publication date after 1989 (BBS development year). We included prognostic studies with older people sample that evaluated the BBS (predictive factor) and the fall event in the last 6 or 12 months (outcome measurement). The studies methodological quality was assessed using the Quality In Prognosis Studies tool. We found 509 studies. This review included 8 studies from ten articles and they presented moderate to low risk of bias. Five studies had a 6 months follow-up period and 3 had a 12 months. The BBS average score for non-fallers was 49.4 and 52.5 points; and for fallers 44.5 and 51 points in 6 and 12 months, respectively. The BBS cut-off ranged from 45 to 51 points. Only in three studies the BBS score was able to discriminate fallers and non-fallers. It was not possible to define a BBS cut-off score due to studies lack of homogeneity, adequate sample size and absence of subgroup analysis. Evidence is insufficient to determine an adequate BBS cut-off score to predict falls in older adults. Ultimately, BBS should not be used as a prediction tool for falls in clinical practice.