Evaluation and treatment of balance in the elderly: A review of the efficacy of the Berg Balance Test and Tai Chi Quan

The purpose of this review of outcome studies was to determine whether the Berg Balance Test (BBT) can be considered a reliable predictor of a risk for falls in the elderly, and to review the efficacy of Tai Chi Quan in the physical therapy intervention of balance disorders in older adults as reported in the literature. The authors examined studies of the BBT, which showed that the two groups of people, fallers and non-fallers, have considerable differences among them. Fallers tended to be more variable in their characteristics as indicated by larger standard deviations. Based on these results, the authors suggest that patients who score high on the BBT should not be referred for further intervention, whereas patients who score 40 or less have a high probability of falls and require appropriate referrals. The BBT, which is relatively safe and simple, uses a quantitative scale, scoring is reproducible, and the strong internal consistency allows for easy interpretation of scores. The BBT has been shown to have moderately good sensitivity, and high specificity, and therefore is a good predictor of older adults who may have fall risks and may need assistive devices. A big challenge, then, is to plan and implement an effective treatment technique to improve balance control. One recently identified intervention is Tai Chi Quan. Tai Chi is an ancient form of exercise for fitness and the martial arts which has been practiced in China for centuries. The second part of this report examines the efficacy of Tai Chi Quan as a treatment modality. A review of studies on Tai Chi Quan indicates that it has a positive effect on improving balance in the elderly, although it has no effect on improving postural stability. The effects of Tai Chi on the treatment of balance still require extensive research. Although the articles reviewed indicate that Tai Chi does have a positive effect on balance, the methodology used in these studies needs to be improved.