Clinical assessment of balance using BBS and SARAbal in cerebellar ataxia: Synthesis of findings of a psychometric property analysis.
Stanley John Winser, Catherine M Smith, Leigh A Hale and 2 others
PMID 30930579WHAT IT FOUND
The Berg Balance Scale and SARA balance sub-score are free, take 15-20 minutes, and accurately separate patients who use walking aids from those who do not.
Cut-offs of less than 44 on the Berg or more than 5 on the SARA identify aid users with high accuracy.
Key findings
01A Berg Balance Scale score below 44 or a SARA balance sub-score above 5 identifies assistive walking device users with 90% sensitivity and high specificity.
02Both measures showed strong reliability and validity, with statistically significant differences in scores between assistive device users and non-users.
03The assessments are feasible for clinical use, requiring 15-20 minutes, no specialized equipment, and no formal training beyond standard physiotherapy qualifications.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study only included patients with cerebellar ataxia secondary to multiple sclerosis, so results may not apply to other causes of ataxia. Responsiveness (ability to detect change over time) and structural validity were not assessed. The minimal clinically important difference (MCID) could not be determined because repeat assessments after intervention were not part of the original analysis. Feasibility was established by qualified physiotherapists, so the ease of administration may not generalize to other professional groups without similar training.
Declared interests
The authors declared no conflicts of interest. The research was funded by various university scholarships, travel grants, and physiotherapy association funds.
The easy way to misread this
Do not assume these measures track recovery or change over time. Responsiveness was not estimated, and the minimal clinically important difference could not be calculated, so these tools are validated for assessing current balance status and identifying assistive device needs, not for measuring treatment efficacy.