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Run: Berg Balance Scale Fall Risk Assessment

Use this Berg Balance Scale Fall Risk Assessment template to document the 14-item BBS, total the score, and record a clear fall-risk interpretation. It helps...

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Assessment Setup and Safety

Patient identity and assessment date/time confirmed

Document the patient identifier and when the assessment was performed.

Assistive device use documented

Record whether the patient used an assistive device during the assessment.

Note (optional)

Environment clear and safe for balance testing critical (required)

Ensure floor space is unobstructed, chair is stable, and testing area is appropriate for standing and reaching tasks.

Yes No N/A

Patient able to follow simple commands critical (required)

Confirm the patient can understand and respond to standardized instructions for the assessment.

Yes No N/A

Berg Balance Scale Item Scores

Sitting to standing critical (required)

Observe the patient rising from sitting to standing without using hands if possible.

Standing unsupported critical (required)

Assess ability to stand without support for the required duration.

Sitting unsupported critical (required)

Assess ability to sit without back or arm support.

Standing to sitting critical (required)

Observe control and safety when lowering from standing to sitting.

Transfers critical (required)

Assess ability to transfer between chairs or surfaces safely.

Standing with eyes closed critical (required)

Assess postural stability while standing with eyes closed.

Standing with feet together critical (required)

Assess ability to stand with feet together without losing balance.

Reaching forward with outstretched arm critical (required)

Assess how far the patient can reach forward while maintaining balance.

Retrieving object from floor critical (required)

Assess ability to bend and retrieve an object from the floor safely.

Turning to look behind critical (required)

Assess trunk rotation and balance while looking over the shoulder.

Turning 360 degrees critical (required)

Assess ability to turn completely in both directions without loss of balance.

Placing alternate foot on stool critical (required)

Assess ability to alternately place each foot on a stool or step.

Standing with one foot in front critical (required)

Assess tandem stance stability with one foot directly in front of the other.

Standing on one foot critical (required)

Assess single-leg stance balance and control.

Total Score and Fall Risk Interpretation

Total Berg Balance Scale score critical (required)

Enter the total score from 0 to 56 based on the 14 item scores.

Note (optional)

Fall risk interpretation critical (required)

Select the overall fall-risk category based on the total score and clinical judgment.

Note (optional)

Recommended follow-up or intervention

Document any recommended therapy, mobility support, reassessment interval, or referral.

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