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The Balance Outcome Measure for Elder Rehabilitation

Original Editor - Ben Kasehagen

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Objective

The Balance Outcome Measure for Elder Rehabilitation (BOOMER)

  • Assesses standing balance and functional mobility in the elderly population.
  • A global multi-system static, dynamic and functional balance measure throughout all settings of elder rehabilitation
  • 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.
  • Time to administer 5-10 minutes, basic equipment required

Intended Population

  • Older adults with deficiencies in standing balance.[1]
  • Clinicians considering using the BOOMER higher-functioning populations should be aware of the potential for ceiling effects. The static standing with eyes closed test demonstrated the greatest ceiling effects of the component tests, with 92% of participants achieving a maximal score.[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

  • Scores range from 0 to 16
  • Each item (4 items) can score between 0-4
  • Overall score is created by the summing the scores for each item.
  • The scale ranges from 0 (unable to perform the test) to 4 (excellent) with a maximum score of 16.[1]

Table: BOOMER scoring[1]

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[3]. It has shown high correlation with the Berg Balance Scale at both admission (ρ=.91; P<.01) and on discharge (ρ=.89; P<.01)[1] and with gait speed at admission and discharge (ρ=.67; P<.01) from geriatric rehabilitation units (n=134)[1].

Construct validity

Another study 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 16-point scale range[3].

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)[1].

Resources

BOOMER Test

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Kuys SS, Morrison G, Bew PG, Clarke J, Haines TP. Further Validation of the Balance Outcome Measure for Elder Rehabilitation. Archives of Physical Medicine and Rehabilitation. 2011 Jan;92(1):101–5.
  2. ↑ Brown ZM, Gibbs JC, Adachi JD, Ashe MC, Hill KD, Kendler DL, Khan A, Papaioannou A, Prasad S, Wark JD, Giangregorio LM. Score distributions of the Balance Outcome Measure for Elder Rehabilitation (BOOMER) in community-dwelling older adults with vertebral fracture. Journal of Geriatric Physical Therapy. 2019 Jul 1;42(3):E87-93.Available from:https://pubmed.ncbi.nlm.nih.gov/29210932/ Last accessed 13.10.2020
  3. ↑ 3.0 3.1 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.
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