Sitting Balance Scale

Use the Sitting Balance Scale to gauge the capability of mostly non-ambulatory patients to balance themselves while sitting, standing, and moving.

By Matt Olivares on Jul 15, 2024.


Fact Checked by Nate Lacson.

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What is the Sitting Balance Scale?

Assessing the balance abilities of patients, particularly those recovering from ambulatory-impacting injuries, neurological disorders, the frail, those who have fallen, and the elderly, is exceptionally vital in their care and treatment.

Balance serves as a critical determinant of independence and functional ability. A comprehensive balance assessment allows healthcare professionals to pinpoint potential problem areas, predict the risk of future falls, and develop individualized care plans.

These plans can enhance patients' mobility, confidence, and overall quality of life and prevent debilitating injuries caused by falls. It's, therefore, crucial to incorporate practical balance tests and self-reported measures into the patient assessment process to gain a holistic understanding of a patient's balance capabilities.

To achieve this, healthcare professionals must conduct thorough examinations of their patients. These examinations involve assessments, some requiring patients to perform specific actions to evaluate their fall risk. Other assessments consist of self-reports or interviews, allowing patients to discuss their confidence in performing certain activities without losing balance. These assessments are crucial as they assist professionals in identifying areas of concern and developing personalized treatment plans for their patients.

One such assessment is the Sitting Balance Scale. This valuable tool is primarily utilized with non-ambulatory, frail patients with chronic conditions. As the name suggests, it assesses sitting balance, specifically the patient's ability to maintain balance while seated and engaging in various activities.

How to use the Sitting Balance Scale

Before using the Sitting Balance Scale to assess your patients, it is essential to inform them about the purpose and instructions of this scale. You can proceed once the patient agrees to be evaluated using the scale.

If they agree to do the activities on the scale, you must prepare the following:

  • Stopwatch
  • 2 lb. cuff weight
  • Pen
  • 12-inch ruler
  • Slipper
  • Physician Desk Reference (PDR) or other stable object 3 to 3.5 inches in height
  • Clipboard
  • 15”x15”x15” foam

Once you have these materials ready, you can follow the procedure:

  • The patient will perform each activity while seated without support on a firm, sturdy surface while their feet are in a weight-beating position unless otherwise specified on the sheet.
  • Your patient only gets one attempt for each activity.
  • Make sure to instruct your patients for each activity.
  • Document each activity.
  • Score according to the prompts for each activity. If the patient fails to achieve a specific objective, score them accordingly. For example, to score a 3 or 4, the patient must sit with their eyes closed for 30 seconds. They get a 3 if supervised or required support (whether it's complete physical assistance or partial) or a 4 if they are unsupervised. If they fail and only get 27 seconds, score them a 2. Prompts vary per item, so follow their respective prompts.
  • You need to remind the patient to maintain their balance for each activity.

Here is a list of the activities they need to do in order:

  1. Sitting unsupported with eyes open
  2. Sitting unsupported with eyes closed
  3. Sitting unsupported with arms as levers
  4. Reaching forward with the outstretched arm while sitting
  5. Picking up an object from the floor while sitting unsupported
  6. Placing an alternate foot on a book or object 3-3.5' in height
  7. Reaching laterally with an outstretched arm while sitting unsupported
  8. Turning to look behind over left and right shoulder while sitting
  9. Lateral bend to elbow in sitting
  10. Sit-to-stand transfers
  11. Picking up an object from the floor while sitting unsupported on foam

Each item can score anything from 0 to 4 according to each prompt, which you will see in our template.

The maximum score of this sitting test is 44. Higher scores indicate a higher level of functionality. There are no score ranges for this, but it's best to note the scores for each item to determine areas of concern.

When is the best time to use the Sitting Balance Scale?

The Sitting Balance Scale is primarily used for patients who are mostly non-ambulatory or have difficulty with movement. It is recommended to use this scale when treating such patients. Before using it, it is essential to inform the patient about the scale, as it requires them to perform activities that involve their balance. If the patient is uncomfortable with the demands of the scale, they have the right to refuse. In such cases, using less strenuous assessments to evaluate their balance is advisable. 

It is important to note that the Sitting Balance Scale should not be the sole assessment used to evaluate patients. To gain a comprehensive understanding, it is recommended to incorporate the Sitting Balance Scale as part of a broader examination. Relying solely on one assessment may not provide a partial picture of the patient's condition. By utilizing additional assessments that involve standing and walking, we can better assess the risk of falling and identify specific areas of concern. Moreover, evaluating the patient's confidence in performing activities without losing balance is crucial. 

What are the benefits of using the Sitting Balance Scale?

It's a great way to gauge if patients can balance themselves while seated.

The Sitting Balance Scale is a nifty assessment that can help professionals examine if a patient can maintain their balance while seated and performing basic movements. Using this scale, professionals can rate patients based on their current capabilities and even jot down their observations as they watch them perform the eleven activities comprising the Sitting Balance Scale. The scale provides standardized ratings for each item, and they all have observable criteria to determine what scores to give.

It can help identify critical areas of concern.

The maximum score for this scale is 44, though there are no score ranges and designations. As a rule of thumb, the higher the score, the higher the functionality/capability the patient has to balance themselves while sitting down and performing specific movements or activities. Despite having no designations, it's good practice to look at the scores for each item. It's the best way to identify critical areas of concern that a patient must know (if they're unfamiliar) and what you need to address.

It can help create treatment plans.

The Sitting Balance Scale can help professionals create personalized patient treatment plans. By identifying key areas of concern, professionals can determine what their treatment plan should focus on and then add what needs to be added to help address those areas of concern.

It can be used to monitor patients down the line.

Let's say you have created a treatment plan for your patient, and they've been following it for a while now. You can schedule a routine checkup with them and inform them about your intent to conduct the Sitting Balance Scale again. If they agree to do it, then rerun the tests. If they score higher than before, they are slowly regaining their functional independence and becoming more capable of balancing themselves independently. If not, you might want to give it time or adjust your plan.

Electronic heath records software benefit
How long does it take to accomplish the scale?
How long does it take to accomplish the scale?

Commonly asked questions

How long does it take to accomplish the scale?

Since the Sitting Balance Scale has eleven activities, it can be accomplished within thirty minutes, but it’s possible to take longer. It depends on your patient.

Are the activities of the Sitting Balance Scale difficult to do?

Given the target population of the Sitting Balance Scale, it is likely to take a lot of work for a good number of patients. It’s best to make sure that the patients are comfortable and to provide support when needed, even if the goal is to have them do the tasks without support. Luckily, the scale has a standardized scoring system and prompts to account for that.

What if I’m not a healthcare professional? Can I use this to gauge a relative that fits the target population for this scale?

No. It’s best to see a professional and have them conduct the activities on the scale. Under no circumstance should you conduct these activities and determine what’s best for your relative.

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