Skip to main content
  

Rehab Measures: Brunel Balance Assessment

Link to instrument

http://usir.salford.ac.uk/4886/1/new_BBA_manual.pdf 

Title of Assessment

Brunel Balance Assessment 

Acronym

BBA

Instrument Reviewer(s)

Initially reviewed by Katie Hays, PT, DPT and the TBI EDGE taskforce of the Neurology Section of the APTA in 5/2012

Summary Date

11/27/2012 

Purpose

Designed to assess functional balance for people with a wide range of abilities, specifically for use post-stroke. It is suitable for use in the clinical setting. Can be used hospital bedside, treatment area, or client’s home.

Description

  • 12 point hierarchical ordinal scale (pass/fail)
  • Score ranges from 0/12 (lowest) to 12/12 (highest)
  • Hierarchical test, individual can pass or fail each item.
  • 3 chances to pass each item. When pt is unable to pass after 3 tries, the test is completed
  • Test administration instructions found in BBA manual (see link above)

Area of Assessment

Balance Non-Vestibular 

Body Part

 

ICF Domain

Activity 

Domain

 

Assessment Type

 

Length of Test

06 to 30 Minutes 

Time to Administer

Approximately 10 minutes

Number of Items

12 items, 3 subscales (sitting, standing, stepping) 

Equipment Required

  • Plinth or suitable seating
  • Ruler
  • Step up block 7.5-10 cm high
  • Stopwatch
  • Tape to mark 5m walkway
  • 2 stools/chairs

Training Required

None (manual available with in depth scoring instructions)

Type of training required

Reading an Article/Manual 

Cost

Free 

Actual Cost

Free

Age Range

 

Administration Mode

 

Diagnosis

Stroke; Traumatic Brain Injury 

Populations Tested

  • Acute Stroke
  • Chronic Stroke

Standard Error of Measurement (SEM)

Not Established

Minimal Detectable Change (MDC)

Stroke: (Tyson and DeSouza, 2004; n=92, broken down into 3 groups for reliability (n=37), scalability (n=80), and validity testing (n=55; mean age=67.4(12.84) years; median time since stroke=9 weeks)

  • MDC= 1 point (out of 12), due to hierarchical scale

Minimally Clinically Important Difference (MCID)

Chronic Stroke: (Tyson and DeSouza, 2004)

  • MCID=1 level (1/12) due to hierarchical scale

Cut-Off Scores

Not Established

Normative Data

Not Established

Test-retest Reliability

Chronic Stroke: (Tyson and DeSouza, 2004)

  •  Excellent test-retest reliability (K=1) 100% agreement

Interrater/Intrarater Reliability

Chronic Stroke: (Tyson and DeSouza, 2004)

  • Excellent inter-rater reliability (K=1) 100% agreement
  • Testing performed by 2 testers. One person administered the test instructions while the second rater observed and rated.

Internal Consistency

Chronic Stroke: (Tyson and DeSouza, 2004)

  • Excellent internal consistency (Cronbach’s alpha=0.93)

Criterion Validity (Predictive/Concurrent)

Acute Stroke: (Tyson et al, 2007; n=102 participants, mean age 70.7(12.6) years; mean time since stroke 21 (5) days; 75 participants completed 3 month follow-up)

  • Balance disability was strongest predictor of function in acute stages (r2= 30-85%)

Chronic Stroke: (Tyson and DeSouza, 2004)

  • Excellent correlation with Motor Assessment Scale (sitting section) (rs =0.83)
  • Excellent correlation with Berg Balance Test (rs =0.97)
  • Excellent correlation with Rivermead Mobility Index (rs= 0.95).

Construct Validity (Convergent/Discriminant)

Not Established

Content Validity

Not Established

Face Validity

Not Established

Floor/Ceiling Effects

Not Established

Responsiveness

Not Established

Professional Association Recommendations

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (VEDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

 

For detailed information about how recommendations were made, please visit:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

 

Abbreviations:

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

 

Recommendations for use based on acuity level of the patient:

 

Acute

(CVA < 2 months post)

(SCI < 1 month post)

(Vestibular < 6 months post)

Subacute

(CVA 2 to 6 months)

(SCI 3 to 6 months)

Chronic

(> 6 months)

StrokEDGE

UR

UR

UR

 

Recommendations based on level of care in which the assessment is taken:

 

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

StrokEDGE

UR

UR

UR

UR

UR

TBI EDGE

LS

LS

LS

LS

LS

 

Recommendations for use based on ambulatory status after brain injury:

 

Completely Independent

Mildly dependant

Moderately Dependant

Severely Dependant

TBI EDGE

NR

LS

LS

LS

 

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

StrokEDGE

No

No

No

Not reported

TBI EDGE

No

No

No

Not reported

Considerations

New tool, all psychometric testing performed by same group, so it is unknown how reproducible the results are.
Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Bibliography

Pollock, C., Eng, J., et al. (2011). "Clinical measurement of walking balance in people post stroke: a systematic review." Clinical Rehabilitation 25(8): 693-708. Find it on PubMed

Tyson, S. F. and Connell, L. A. (2009). "How to measure balance in clinical practice. A systematic review of the psychometrics and clinical utility of measures of balance activity for neurological conditions." Clinical Rehabilitation 23(9): 824-840. Find it on PubMed

Tyson, S. F. and DeSouza, L. H. (2004). "Development of the Brunel Balance Assessment: a new measure of balance disability post stroke." Clinical Rehabilitation 18(7): 801-810. Find it on PubMed

Tyson, S. F., Hanley, M., et al. (2007). "The relationship between balance, disability, and recovery after stroke: predictive validity of the brunel balance assessment." Neurorehabilitation & Neural Repair 21(4): 341-346. Find it on PubMed

Year published

 

Instrument in PDF Format

Yes 
Approval Status Approved 
 
Attachments
Created at 11/28/2012 8:38 PM  by Jason Raad 
Last modified at 8/29/2014 1:52 PM  by Jason Raad