The BOOMER assesses standing balance and functional mobility in the elderly population. A global multi-item static, dynamic, and functional balance measure throughout all settings of elder rehabilitation. Collaboration of 4 test scores used to measure balance, mobility and perceived confidence in the geriatric population.
4
5-10 minutes
May vary with patient's abilities
Initially reviewed by Kartik Srinivasan, PT, MHS; Evan Papa, DPT, PhD for The University of North Texas Health Science Center, DPT Class of 2015 in June 2014.
Quick and easy to administer, is able to be used at bedside, and appears to be able to differentiate between patients requiring inpatient rehabilitation as well as those hospitalized following a fall. (Kuys et al, 2014) Recommended as a tool to guide referral for rehabilitation or determine patients who could be safely discharged from an acute care setting to their usual residence. (Kuys et al, 2014)The study only considered existing standing balance measures. (Haines et al, 2007)The Boomer has not been investigated for its use as a falls prediction tool. The BOOMER utilizes a composite of several clinical balance measures. Links to the instructions for using these instruments can be found as follows:
Step Test: http://www.rehabmeasures.org/Lists/RehabMeasures/DispForm.aspx?ID=1107
Functional Reach Test: http://www.rehabmeasures.org/PDF%20Library/Functional%20Reach%20Test.pdf
Static stance feet together eyes closed: http://www.rehabmeasures.org/Lists/RehabMeasures/PrintView.aspx?ID=1173
TUG: http://www.cdc.gov/homeandrecreationalsafety/pdf/steadi/timed_up_and_go_test.pdf
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Older adults with dementia: (Fox et al. 2014; n=12; male: 1; female: 11; mean age = 83.25 + 9.94 years)
The SEM for the components of BOOMER are as follows:
Elderly: (Haines et al., 2007; n =1769; mean age=74 (13.5) years; data from several rehabilitation units including various diagnoses: stroke, neurologic, orthopedic etc.)
Elderly: (Haines et al., 2007)
4 cut off points were selected allowing for 5 categories
|
Test |
0 |
1 |
2 |
3 |
4 |
|
Step Test (average number of steps) |
Unable |
>0-5 |
>5-8 |
>8-12 |
>12 |
|
TUG test (s) |
Unable |
>/= 30 |
<30-20 |
<20-10 |
<10 |
|
FRT (cm) |
0 |
>0-15 |
>15-20 |
>20-30 |
>30 |
|
Static Standing eyes closed (s) |
Unable |
>0-30 |
>30-60 |
>60-<90 |
90 |
An overall score is created by summing the scores for each item (ranging from 0-16)
Older adults with dementia (Fox et al. 2014; n =12; female = 11, male = 1; mean age: 83.25 + 9.94 years)
|
Component |
ICC |
|
ST R foot |
0.696 (Adequate) |
|
ST L foot |
0.790 (Excellent) |
|
TUG |
0.857 (Excellent) |
|
FR |
0.384 (Poor) |
|
Static Timed Standing |
0.469 (Adequate) |
Excellent test-retest reliability - TUG and ST L foot
Adequate test-retest reliability – ST R foot and Static Timed Standing
Poor test-retest reliability - FR
Elderly:
Concurrent Validity:
Geriatric rehab setting: (Kuys et al, 2011; n = 134, mean age = 78 (11) years)
Excellent correlation between BOOMER and BBS (ρ = .91, P < .01 at admission; ρ = .89 P < .01 at discharge)
Excellent correlation between BOOMER and gait speed (ρ = .67, P < .01 at admission; ρ = .68, P < .01 at discharge)
Geriatric rehab setting: (Haines et al., 2007)
Excellent concurrent validity of the BOOMER with the motor FIM (admission data, ρ = .73; discharge data, ρ =.72) and the Modified Elderly Mobility Scale (MEMS) (admission data, ρ =.88; discharge data, ρ =.83). Each of these associations was statistically signi?cant (P<.001).
Acute Inpatient setting: (Kuys et al 2014, n = 44; mean age= 77 (7) years)
Excellent correlation with BBS (ρ =.93, p<0.001)
Excellent correlation with de Morton Mobility Index (ρ =.89, p<0.001)
Adequate correlation with Activities-Specific Balance Confidence scale (ρ =.52, p<0.001)
Elderly: (Lindenberg et al. 2014; n=227; age > 60 years; mean age = 79(9) years)
|
Outcome Measure |
Correlation with discharge to RACFa |
|
BOOMER total score |
-0.33b |
|
Boomer Total score < 4 |
-0.47 |
|
10MWT |
0.07 |
|
10MWT (unable to perform) |
0.34b |
|
Age |
0.15b |
|
Rehabilitation LOS |
0.37b |
a Spearman rank correlation
b Significant when P < 0.05
Elderly population: (Haines et al. 2007; Phase 3; n=272; mean age = 75 (14) years)
Floor/Ceiling Effects Elderly: (Haines et al., 2007)
Fox B., Henwood T., et al. (2014). “Relative and absolute reliability of functional performance measures for older adults with dementia living in residential aged care.” Int Psychogeriatr 26(10): 1659-1667.
Haines, T., Kuys, S., et al. (2007). “Development and validation of the Balance Outcome Measure for Elder Rehabilitation.” Arch Phys Med Rehabil 88: 1614-21.
Kuys S.S., Morrison G., et al. (2011). “Further validation of the Balance Outcome Measure for Elder Rehabilitation.” Arch Phys Med Rehabil. 92(1):101-105.
Kuys S.S., Crouch T., et al. (2014). “Use and validation of the Balance Outcome Measure for Elder Rehabilitation in acute care.” New Zealand Journal of Physiotherapy 42(1): 16-21.
Lindenberg K., Nitz J.C., et al. (2014). “Predictors of discharge destination in a geriatric population after undergoing rehabilitation.” J Geriatr Phys Ther 37(2): 92-98.
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.