Psychometric properties of Brief-Balance Evaluation Systems Test (Brief-BESTest) in evaluating balance performance in individuals with chronic stroke

BackgroundThe Mini-Balance Evaluation Systems Test (Mini-BESTest) is a new balance assessment, but its psychometric properties have not been specifically tested in individuals with stroke.ObjectivesThe purpose of this study was to examine the reliability and validity of the Mini-BESTest and its accuracy in categorizing people with stroke based on fall history.DesignAn observational measurement study with a test-retest design was conducted.MethodsOne hundred six people with chronic stroke were recruited. Intrarater reliability was evaluated by repeating the Mini-BESTest within 10 days by the same rater. The Mini-BESTest was administered by 2 independent raters to establish interrater reliability. Validity was assessed by correlating Mini-BESTest scores with scores of other balance measures (Berg Balance Scale, one-leg-standing, Functional Reach Test, and Timed “Up & Go” Test) in the stroke group and by comparing Mini-BESTest scores between the stroke group and 48 control participants, and between fallers (≥1 falls in the previous 12 months, n=25) and nonfallers (n=81) in the stroke group.ResultsThe Mini-BESTest had excellent internal consistency (Cronbach alpha=.89–.94), intrarater reliability (intraclass correlation coefficient [3,1]=.97), and interrater reliability (intraclass correlation coefficient [2,1]=.96). The minimal detectable change at 95% confidence interval was 3.0 points. The Mini-BESTest was strongly correlated with other balance measures. Significant differences in Mini-BESTest total scores were found between the stroke and control groups and between fallers and nonfallers in the stroke group. In terms of floor and ceiling effects, the Mini-BESTest was significantly less skewed than other balance measures, except for one-leg-standing on the nonparetic side. The Berg Balance Scale showed significantly better ability to identify fallers (positive likelihood ratio=2.6) than the Mini-BESTest (positive likelihood ratio=1.8).LimitationsThe results are generalizable only to people with mild to moderate chronic stroke.ConclusionsThe Mini-BESTest is a reliable and valid tool for evaluating balance in people with chronic stroke.

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Development of a Smartphone-Based Balance Assessment System for Subjects with Stroke

Sensors ◽

10.3390/s20010088 ◽

2019 ◽

Vol 20 (1) ◽

pp. 88 ◽

Cited By ~ 6

Author(s):

You-Ruei Hou ◽

Ya-Lan Chiu ◽

Shang-Lin Chiang ◽

Hui-Ya Chen ◽

Wen-Hsu Sung

Keyword(s):

Intraclass Correlation ◽

Reliability And Validity ◽

Smartphone Application ◽

Chronic Stroke ◽

Healthy Adults ◽

Assessment System ◽

Balance Performance ◽

Balance Assessment ◽

Artery Disease ◽

Validity Tests

Stroke is a cerebral artery disease that negatively affects activities of daily living (ADLs) and quality of life (QoL). Smartphones have demonstrated strong potential in assessing balance performance. However, such smartphone-based tools have thus far not been applied to stroke survivors. The purpose of this study was to develop a smartphone-based balance assessment system for subjects who have experienced strokes and evaluate the system feasibility. The smartphone-based balance assessment application was developed with Android Studio, and reliability and validity tests were conducted. The smartphone was used to record data using a built-in accelerometer and gyroscope, and increased changes represented greater instability. Six postures were tested for 30 s each. Ten healthy adults were recruited in the reliability test, and the intraclass correlation coefficient (ICC) was used to analyze the within-day and between-day reliabilities. Eight subjects with chronic stroke and eight healthy adults were recruited for the validity test, in which balance performance was compared to represent the application validity. The ICC values of the reliability tests were at least 0.76 (p = 0.00). The acceleration data exhibited no difference between individuals who have experienced stroke and healthy subjects; however, all six postures were found to differ significantly between the two groups in the gyroscope data. The study demonstrates that the smartphone application provides a convenient, reliable, and valid tool for the balance assessments of subjects who have experienced chronic stroke.

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Psychometric Properties of Brief-Balance Evaluation Systems Test Among Multiple Populations: A Systematic Review and Meta-analysis

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2021.04.013 ◽

2021 ◽

Author(s):

Cathy W.T. Lo ◽

C.-Y. Lin ◽

William W.N. Tsang ◽

C.H. Yan ◽

Arnold Y.L. Wong

Keyword(s):

Systematic Review ◽

Psychometric Properties ◽

Meta Analysis ◽

Multiple Populations ◽

Evaluation Systems

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Concurrent and Discriminative Validity of the Mini Balance Evaluation Systems Test (miniBESTest) in People with Parkinson's Disease

Indian Journal of Physical Medicine and Rehabilitation ◽

10.5005/ijopmr-26-2-43 ◽

2015 ◽

Vol 26 (2) ◽

pp. 43-48

Author(s):

Margaret KY Mak

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Healthy Subjects ◽

Balance Performance ◽

Discriminative Validity ◽

Evaluation Systems ◽

Balance Confidence ◽

Analysis Laboratory ◽

Abc Scale ◽

The University

Abstract Purpose To examine the concurrent and discriminative validity of the miniBESTest in individuals with Parkinson's disease (PD). Method Thirty-four individuals with PD participated in study 1. Thirty-one healthy subjects and 127 individuals with PD completed study 2. All participants were assessed at the University Balance and motion analysis laboratory. Balance performance was assessed using the miniBESTest and Berg's balance scale (BBS). Self-perceived balance confidence level of subjects was measured by the activities-specific balance confidence (ABC) scale. Results In study 1, results of Pearson's correlation showed that the scores of the miniBESTest correlated well with BBS (r=0.765; p<0.001) and moderately well with ABC scores (r=0.587; p<0.001). For study 2, results of one-way analysis of variance demonstrated significant differences in miniBESTest scores among healthy subjects, PD non-fallers (PD-NF) and PD fallers (PD-F). Healthy subjects obtained the highest mini-BESTest score of 88.2 ± 8.9%, followed by PD-NF (73.6 ± 14.7%) and PDF (57.1 ± 17.0%) (all p<0.001). Significant differences were also observed among healthy subjects, PD-NF and PD-F for each miniBESTest domain score (all p<0.05). Conclusion The miniBESTest is a valid method to document balance performance in individuals with PD. Both total and domain miniBESTest scores could differentiate between healthy subjects, PD-NF and PD-F.

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Fatigue impact, gait and balance performance in chronic stroke survivors

Physiotherapy Practice and Research ◽

10.3233/ppr-130029 ◽

2014 ◽

Vol 35 (1) ◽

pp. 49-54

Author(s):

Adebimpe Olayinka Obembe ◽

Alaba Ezekiel Olalemi ◽

Beatrice Oluwayinka Loto

Keyword(s):

Chronic Stroke ◽

Stroke Survivors ◽

Balance Performance

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Test-Retest Reliability, Validity, and Minimal Detectable Change of the Balance Evaluation Systems Test to Assess Balance in Persons with Multiple Sclerosis

International Journal of MS Care ◽

10.7224/1537-2073.2016-118 ◽

2018 ◽

Vol 20 (5) ◽

pp. 231-237 ◽

Cited By ~ 5

Author(s):

Kathryn D. Mitchell ◽

Han Chen ◽

Sheri P. Silfies

Keyword(s):

Multiple Sclerosis ◽

Fear Of Falling ◽

Intraclass Correlation ◽

Berg Balance Scale ◽

Minimal Detectable Change ◽

Detectable Change ◽

Balance Performance ◽

Retest Reliability ◽

Evaluation Systems ◽

Test Retest Reliability

Abstract Background: Individuals with multiple sclerosis (MS) have balance deficits that result in falls. Balance tests developed for older adults do not discriminate between fallers and nonfallers with MS. The Balance Evaluation Systems Test (BESTest) identifies body systems contributing to imbalance/fall risk. This study evaluated the test-retest reliability and construct validity of the BESTest to assess balance in individuals with MS, compared the diagnostic accuracy of the BESTest and Berg Balance Scale (BBS), and investigated the minimal detectable change of the BESTest in this population. Methods: Twenty individuals with MS were recruited. Age, onset of disease, and fall history were obtained. The following measures were used: Expanded Disability Status Scale, University of Illinois at Chicago Fear of Falling Measure, BESTest, and BBS. Twelve participants were retested to determine test-retest reliability of the BESTest. Results: The BESTest demonstrated strong test-retest reliability (intraclass correlation coefficient [3,1] = 0.98 [95% CI, 0.91–0.99], P = .01) and was highly correlated with the BBS (r = 0.94, P = .01). The BBS had poor accuracy to identify fallers. Using a score of 81%, the BESTest had moderate sensitivity (0.89) to identify fallers. The standard error of the measurement for the BESTest was 4.16 points, which translates into a minimal detectable change of 9.7% [90% CI] to 11.5% [95% CI]. Conclusions: The BESTest demonstrates excellent test-retest reliability and diagnostic utility as a measure of functional balance in persons with moderate MS. A change in BESTest score of at least 10% may indicate a true change in balance performance in this population.

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