Balance Assessment Tool (Berg, TUG, SPPB)

Balance & Mobility Assessment Suite

Berg Balance Scale • Timed Up and Go (TUG) • SPPB

Berg Balance Scale (Max Score: 56)

0 / 56

Complete the assessment to view risk.

Protocol Overview

• **Purpose:** Objective measure of static and dynamic balance in the elderly or neurological patients.
• **Procedure:** 14 tasks are scored from 0 (unable) to 4 (independent) based on observation. Maximum time is 5 minutes.
• **Cut-off:** A score of **<45 indicates increased fall risk**. Scores below 36 often indicate severe fall risk.

Timed Up and Go (TUG) Test

Time Taken (Seconds):

-- s

Enter time to assess fall risk.

TUG Protocol & Interpretation

• **Setup:** Patient sits in a standard chair (45 cm height). A line or cone is placed 3 meters (10 feet) away.
• **Procedure:** On command "Go," the patient stands up, walks to the line, turns, walks back, and sits down. Time stops when they are seated.
• **Fall Risk Cut-offs:**
  • **< 10 seconds:** Independent mobility (Low risk).
  • **10-14 seconds:** Increased risk; may require supervision.
  • **> 13.5 seconds:** High Fall Risk (common cut-off).

Short Physical Performance Battery (SPPB) - Max Score: 12

SPPB Components (0-4 points per component)

The SPPB aggregates performance across three domains to give a prognostic score (0-12).

1. Balance Test (Score based on time held): 0: Unable to hold 10 seconds or more 1: Semi-Tandem (3-9.99s) or Full Tandem (< 3s) 2: Full Tandem (3-9.99s) 3: Full Tandem (10s) 4: Full Tandem (10s) + Semi-Tandem (10s)

2. Gait Speed (4-meter walk time):

3. Chair Stand Test (Time for 5 repetitions):

0 / 12

Complete tests to find prognosis.

SPPB Prognosis Interpretation

• **Score 10-12:** High Functional Reserve. Low disability risk.
• **Score 7-9:** Moderate Functional Limitation.
• **Score < 7:** Poor Score. Suggests high risk of nursing home placement and disability.

❓ Frequently Asked Questions (FAQ)

**Q: Should I use an assistive device (cane/walker)?**
A: **Yes**, if needed for safety. Note its use in the chart, but compare scores only when the same device is used. TUG time will be slower.

**Q: Why is 1+ (Berg) better than 1?**
A: There is no 1+ in the Berg Scale; scores are 0, 1, 2, 3, or 4. Each number has a specific meaning regarding the level of assist needed.

**Q: What if the patient refuses a task?**
A: Score that item as **0 (Unable to Perform)**, as the goal is to measure current functional ability, not motivation.

📚 References

Berg Balance Scale: Berg, K. O., Wood-Dauphinee, S. L., Williams, J. I., & Maki, B. (1992). Measuring balance in the elderly: validation of an instrument. *Physical Therapy*, 72(12), 1083-1093.

Timed Up and Go (TUG): Podsiadlo, D., & Richardson, S. (1991). The Timed "Up & Go": a test of basic functional mobility for frail elderly persons. *J Am Geriatr Soc*, 39(2), 142-148.

SPPB: Guralnik, J. M., et al. (1994). A short battery of performance measures to assess physical function in older women. *J Gerontol*, 49(2), M85-M90.