Vol. 16 Issue 21
The Berg Balance Scale: Treatment Ideas
The Berg Balance Scale lends itself easily to treatments based on each deficit noted on the test. This article will outline each of the 14 items and provide treatment strategies based on exercises and therapeutic activities. Therefore, time spent on these activities can be billed as such. Not only will therapists see adequate reimbursement for their time, but also task-specific improvement for each of the items.
A. Sit-to-stand functional training from chairs of different heights;
B. Sit-to-stand functional training on chairs with phone books of varied heights;
C. Chair push-ups;
E. Forward reach with clasped hands;
F. Forward reaching over a ball, roll back and forth.
2. Standing unsupported
A. Resisted side step;
B. Standing on foam or pillow;
C. Tandem and semi-tandem standing;
D. Lateral swaying;
E. Narrow base–head and trunk turns;
F. Narrow base–arm reaches.
3. Sitting unsupported
A. Pelvic tilt progression sitting;
B. Reaching forward;
C. Partial sit-ups;
D. Sitting PNF diagonals;
E. Pointing at targets with laser light on their head;
F. Toes only on the ground turning head and trunk.
4. Standing to sitting
B. Stand to sits at different heights;
C. Wall slides;
D. Mini-squats with exercise bands;
E. Standing forward hip thrusts;
F. Touching buttocks to phonebooks on chair.
C. One-legged standing;
D. Head turns through the movement pattern;
E. Reaches through the movement pattern;
F. Side steps.
6. Standing with eyes closed
A. Head turns with eyes closed;
B. Turns with eyes closed;
C. Sit to stand with eyes closed;
D. Ankle rocks with eyes closed;
E. Lateral sways with eyes closed;
F. Head, shoulders, knees and toes with eyes closed.
7. Standing with feet together
A. Hip abduction;
B. Balance board;
C. Side stepping;
D. Side reaching;
E. Lateral sways;
F. Multidirectional dot reaches.
8. Forward reach
A. Plantar flexion PRE progression;
B. Trunk extension;
C. Shoulder flexion;
D. Ankle sways;
E. Wobble board;
F. Plantar flexion stretch.
9. Retrieving object from the floor
A. Deep squats;
B. Progressive reach;
C. Wall slides;
D. Knee flexion;
E. Hip flexion;
F. Weighted mini-squats.
10. Turning to look behind
A. Tai Chi;
B. Trunk rotation;
C. Knee rocks;
D. Axial mobility work;
E. Looking behind at targets sitting progression to standing;
F. Pilates trunk turns.
11. Turning 360 degrees
A. Vestibular exercises;
B. Head turns;
C. One-legged stands;
D. Tai Chi;
E. Progressive head turns sitting progressing to standing;
F. Progressive trunk turns sitting progressing to standing.
12. Placing alternating feet on stool
B. Progressive marching using exercise band at weak part for resistance;
C. Cone taps;
D. Long arc quads;
E. Hip abduction;
F. One-legged stands.
13. Tandem standing
A. Side stepping;
B. Semi-tandem progression;
C. Narrow base dot reach;
D. One legged standing;
E. Tandem walking;
F. Narrow base progression with ball
14. One-legged standing
A.Narrow base progression with ball kick;
B. Leg swing;
C. One-legged standing;
D. One-legged standing on exercise pads, touching toe to other pads;
E. Tandem and one-legged ball throw;
F. One-legged standing with eyes closed.
Above are 98 different treatment ideas for the items on the Berg Balance Scale. These interventions can be used as basis of treatment or as a starting point for more creative exercises and therapeutic activities.
Dr. Lewis is a physical therapist in private practice and president of Premier Physical Therapy of Washington, DC. She lectures exclusively for GREAT Seminars and Books, Inc. Dr. Lewis is also the author of numerous textbooks. Her Website address is www.greatseminarsandbooks.com. Dr. Shaw is an assistant professor in the physical therapy program at the University of South Florida and she is dedicated to the area of geriatric rehabilitation. She lectures exclusively for GREAT Seminars and Books in the area of geriatric function.