- Hi, I'm Bob Schrupp, physical therapist. - Brad Heineck, physical therapist. - And together, we are the most famous physical therapists
on the internet. - In our opinion, of course, Bob. - Brad, today we're going to talk about the Berg Balance Scale. I've also seen it called
the Berg Balance Test. - Sure. - We're gonna go through it,
developed by Katherine Berg. We think she's from Canada because the first time I saw it published, it was in a Canadian journal. So, eh? - I think she is a little
German though, but maybe not. - Oh, Berg, yeah. That Berg could be. All right, let's go ahead
and get started here. What do you need for
equipment first, Brad? Let's go over that. - Sure. - You're gonna need some
type of stepping stool, which you can't see right
now, but like usually with a six inch step. You'll see that a little later. You need a chair with
arms, chair without arms. You need a slipper. You need a stopwatch, and you need a ruler taped to the wall, which we're gonna reveal later. All right, let's go ahead
and get started, Brad- - Okay. - With this equipment,
and there's fourteen different steps we gotta take here, and we're gonna start off with number one. - And this is gonna reveal
your risk for falling? - Your risk for falling, yeah. Did I even say that? This
is a test, by the way, this is a test for measuring
your risk for falling. We use it a lot on the elderly, don't we? - You bet. Yep. - And it's very, very good at picking out details on someone who might fall. We'll show you that at the end. - Whether you need a cane,
a walker, a wheelchair, it can help that out. - Right. It can bring that down. All right, the first instruction is you're gonna start with
a chair with no arms. I want you to go ahead, please stand up, and try not to use your arms for support. - Okay? So my hands will be here. - Right. And the score is he gets a perfect score of four points if he's able to do that. Otherwise, there's different
variations of that. You can read those on the test. Now the next one is standing unsupported. So now Brad, you could have
stayed standing actually, and stand for two minutes
without holding onto something. That's where I'd use the stopwatch. And I would time him. Obviously. I'm not gonna
go for two minutes. And if he needs supervision, by the way, you don't have a belt on do you, Brad? Oh yes he does. - Oh yeah. - That's the one thing we wanna remember, is when you're a therapist
and if you're doing this, is safety comes first. And so I always have a belt on them. I'm always close. They
talked about being close to a wall, so they could hold onto that. But I don't really like that idea. They'll just fall against the wall then. So, I'd rather have
that I'm gonna be close and you can hang onto 'em. - Feet or shoulder width apart? - Shoulder width apart is fine. Yep. All right, if they're able
to stand for the two minutes you can actually skip the next one, which is measuring their
balance in a chair, but let's pretend that you
didn't pass this one, Brad. Yep. So we're gonna go
ahead and have you sit. Scoot forward a little bit on the chair, and please sit with your
arms folded for two minutes. - This is number three? - This is number three.
Again, variations on this. If you don't pass it, you
maybe can do it for 10 seconds. Okay. Now standing to sit, which is kind of a weird order, but go ahead and stand up again. And I want you to please sit down, and again, we're looking to see is he able to do so
without using his arms? Good. And that's a flop
actually, and that's gonna- he's gonna lose some points based on that. Let's go to number five. Now you're gonna have two chairs. You're gonna have a chair with arms and a chair without arms. And I want you to transfer- you can start with either one, actually, you can start. Why don't you start, you're gonna transfer to this one over here. And I noticed you used your arms there. And now you're gonna go back again. And again, in both cases he used his arms. You can try to use it, you know, try to do it without using your arms. All right, now you're gonna
go ahead and stand up, Brad. And we're gonna have you
stand with your feet, just normal width apart, and gonna see if you can
stand with your eyes closed for ten seconds. Yeah, you can face this way. Again, I'm close. You know, again, very- how
many points he's gonna get. "Needs help, keep from falling." I would say this, you're
able to stand ten seconds with supervision if you're swaying. So, alright. Now standing
unsupported with feet together. Now, Brad, on your feet right
now with a lot of people what we have found if
you're in the clinic a lot, there's a lot of people that can't keep- put their feet all the way together. Can they, because of their knees? - Right, if they've
got their knees valgus, or their knees are- - [Bob] Even varus, too. - Yep. - [Bob] So, that means if
they're bowed in or bowed out. - Their knees touched
before their feet here. - [Bob] Right. So if they can't touch, the first thing you try to do is maybe see if they can put their
heels together like that. 'Cause sometimes they can do that. Otherwise you just put 'em as
close together as possible. And you're gonna see if they
can do this for one minute. Okay. - [Brad] And on all of these, if you're not able to meet the requirement you can read through the
level of points they get. And it'll describe to you
where to check and get- - By the way, this is
obviously- this is a video not only for professionals, but it's also if you have a family member that's at a high risk for falling, or that's been falling, you might go to your
local therapist and say, "Hey, could you do the bird test on them?" - Exactly. - And that way you're gonna kind of know what they're all testing
when you do it, so. All right, reaching forward. Now we get to reveal the yard stick, Brad. - We have more than
just a 'famous PT' here. - Yeah. Famous PT. - We have- - All right. So what Brad's gonna do is he's gonna line up so that
his fingertip or knuckles, one of the two whichever
one you want, Brad. Okay, he's going knuckles. And that's right on the, you know, number one of the yard stick. And I want him to reach
forward as far as possible, without- you shouldn't rotate the trunk. - Right. - And your fingers should
not touch the ruler. And obviously you shouldn't
lose your balance either. - And feet squared off. - Yeah. Have we seen all this okay? Yeah, I think so. It looks good. All right, Brad, why don't you go ahead and reach forward as far as you can. - You're kind of wobbly here, Bob. - And if he goes past ten
inches, which he is doing, then he gets the full four points. Very good, Brad. - All right. - All right. Now you're gonna pick up an object from the floor,
from a standing position. And usually we like a slipper, 'cause that's obviously
something very practical. And then quite often you're
gonna see a person doing that. And you can see we have the shoe there. And again, I would want to be very close to the patient here when
you're doing this one. I might even have a hand on
the belt to be honest with you. - [Brad] Sure. You bet I would too. - [Bob] And go ahead and
have 'em bend forward. Pick it up. Good. You know, if he needs supervision, or if he's unable to pick it up, and you know, there's
different variations on how many points he's gonna get. Very nice, Mr. Heineck. - [Brad] Thank you, Mr. Schrupp. - [Bob] As you might have noticed we don't have our camera person today. But we're working on it. - Yeah, we can do this by ourself, Bob. We are good. - Alright, the next one,
Brad, go ahead and stand up. All right, now I'm gonna
show you what to do. You're gonna turn completely
around in a full circle. So I'm gonna have you stand, and this is one you should
demonstrate to the patient, I just think it's the best way to do it. Turn all the way around. Pause. And then turn all the
way around the other way. Okay? - Okay. So what direction do I go first? - Either way. - Okay. - And what we're looking for is can you do it in four seconds or less. Now, if he does one direction
in four seconds or less, he gets, you know, three points. If he does both, he gets four points. Then you pause and you
go the other direction. - And if they reach
out to touch something- - Yeah, obviously they're
gonna lose some points. - Yeah. - All right. The next one is, we're gonna now use the step stool. Now I'm gonna go ahead and
jump on the camera here. But I'm gonna also demonstrate
this one to the person first. And you want to just go
down real quick, Brad. - [Brad] Alright. - Now what they have to do is eight steps in twenty seconds, so. (counting) One, two, three,
four, five, six, seven, eight. And I would demonstrate it first and then have the person try. Which, I think we don't need
to have you try it, Brad, 'cause you just saw it, so- - [Brad] And that's a six inch step? - [Bob] A six inch step. Yep. - [Brad] Okay. - Okay. Looks good. All right, then we're gonna have you stand unsupported, Brad. Oh, this is one-two. Can I just describe it to you? - Sure. - [Bob] 'Cause I'll take
the camera again, Brad. You're gonna stand with one foot in tandem in front of the other. Why don't you face one direction, Brad. - [Brad] So it's gonna be- - [Bob] You wanna face that way? - [Brad] Yeah. I'm gonna do it both ways. - [Bob] Okay. - [Brad] This way. So you can see that and then from the side view. - [Bob] Right. - [Brad] Like you're walking the line. - [Bob] Yeah. And it's
right in front of the other. Now, if you can't do that,
the next thing would be is if he could put one
foot ahead of the other. Yeah. No, off to the
side even a little bit. Yeah. Just one foot ahead
or the other, that's it. - [Brad] Stay here? - [Bob] Yeah. Do you wanna do that to the side again, Brad? Or not? You wanna show that to the side? - [Brad] Oh, that's what
you're saying, yeah. - [Bob] Yeah. Like that, okay. And the next- and if
he's not able to do that, the next step would be
if he could just take a small step ahead. Like that, exactly. And if he's unable to do that then it would be that we
have to actually help him take the small step forward, but he still can hold
it for fifteen seconds. - [Brad] So you're saying actually, physically move that foot forward? - [Bob] I would would say maybe even- - [Brad] To balance, yeah. - [Bob] I balance you
to help you get there. - [Brad] And once I'm there- - [Bob] Once you're there, but you can hold it for fifteen seconds. All right. Then the last
one is standing on one leg. - [Brad] Oh! - [Bob] Either leg. And you wanna make sure with this, is when he stands on one leg that he's not holding the leg up against the other one for support. - [Brad] So we want it out
suspended, but not touching. - [Bob] Right. - [Brad] Yeah, that helps
when you get to touch. - [Bob] Now. I go back up here again, now
that is it. That's the test. All right, Brad, so that was the test. On the next video we're gonna interpret the results of the test, Brad, because it's kind of involved. I don't wanna add it to this video. - But you get a score
of zero to fifty-six. - Zero to fifty-six, yeah. - And those numbers we'll
tell you what those numbers- - Each one means something. So you wanna look at the next
video for the interpretation. - All righty then!
