CDE Detailed Report

Disease: Multiple Sclerosis
Sub-Domain: Activities of Daily Living/Performance
CRF: Berg Balance Scale (BBS)

Displaying 1 - 15 of 15
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (Question Text) Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C14699 Berg Balance Scale (BBS) - unsupport feet together scale BBSUnsprtFtTogthrScale The scale for assessment of standing unsupported with feet together based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. The scale for assessment of standing unsupported with feet together based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. Standing unsupported with feet together 4;3;2;1;0 able to place feet together independently and stand 1 minute safely;able to place feet together independently and stand 1 minute with supervision;able to place feet together independently but unable to hold for 30 seconds;needs help to attain position but able to stand 15 seconds feet together;needs help to attain position and unable to hold for 15 seconds Numeric values

Place your feet together and stand without holding on

Berg K, Wood-Dauphinee S, Williams JI and Gayton D. (1989): Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 41: 304-311. Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Berg Balance Scale (BBS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C14700 Berg Balance Scale (BBS) - reach forward scale BBSReachFrwdScale The scale for assessment of reaching forward with outstretched arm while standing based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. The scale for assessment of reaching forward with outstretched arm while standing based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. Reaching forward with outstretched arm while standing 4;3;2;1;0 can reach forward confidently 25 cm (10 inches);can reach forward 12 cm (5 inches);can reach forward 5 cm (2 inches);reaches forward but needs supervision;loses balance while trying/requires external support Numeric values

Lift arm to 90 degrees. Stretch out your fingers and reach forward as far as you can. (Examiner places a ruler at the end of fingertips when arm is at 90 degrees. Fingers should not touch the ruler while reaching forward. The recorded measure is the distance forward that the fingers reach while the subject is in the most forward lean position. When possible, ask subject to use both arms when reaching to avoid rotation of the trunk.)

Berg K, Wood-Dauphinee S, Williams JI and Gayton D. (1989): Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 41: 304-311. Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Berg Balance Scale (BBS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C14701 Berg Balance Scale (BBS) - retrieve floor object scale BBSRetrieveFlrObjScale The scale for assessment of picking up object from the floor from a standing position based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. The scale for assessment of picking up object from the floor from a standing position based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. Pick up object from the floor from a standing position 4;3;2;1;0 able to pick up slipper safely and easily;able to pick up slipper but needs supervision;unable to pick up but reaches 2=5 cm(1=2 inches) from slipper and keeps balance independently;unable to pick up and needs supervision while trying;unable to try/needs assist to keep from losing balance or falling Numeric values

Pick up the shoe/slipper, which is in front of your feet.

Berg K, Wood-Dauphinee S, Williams JI and Gayton D. (1989): Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 41: 304-311. Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Berg Balance Scale (BBS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C14702 Berg Balance Scale (BBS) - turn head scale BBSTrnHeadScale The scale for assessment of turning to look behind over left and right shoulders while standing based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. The scale for assessment of turning to look behind over left and right shoulders while standing based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. Turning to look behind over left and right shoulders while standing 4;3;2;1;0 looks behind from both sides and weight shifts well;looks behind one side only other side shows less weight shift;turns sideways only but maintains balance;needs supervision when turning;needs assist to keep from losing balance or falling Numeric values

Turn to look directly behind you over toward the left shoulder. Repeat to the right. (Examiner may pick an object to look at directly behind the subject to encourage a better twist turn.)

Berg K, Wood-Dauphinee S, Williams JI and Gayton D. (1989): Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 41: 304-311. Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Berg Balance Scale (BBS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C14703 Berg Balance Scale (BBS) - turn around scale BBSTrnArndScale The scale for assessment of turning 360 degrees based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. The scale for assessment of turning 360 degrees based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. Turn 360 degrees 4;3;2;1;0 able to turn 360 degrees safely in 4 seconds or less;able to turn 360 degrees safely one side only 4 seconds or less;able to turn 360 degrees safely but slowly;needs close supervision or verbal cuing;needs assistance while turning Numeric values

Turn completely around in a full circle. Pause. Then turn a full circle in the other direction

Berg K, Wood-Dauphinee S, Williams JI and Gayton D. (1989): Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 41: 304-311. Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Berg Balance Scale (BBS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C14693 Berg Balance Scale (BBS) - sit stand scale BBSSitStndScale The scale for assessment of sitting to standing based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. The scale for assessment of sitting to standing based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. Sitting to standing 4;3;2;1;0 able to stand without using hands and stabilize independently;able to stand independently using hands;able to stand using hands after several tries;needs minimal aid to stand or stabilize;needs moderate or maximal assist to stand Numeric values

Please stand up. Try not to use your hand for support

Berg K, Wood-Dauphinee S, Williams JI and Gayton D. (1989): Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 41: 304-311. Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Berg Balance Scale (BBS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C14704 Berg Balance Scale (BBS) - alternate foot step up scale BBSAltFtStepUpScale The scale for assessment of placing alternate foot on step or stool while standing unsupported based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. The scale for assessment of placing alternate foot on step or stool while standing unsupported based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. Place alternate foot on step or stool while standing unsupported 4;3;2;1;0 able to stand independently and safely and complete 8 steps in 20 seconds;able to stand independently and complete 8 steps in > 20 seconds;able to complete 4 steps without aid with supervision;able to complete > 2 steps needs minimal assist;needs assistance to keep from falling/unable to try Numeric values

Place each foot alternately on the step/stool. Continue until each foot has touched the step/stool four times.

Berg K, Wood-Dauphinee S, Williams JI and Gayton D. (1989): Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 41: 304-311. Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Berg Balance Scale (BBS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C14694 Berg Balance Scale (BBS) - unsupport stand scale BBSUnSprtStndScale The scale for assessment of standing unsupported based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. The scale for assessment of standing unsupported based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. Standing unsupported 4;3;2;1;0 able to stand safely for 2 minutes;able to stand 2 minutes with supervision;able to stand 30 seconds unsupported;needs several tries to stand 30 seconds unsupported;unable to stand 30 seconds unsupported Numeric values

Please stand for two minutes without holding on.

Berg K, Wood-Dauphinee S, Williams JI and Gayton D. (1989): Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 41: 304-311. Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Berg Balance Scale (BBS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C14705 Berg Balance Scale (BBS) - unsupport stand front foot scale BBSUnsprtStndFrntFtScale The scale for assessment of standing unsupported one foot in front based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. The scale for assessment of standing unsupported one foot in front based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. Standing unsupported one foot in front 4;3;2;1;0 able to place foot tandem independently and hold 30 seconds;able to place foot ahead independently and hold 30 seconds;able to take small step independently and hold 30 seconds;needs help to step but can hold 15 seconds;loses balance while stepping or standing Numeric values

(DEMONSTRATE TO SUBJECT) Place one foot directly in front of the other. If you feel that you cannot place your foot directly in front, try to step far enough ahead that the heel of your forward foot is ahead of the toes of the other foot. (To score 3 points, the length of the

Berg K, Wood-Dauphinee S, Williams JI and Gayton D. (1989): Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 41: 304-311. Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Berg Balance Scale (BBS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C14695 Berg Balance Scale (BBS) - unsupport sit scale BBSUnsprtSitScale The scale for assessment of sitting with back unsupported but feet supported on floor or on a stool based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. The scale for assessment of sitting with back unsupported but feet supported on floor or on a stool based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. Sitting with back unsupported but feet supported on floor or on a stool 4;3;2;1;0 able to sit safely and securely for 2 minutes;able to sit 2 minutes under supervision;able to able to sit 30 seconds;able to sit 10 seconds;unable to sit without support 10 seconds Numeric values

Please sit with arms folded for 2 minutes

Berg K, Wood-Dauphinee S, Williams JI and Gayton D. (1989): Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 41: 304-311. Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Berg Balance Scale (BBS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C14706 Berg Balance Scale (BBS) - scale total score BBSTotScore The total score on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. The total score on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. Total score Numeric Values

The maximum score is 56.

Berg K, Wood-Dauphinee S, Williams JI and Gayton D. (1989): Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 41: 304-311. Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Berg Balance Scale (BBS) Activities of Daily Living/Performance Outcomes and End Points

Free-Form Entry

0 56
C14696 Berg Balance Scale (BBS) - stand sit scale BBSStndSitScale The scale for assessment of standing to sitting based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. The scale for assessment of standing to sitting based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. Standing to sitting 4;3;2;1;0 sits safely with minimal use of hands;controls descent by using hands;uses back of legs against chair to control descent;sits independently but has uncontrolled descent;needs assist to sit Numeric values

Please sit down

Berg K, Wood-Dauphinee S, Williams JI and Gayton D. (1989): Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 41: 304-311. Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Berg Balance Scale (BBS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C17394 Berg Balance Scale (BBS) - stand one leg scale BBSStndOneLegScale The scale for assessment of standing on one leg based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. The scale for assessment of standing on one leg based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. Standing on one leg 4;3;2;1;0 able to lift leg independently and hold > 10 seconds;able to lift leg independently and hold 5-10 seconds;able to lift leg independently and hold L 3 seconds;tries to lift leg unable to hold 3 seconds but remains standing independently.;unable to try of needs assist to prevent fall Numeric values

Stand on one leg as long as you can without holding on.

Berg K, Wood-Dauphinee S, Williams JI and Gayton D. (1989): Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 41: 304-311. Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Berg Balance Scale (BBS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C14697 Berg Balance Scale (BBS) - transfer scale BBSTransfScale The scale for assessment of transfers based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. The scale for assessment of transfers based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. Transfers 4;3;2;1;0 able to transfer safely with minor use of hands;able to transfer safely definite need of hands;able to transfer with verbal cuing and/or supervision;needs one person to assist;needs two people to assist or supervise to be safe Numeric values

Arrange chair(s) for pivot transfer. Ask subject to transfer one way toward a seat with armrests and one way toward a seat without armrests. You may use two chairs (one with and one without armrests) or a bed and a chair.

Berg K, Wood-Dauphinee S, Williams JI and Gayton D. (1989): Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 41: 304-311. Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Berg Balance Scale (BBS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

C14698 Berg Balance Scale (BBS) - unsupport stand closed eyes scale BBSUnSprtStndScaleClsdEyesScl The scale for assessment of standing unsupported with eyes closed based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. The scale for assessment of standing unsupported with eyes closed based on the Berg Balance Scale (or BBS), a clinical test of a person's static and dynamic balance abilities. Standing unsupported with eyes closed 4;3;2;1;0 able to stand 10 seconds safely;able to stand 10 seconds with supervision;able to stand 3 seconds;unable to keep eyes closed 3 seconds but stays safely;needs help to keep from falling Numeric values

Please close your eyes and stand still for 10 seconds

Berg K, Wood-Dauphinee S, Williams JI and Gayton D. (1989): Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada 41: 304-311. Adult;Pediatric Supplemental 3.00 2013-06-11 00:00:00.0 Berg Balance Scale (BBS) Activities of Daily Living/Performance Outcomes and End Points

Single Pre-Defined Value Selected

CSV