scholarly journals A Two-Minute Walking Test With a Smartphone App for Persons With Multiple Sclerosis: Validation Study (Preprint)

2021 ◽  
Author(s):  
Pim van Oirschot ◽  
Marco Heerings ◽  
Karine Wendrich ◽  
Bram den Teuling ◽  
Frank Dorssers ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Validation Study ◽  
Concurrent Validity ◽  
Intraclass Correlation ◽  
Study Participant ◽  
Walking Test ◽  
Retest Reliability ◽  
Matched Group ◽  
Test Retest Reliability ◽  
Study Participants

BACKGROUND Walking disturbances are a common dysfunction in persons with multiple sclerosis (MS). The 2-Minute Walking Test (2MWT) is widely used to quantify walking speed. We implemented a smartphone-based 2MWT (s2MWT) in MS sherpa, an app for persons with MS. When performing the s2MWT, users of the app are instructed to walk as fast as safely possible for 2 minutes in the open air, while the app records their movement and calculates the distance walked. OBJECTIVE The aim of this study is to investigate the concurrent validity and test-retest reliability of the MS sherpa s2MWT. METHODS We performed a validation study on 25 persons with relapsing-remitting MS and 79 healthy control (HC) participants. In the HC group, 21 participants were matched to the persons with MS based on age, gender, and education and these followed the same assessment schedule as the persons with MS (the <i>HC-matched</i> group), whereas 58 participants had a less intense assessment schedule to determine reference values (the <i>HC-normative</i> group). Intraclass correlation coefficients (ICCs) were determined between the distance measured by the s2MWT and the distance measured using distance markers on the pavement during these s2MWT assessments. ICCs were also determined for test-retest reliability and derived from 10 smartphone tests per study participant, with 3 days in between each test. We interviewed 7 study participants with MS regarding their experiences with the s2MWT. RESULTS In total, 755 s2MWTs were completed. The adherence rate for the persons with MS and the participants in the HC-matched group was 92.4% (425/460). The calculated distance walked on the s2MWT was, on average, 8.43 m or 5% (SD 18.9 m or 11%) higher than the distance measured using distance markers (n=43). An ICC of 0.817 was found for the concurrent validity of the s2MWT in the combined analysis of persons with MS and HC participants. Average ICCs of 9 test-retest reliability analyses of the s2MWT for persons with MS and the participants in the HC-matched group were 0.648 (SD 0.150) and 0.600 (SD 0.090), respectively, whereas the average ICC of 2 test-retest reliability analyses of the s2MWT for the participants in the HC-normative group was 0.700 (SD 0.029). The interviewed study participants found the s2MWT easy to perform, but they also expressed that the test results can be confronting and that a pressure to reach a certain distance can be experienced. CONCLUSIONS The high correlation between s2MWT distance and the conventional 2MWT distance indicates a good concurrent validity. Similarly, high correlations underpin a good test-retest reliability of the s2MWT. We conclude that the s2MWT can be used to measure the distance that the persons with MS walk in 2 minutes outdoors near their home, from which both clinical studies and clinical practice can benefit.

scholarly journals A Two-Minute Walking Test With a Smartphone App for Persons With Multiple Sclerosis: Validation Study

10.2196/29128 ◽  
2021 ◽  
Vol 5 (11) ◽  
pp. e29128
Author(s):  
Pim van Oirschot ◽  
Marco Heerings ◽  
Karine Wendrich ◽  
Bram den Teuling ◽  
Frank Dorssers ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Validation Study ◽  
Concurrent Validity ◽  
Intraclass Correlation ◽  
Study Participant ◽  
Walking Test ◽  
Retest Reliability ◽  
Matched Group ◽  
Test Retest Reliability ◽  
Study Participants

Background Walking disturbances are a common dysfunction in persons with multiple sclerosis (MS). The 2-Minute Walking Test (2MWT) is widely used to quantify walking speed. We implemented a smartphone-based 2MWT (s2MWT) in MS sherpa, an app for persons with MS. When performing the s2MWT, users of the app are instructed to walk as fast as safely possible for 2 minutes in the open air, while the app records their movement and calculates the distance walked. Objective The aim of this study is to investigate the concurrent validity and test-retest reliability of the MS sherpa s2MWT. Methods We performed a validation study on 25 persons with relapsing-remitting MS and 79 healthy control (HC) participants. In the HC group, 21 participants were matched to the persons with MS based on age, gender, and education and these followed the same assessment schedule as the persons with MS (the HC-matched group), whereas 58 participants had a less intense assessment schedule to determine reference values (the HC-normative group). Intraclass correlation coefficients (ICCs) were determined between the distance measured by the s2MWT and the distance measured using distance markers on the pavement during these s2MWT assessments. ICCs were also determined for test-retest reliability and derived from 10 smartphone tests per study participant, with 3 days in between each test. We interviewed 7 study participants with MS regarding their experiences with the s2MWT. Results In total, 755 s2MWTs were completed. The adherence rate for the persons with MS and the participants in the HC-matched group was 92.4% (425/460). The calculated distance walked on the s2MWT was, on average, 8.43 m or 5% (SD 18.9 m or 11%) higher than the distance measured using distance markers (n=43). An ICC of 0.817 was found for the concurrent validity of the s2MWT in the combined analysis of persons with MS and HC participants. Average ICCs of 9 test-retest reliability analyses of the s2MWT for persons with MS and the participants in the HC-matched group were 0.648 (SD 0.150) and 0.600 (SD 0.090), respectively, whereas the average ICC of 2 test-retest reliability analyses of the s2MWT for the participants in the HC-normative group was 0.700 (SD 0.029). The interviewed study participants found the s2MWT easy to perform, but they also expressed that the test results can be confronting and that a pressure to reach a certain distance can be experienced. Conclusions The high correlation between s2MWT distance and the conventional 2MWT distance indicates a good concurrent validity. Similarly, high correlations underpin a good test-retest reliability of the s2MWT. We conclude that the s2MWT can be used to measure the distance that the persons with MS walk in 2 minutes outdoors near their home, from which both clinical studies and clinical practice can benefit.

scholarly journals Symbol Digit Modalities Test Variant in a Smartphone App for Persons With Multiple Sclerosis: Validation Study (Preprint)

2020 ◽  
Author(s):  
Pim van Oirschot ◽  
Marco Heerings ◽  
Karine Wendrich ◽  
Bram den Teuling ◽  
Marijn B Martens ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Construct Validity ◽  
Validation Study ◽  
Intraclass Correlation ◽  
Study Participant ◽  
Smartphone App ◽  
Retest Reliability ◽  
Matched Group ◽  
Test Retest Reliability ◽  
Study Participants

BACKGROUND The decline of cognitive processing speed (CPS) is a common dysfunction in persons with multiple sclerosis (MS). The Symbol Digit Modalities Test (SDMT) is widely used to formally quantify CPS. We implemented a variant of the SDMT in MS sherpa, a smartphone app for persons with MS. OBJECTIVE The aim of this study was to investigate the construct validity and test-retest reliability of the MS sherpa smartphone variant of the SDMT (sSDMT). METHODS We performed a validation study with 25 persons with relapsing-remitting MS and 79 healthy control (HC) subjects. In the HC group, 21 subjects were matched to the persons with MS with regard to age, gender, and education and they followed the same assessment schedule as the persons with MS (the “HC matched” group) and 58 subjects had a less intense assessment schedule to determine reference values (the “HC normative” group). Intraclass correlation coefficients (ICCs) were determined between the paper-and-pencil SDMT and its smartphone variant (sSDMT) on 2 occasions, 4 weeks apart. Other ICCs were determined for test-retest reliability, which were derived from 10 smartphone tests per study participant, with 3 days in between each test. Seven study participants with MS were interviewed regarding their experiences with the sSDMT. RESULTS The SDMT scores were on average 12.06% higher than the sSDMT scores, with a standard deviation of 10.68%. An ICC of 0.838 was found for the construct validity of the sSDMT in the combined analysis of persons with MS and HC subjects. Average ICCs for test-retest reliability of the sSDMT for persons with MS, the HC matched group, and the HC normative group were 0.874, 0.857, and 0.867, respectively. The practice effect was significant between the first and the second test of the persons with MS and the HC matched group and trivial for all other test-retests. The interviewed study participants expressed a positive attitude toward the sSDMT, but they also discussed the importance of adapting a smartphone cognition test in accordance with the needs of the individual persons with MS. CONCLUSIONS The high correlation between sSDMT and the conventional SDMT scores indicates a very good construct validity. Similarly, high correlations underpin a very good test-retest reliability of the sSDMT. We conclude that the sSDMT has the potential to be used as a tool to monitor CPS in persons with MS, both in clinical studies and in clinical practice.

scholarly journals Symbol Digit Modalities Test Variant in a Smartphone App for Persons With Multiple Sclerosis: Validation Study

10.2196/18160 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e18160
Author(s):  
Pim van Oirschot ◽  
Marco Heerings ◽  
Karine Wendrich ◽  
Bram den Teuling ◽  
Marijn B Martens ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Construct Validity ◽  
Validation Study ◽  
Intraclass Correlation ◽  
Study Participant ◽  
Smartphone App ◽  
Retest Reliability ◽  
Matched Group ◽  
Test Retest Reliability ◽  
Study Participants

Background The decline of cognitive processing speed (CPS) is a common dysfunction in persons with multiple sclerosis (MS). The Symbol Digit Modalities Test (SDMT) is widely used to formally quantify CPS. We implemented a variant of the SDMT in MS sherpa, a smartphone app for persons with MS. Objective The aim of this study was to investigate the construct validity and test-retest reliability of the MS sherpa smartphone variant of the SDMT (sSDMT). Methods We performed a validation study with 25 persons with relapsing-remitting MS and 79 healthy control (HC) subjects. In the HC group, 21 subjects were matched to the persons with MS with regard to age, gender, and education and they followed the same assessment schedule as the persons with MS (the “HC matched” group) and 58 subjects had a less intense assessment schedule to determine reference values (the “HC normative” group). Intraclass correlation coefficients (ICCs) were determined between the paper-and-pencil SDMT and its smartphone variant (sSDMT) on 2 occasions, 4 weeks apart. Other ICCs were determined for test-retest reliability, which were derived from 10 smartphone tests per study participant, with 3 days in between each test. Seven study participants with MS were interviewed regarding their experiences with the sSDMT. Results The SDMT scores were on average 12.06% higher than the sSDMT scores, with a standard deviation of 10.68%. An ICC of 0.838 was found for the construct validity of the sSDMT in the combined analysis of persons with MS and HC subjects. Average ICCs for test-retest reliability of the sSDMT for persons with MS, the HC matched group, and the HC normative group were 0.874, 0.857, and 0.867, respectively. The practice effect was significant between the first and the second test of the persons with MS and the HC matched group and trivial for all other test-retests. The interviewed study participants expressed a positive attitude toward the sSDMT, but they also discussed the importance of adapting a smartphone cognition test in accordance with the needs of the individual persons with MS. Conclusions The high correlation between sSDMT and the conventional SDMT scores indicates a very good construct validity. Similarly, high correlations underpin a very good test-retest reliability of the sSDMT. We conclude that the sSDMT has the potential to be used as a tool to monitor CPS in persons with MS, both in clinical studies and in clinical practice.

scholarly journals Reliability, construct and concurrent validity of a smartphone-based cognition test in multiple sclerosis

2021 ◽  
pp. 135245852110181
Author(s):  
KH Lam ◽  
P van Oirschot ◽  
B den Teuling ◽  
HE Hulst ◽  
BA de Jong ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Concurrent Validity ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Information Processing Speed ◽  
Retest Reliability ◽  
Intraclass Correlation Coefficients ◽  
Smallest Detectable Change ◽  
Baseline Test ◽  
Test Retest Reliability

Background: Early detection and monitoring of cognitive dysfunction in multiple sclerosis (MS) may be enabled with smartphone-adapted tests that allow frequent measurements in the everyday environment. Objectives: The aim of this study was to determine the reliability, construct and concurrent validity of a smartphone-adapted Symbol Digit Modalities Test (sSDMT). Methods: During a 28-day follow-up, 102 patients with MS and 24 healthy controls (HC) used the MS sherpa® app to perform the sSDMT every 3 days on their own smartphone. Patients performed the Brief International Cognitive Assessment for MS at baseline. Test–retest reliability (intraclass correlation coefficients, ICC), construct validity (group analyses between cognitively impaired (CI), cognitively preserved (CP) and HC for differences) and concurrent validity (correlation coefficients) were assessed. Results: Patients with MS and HC completed an average of 23.2 ( SD = 10.0) and 18.3 ( SD = 10.2) sSDMT, respectively. sSDMT demonstrated high test–retest reliability (ICCs > 0.8) with a smallest detectable change of 7 points. sSDMT scores were different between CI patients, CP patients and HC (all ps < 0.05). sSDMT correlated modestly with the clinical SDMT (highest r = 0.690), verbal (highest r = 0.516) and visuospatial memory (highest r = 0.599). Conclusion: Self-administered smartphone-adapted SDMT scores were reliable and different between patients who were CI, CP and HC and demonstrated concurrent validity in assessing information processing speed.

Test–Retest Reliability of the Mini-BESTest in People With Mild to Moderate Multiple Sclerosis

2021 ◽  
Author(s):  
A Wallin ◽  
M Kierkegaard ◽  
E Franzén ◽  
S Johansson
Keyword(s):  
Multiple Sclerosis ◽  
Measurement Errors ◽  
Balance Control ◽  
Intraclass Correlation ◽  
Repeated Measurements ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Limits Of Agreement ◽  
Retest Reliability ◽  
Test Retest Reliability

Abstract Objective The mini-BESTest is a balance measure for assessment of the underlying physiological systems for balance control in adults. Evaluations of test–retest reliability of the mini-BESTest in larger samples of people with multiple sclerosis (MS) are lacking. The purpose of this study was to investigate test–retest reliability of the mini-BESTest total and section sum scores and individual items in people with mild to moderate overall MS disability. Methods This study used a test–retest design in a movement laboratory setting. Fifty-four people with mild to moderate overall MS disability according to the Expanded Disability Status scale (EDSS) were included, with 28 in the mild subgroup (EDSS 2.0–3.5) and 26 in the moderate subgroup (EDSS 4.0–5.5). Test–retest reliability of the mini-BESTest was evaluated by repeated measurements taken 1 week apart. Reliability and measurement error were analyzed. Results Test–retest reliability for the total scores were considered good to excellent, with intraclass correlation coefficients of .88 for the whole sample, .83 for the mild MS subgroup, and .80 for the moderate MS subgroup. Measurement errors were small, with standard error of measurement and minimal detectable change of 1.3 and 3.5, respectively, in mild MS, and 1.7 and 4.7, respectively, in moderate MS. The limits of agreement were − 3.4 and 4.6. Test–retest reliability for the section scores were fair to good or excellent; weighted kappa values ranged from .62 to .83. All items but 1 showed fair to good or excellent test–retest reliability, and percentage agreement ranged from 61% to 100%. Conclusions The mini-BESTest demonstrated good to excellent test–retest reliability and small measurement errors and is recommended for use in people with mild to moderate MS. Impact Knowledge of limits of agreement and minimal detectable change contribute to interpretability of the mini-BESTest total score. The findings of this study enhance the clinical usefulness of the test for evaluation of balance control and for designing individually customized balance training with high precision and accuracy in people with MS.

scholarly journals Adaptation and Psychometric Evaluation of the Chinese Counseling Competencies Scale-Revised

2021 ◽  
Vol 12 ◽  
Author(s):  
Wei Xia ◽  
William Ho Cheung Li ◽  
Tingna Liang ◽  
Yuanhui Luo ◽  
Laurie Long Kwan Ho ◽  
...  
Keyword(s):  
Concurrent Validity ◽  
Convergent Validity ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Psychometric Evaluation ◽  
Counseling Competencies ◽  
Counselors In Training ◽  
Rater Reliability ◽  
Retest Reliability ◽  
Test Retest Reliability

Objectives: This study conducted a linguistic and psychometric evaluation of the Chinese Counseling Competencies Scale-Revised (CCS-R).Methods: The Chinese CCS-R was created from the original English version using a standard forward-backward translation process. The psychometric properties of the Chinese CCS-R were examined in a cohort of 208 counselors-in-training by two independent raters. Fifty-three counselors-in-training were asked to undergo another counseling performance evaluation for the test-retest. The confirmatory factor analysis (CFA) was conducted for the Chinese CCS-R, followed by internal consistency, test-retest reliability, inter-rater reliability, convergent validity, and concurrent validity.Results: The results of the CFA supported the factorial validity of the Chinese CCS-R, with adequate construct replicability. The scale had a McDonald's omega of 0.876, and intraclass correlation coefficients of 0.63 and 0.90 for test-retest reliability and inter-rater reliability, respectively. Significantly positive correlations were observed between the Chinese CCS-R score and scores of performance checklist (Pearson's γ = 0.781), indicating a large convergent validity, and knowledge on drug abuse (Pearson's γ = 0.833), indicating a moderate concurrent validity.Conclusion: The results support that the Chinese CCS-R is a valid and reliable measure of the counseling competencies.Practice implication: The CCS-R provides trainers with a reliable tool to evaluate counseling students' competencies and to facilitate discussions with trainees about their areas for growth.

scholarly journals Gait Asymmetry Post-Stroke: Determining Valid and Reliable Methods Using a Single Accelerometer Located on the Trunk

Sensors ◽  
2019 ◽  
Vol 20 (1) ◽  
pp. 37 ◽  
Author(s):  
Christopher Buckley ◽  
M. Encarna Micó-Amigo ◽  
Michael Dunne-Willows ◽  
Alan Godfrey ◽  
Aodhán Hickey ◽  
...  
Keyword(s):  
Concurrent Validity ◽  
Intraclass Correlation ◽  
Future Research ◽  
Validity And Reliability ◽  
Gait Symmetry ◽  
Retest Reliability ◽  
Post Stroke ◽  
Gait Asymmetry ◽  
Test Retest Reliability ◽  
Cardinal Symptom

Asymmetry is a cardinal symptom of gait post-stroke that is targeted during rehabilitation. Technological developments have allowed accelerometers to be a feasible tool to provide digital gait variables. Many acceleration-derived variables are proposed to measure gait asymmetry. Despite a need for accurate calculation, no consensus exists for what is the most valid and reliable variable. Using an instrumented walkway (GaitRite) as the reference standard, this study compared the validity and reliability of multiple acceleration-derived asymmetry variables. Twenty-five post-stroke participants performed repeated walks over GaitRite whilst wearing a tri-axial accelerometer (Axivity AX3) on their lower back, on two occasions, one week apart. Harmonic ratio, autocorrelation, gait symmetry index, phase plots, acceleration, and jerk root mean square were calculated from the acceleration signals. Test–retest reliability was calculated, and concurrent validity was estimated by comparison with GaitRite. The strongest concurrent validity was obtained from step regularity from the vertical signal, which also recorded excellent test–retest reliability (Spearman’s rank correlation coefficients (rho) = 0.87 and Intraclass correlation coefficient (ICC21) = 0.98, respectively). Future research should test the responsiveness of this and other step asymmetry variables to quantify change during recovery and the effect of rehabilitative interventions for consideration as digital biomarkers to quantify gait asymmetry.

scholarly journals Concurrent Validity and Reliability of My Jump 2 App for Measuring Vertical Jump Height in Recreationally Active Adults

2020 ◽  
Vol 10 (11) ◽  
pp. 3805 ◽  
Author(s):  
Špela Bogataj ◽  
Maja Pajek ◽  
Slobodan Andrašić ◽  
Nebojša Trajković
Keyword(s):  
Concurrent Validity ◽  
Female Athletes ◽  
Vertical Jump ◽  
Intraclass Correlation ◽  
Jump Height ◽  
Validity And Reliability ◽  
Retest Reliability ◽  
Study Results ◽  
Test Retest Reliability ◽  
Active Adults

This study aimed to examine the reliability, validity, and usefulness of the smartphone-based application, My Jump 2, against Optojump in recreationally active adults. Participants (18 women, 28.9 ± 5.6 years, and 26 men, 30.1 ± 10.6 years) completed squat jumps (SJ), counter-movement jumps (CMJ), and CMJ with arm swing (CMJAS) on Optojump and were simultaneously recorded using My Jump 2. To evaluate concurrent validity, jump height, calculated from flight time attained from each device, was compared for each jump type. Test-retest reliability was determined by replicating data analysis of My Jump 2 recordings on two occasions separated by two weeks. High test-retest reliability (Intraclass correlation coefficient (ICC) > 0.93) was observed for all measures in both male and female athletes. Very large correlations were observed between the My Jump 2 app and Optojump for SJ (r = 0.95, p = 0.001), CMJ (r = 0.98, p = 0.001), and CMJAS (r = 0.98, p = 0.001) in male athletes. Similar results were obtained for female recreational athletes for all jumps (r > 0.94, p = 0.001). The study results suggest that My Jump 2 is a valid, reliable, and useful tool for measuring vertical jump in recreationally active adults. Therefore, due to its simplicity and practicality, it can be used by practitioners, coaches, and recreationally-active adults to measure vertical jump performance with a simple test as SJ, CMJ, and CMJAS.

Identifying reliable change in tactile temporal thresholds in multiple sclerosis: test-retest reliability

2006 ◽  
Vol 12 (5) ◽  
pp. 573-577 ◽  
Author(s):  
L N Brown ◽  
L M Metz ◽  
M Eliasziw
Keyword(s):  
Multiple Sclerosis ◽  
Measurement Error ◽  
Corpus Callosum ◽  
Validation Study ◽  
Outcome Measure ◽  
Retest Reliability ◽  
Real Change ◽  
Test Retest Reliability ◽  
Standard Error Of Measurement ◽  
Error Of Measurement

Background Tactile temporal thresholds are typically significantly higher (ie, prolonged) in multiple sclerosis (MS) patients when compared to controls and increase significantly during relapses, probably reflecting integrity of conduction across a portion of the corpus callosum. As part of an ongoing validation study of tactile temporal thresholds, the test-retest reliability of these thresholds was examined in patients with MS. Methods Tactile temporal thresholds were measured in 61 MS patients during two separate test sessions within three weeks. Test-retest reliability and the standard error of measurement were calculated. The threshold of change in tactile temporal thresholds in MS patients that would correspond to real change beyond measurement error with 95% certainty was also calculated. Results The test-retest reliability of this measure of tactile temporal thresholds was 0.93. The threshold indicating change beyond chance or measurement error with 95% certainty was 19 ms. Conclusions This measure of tactile temporal thresholds has excellent test - retest reliability and a change of greater than 19 ms is highly likely to represent real change. This measure is promising as a precise, reliable outcome measure in MS.

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

2018 ◽  
Vol 20 (5) ◽  
pp. 231-237 ◽  
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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