[Comparison of the performance-oriented mobility assessment and the Berg balance scale. Assessment tools in geriatrics and geriatric rehabilitation]

Abstract

Background: In order to develop and coordinate an integrated plan for treatment of hospitalized elderly patients in danger of future falls it is of utmost importance to ensure using the assessment that best targets people who are at risk for falling. For this purpose the performance-oriented mobility assessment (POMA) and the Berg balance scale (BBS) can be used. The purpose of this study was to collate the results of articles published on these assessment tools in order to appraise whether one of them could be favored under the viewpoint of practicability and expressiveness.

Method: A literature search was conducted for studies examining the two assessment tools published since 1986 through December 2011 in English and German language. Reference sections were also inspected for additional citations.

Result: Overall 19 studies were retrieved in order to answer the posed question. Of the total number of 1,455 patients in the identified articles, 712 with an average age of 74.1 years were included in the BBS trials and the POMA was assessed using 743 patients with an average age of 75.7 years. The BBS was good at identifying elderly people who are at risk for falling (sensitivity 84-95.5 %) and those who are not at-risk for falling (specificity 76.5-95.5 %. The demonstrated results for the POMA ranged from relatively poor to good (sensitivity 64-95.5 %) and from poor to very high (specificity 60-100 %). The BBS demonstrated its strengths in the more precise survey for monitoring balance and predicting risk for falling. Weaknesses of the BBS were the higher average time of processing and the inability to detect changes in gait. The advantages of the POMA was the short processing time, the possibility for separate identification of balance and gait and the high accuracy in recognition of gait changes.

Conclusion: The results suggest that the POMA can be used as a fast screening tool to evaluate risk for falling or changes in gait ability. Geriatric patients who screen positive for risks of falls using the POMA should be selected for further assessment using the BBS. The BBS is a concise assessment tool for monitoring balance and to predict a person's current risk for falling.