The Balance Outcome Measure for Elder Rehabilitation (BOOMER)

Original Editor - Ben Kasehagen

Top Contributors - Lauren Lopez, Ben Kasehagen, Evan Thomas, Scott Buxton and Claire Knott

Objective

The Balance Outcome Measure for Elder Rehabilitation (BOOMER) was developed to assist in clinical practice to quantify standing balance.[1] The combination of a variety of commonly used, single-item outcome measures makes the BOOMER a highly feasible and applicable tool that is both time and resource efficient[1].

Intended Population

Older adults with deficiencies in standing balance.[2]

Method of Use

Instructions

The BOOMER consists of the following four tests:

Test Description
Step Test One foot is repeatedly placed on top of a 7.5cm step and returned back down to the ground

as many times as able in 15 sec. The average between legs is then calculated for scoring.

Timed Up and Go From a seated position, individual stands, walks 3m, turns 180°, walks 3m back to chair and sits

down with back resting against backrest.

Functional Reach Individual reaches as far forward as possible in a standing position without losing balance.
Timed Static Stance Standing with feet together and eyes closed.

The four components of the BOOMER are performed in one session. Areas of interest are identified with treatment continued accordingly.

Scoring

An individual's performance on each measure will be converted to a 5-point ordinal scale. The scale ranges from 0 (unable to perform the test/0 on Functional Reach) to 4 (excellent) with a maximum score of 16.[2]

Table: BOOMER scoring[2]

Test Scoring
0 1 2 3 4
Step test (average number of steps) Unable 0 - 5 5 - 8 8 - 12 >12
TUG (seconds) Unable ≥ 30
29 - 20 19 - 10 <10
FR (centimetres) 0 1 - 15 16 - 20 21 - 30 > 30
Timed Static Stance (seconds) Unable 0 - 30 30 - 60 60 - <90 90

Evidence

Validity

Concurrent validity

The BOOMER correlates with Functional Independence Measure and Modified Elderly Mobility Scale[1]. It has shown high correlation with the Berg Balance Scale at both admission (ρ=.91; P<.01) and on discharge (ρ=.68; P<.01) from geriatric rehabilitation units (n=134)[2].

Construct validity

Another study[3] showed that BOOMER scores highly associated with BBS scores (r = .93, p < 0.001), as well as with raw scores on the de Morton Mobility Index (r = .89, p < 0.001). The same study showed only moderate associations with perceived confidence on the Activities-specific Balance Confidence scale (r > .52, p < 0.001).

Responsiveness

A minimum clinically significant change in the BOOMER is 3 points over its 17-point scale range[1]. Change scores between admission and discharge for the BOOMER and BBS displayed moderate correlation (ρ=.55; P<.01), while those between the BOOMER and gait speed displayed only fair correlation (ρ=.33 P<.01)[2].

References

  1. 1.0 1.1 1.2 1.3 Haines T, Kuys SS, Morrison G, Clarke J, Bew P, McPhail S. Development and validation of the balance outcome measure for elder rehabilitation. Arch Phys Med Rehabil. 2007; 88(12): 1614-1621.
  2. 2.0 2.1 2.2 2.3 2.4 Kuys SS, Morrison G, Bew, PG, Clarke J, Haines TP. Further validation of the balance outcome measure for elder rehabilitation. Arch Phys Med Rehabil. 2011; 92(1):101-105.
  3. Kuys SS, Crouch T, Dolecka UE, Steel M, Low Choy NL. Use and validation of the Balance Outcome Measure for Elder Rehabilitation in acute care. New Zealand Journal of Physiotherapy. 2014; 42(1): 16-21. Accessed 23 August 2018.