scholarly journals Comparison of Reliability, Validity, and Responsiveness of the Mini-BESTest and Berg Balance Scale in Patients With Balance Disorders

2013 ◽  
Vol 93 (2) ◽  
pp. 158-167 ◽  
Author(s):  
Marco Godi ◽  
Franco Franchignoni ◽  
Marco Caligari ◽  
Andrea Giordano ◽  
Anna Maria Turcato ◽  
...  
Keyword(s):  
Dynamic Balance ◽  
Intraclass Correlation ◽  
Area Under The Curve ◽  
Correlation Coefficients ◽  
Berg Balance Scale ◽  
Important Change ◽  
Global Rating ◽  
Minimal Important Change ◽  
External Criterion ◽  
Balance Scale

Background Recently, a new tool for assessing dynamic balance impairments has been presented: the 14-item Mini-BESTest. Objective The aim of this study was to compare the psychometric performance of the Mini-BESTest and the Berg Balance Scale (BBS). Design A prospective, single-group, observational design was used in the study. Methods Ninety-three participants (mean age=66.2 years, SD=13.2; 53 women, 40 men) with balance deficits were recruited. Interrater (3 raters) and test-retest (1–3 days) reliability were calculated using intraclass correlation coefficients (ICCs). Responsiveness and minimal important change were assessed (after 10 sessions of physical therapy) using both distribution-based and anchor-based methods (external criterion: the 15-point Global Rating of Change [GRC] scale). Results At baseline, neither floor effects nor ceiling effects were found in either the Mini-BESTest or the BBS. After treatment, the maximum score was found in 12 participants (12.9%) with BBS and in 2 participants (2.1%) with Mini-BESTest. Test-retest reliability for total scores was significantly higher for the Mini-BESTest (ICC=.96) than for the BBS (ICC=.92), whereas interrater reliability was similar (ICC=.98 versus .97, respectively). The standard error of measurement (SEM) was 1.26 and the minimum detectable change at the 95% confidence level (MDC95) was 3.5 points for Mini-BESTest, whereas the SEM was 2.18 and the MDC95 was 6.2 points for the BBS. In receiver operating characteristic curves, the area under the curve was 0.92 for the Mini-BESTest and 0.91 for the BBS. The best minimal important change (MIC) was 4 points for the Mini-BESTest and 7 points for the BBS. After treatment, 38 participants evaluated with the Mini-BESTest and only 23 participants evaluated with the BBS (out of the 40 participants who had a GRC score of ≥3.5) showed a score change equal to or greater than the MIC values. Limitations The consecutive sampling method drawn from a single rehabilitation facility and the intrinsic weakness of the GRC for calculating MIC values were limitations of the study. Conclusions The 2 scales behave similarly, but the Mini-BESTest appears to have a lower ceiling effect, slightly higher reliability levels, and greater accuracy in classifying individual patients who show significant improvement in balance function.

scholarly journals Between-Rater Reliability of the 6-Minute Walk Test, Berg Balance Scale, and Handheld Dynamometry in People with Multiple Sclerosis

2013 ◽  
Vol 15 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Elaine Toomey ◽  
Susan Coote
Keyword(s):  
Multiple Sclerosis ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Berg Balance Scale ◽  
Small Sample ◽  
Walk Test ◽  
Rater Reliability ◽  
Balance Scale ◽  
6 Minute Walk Test ◽  
Minute Walk

This study investigated the between-rater reliability of the Berg Balance Scale (BBS), 6-Minute Walk test (6MW), and handheld dynamometry (HHD) in people with multiple sclerosis (MS). Previous studies that examined BBS and 6MW reliability in people with MS have not used more than two raters, or analyzed different mobility levels separately. The reliability of HHD has not been previously reported for people with MS. In this study, five physical therapists assessed eight people with MS using the BBS, 6MW, and HHD, resulting in 12 pairs of data. Data were analyzed using intraclass correlation coefficients (ICCs), Spearman correlation coefficients (SCCs), and Bland and Altman methods. The results suggest excellent agreement for the BBS (SCC = 0.95, mean difference between raters [d̄] = 2.08, standard error of measurement [SEM] = 1.77) and 6MW (ICC = 0.98, d̄ = 5.22 m, SEM = 24.76 m) when all mobility levels are analyzed together. Reliability is lower in less mobile people with MS (BBS SCC = 0.6, d̄ = −1.83; 6MW ICC = 0.95, d̄ = 20.04 m). Although the ICC and SCC results for HHD suggest good-to-excellent reliability (0.65–0.85), d̄ ranges up to 17.83 N, with SEM values as high as 40.95 N. While the small sample size is a limitation of this study, the preliminary evidence suggests strong agreement between raters for the BBS and 6MW and decreased agreement between raters for people with greater mobility problems. The mean differences between raters for HHD are probably too high for it to be applied in clinical practice.

scholarly journals Minimal important change and responsiveness of the Migraine Disability Assessment Score (MIDAS) questionnaire

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Gabriela F. Carvalho ◽  
Kerstin Luedtke ◽  
Tobias Braun
Keyword(s):  
Area Under The Curve ◽  
Important Change ◽  
Global Rating ◽  
Minimal Important Change ◽  
Perceived Change ◽  
Midas Questionnaire ◽  
Assess Treatment Response ◽  
Clinically Important Change ◽  
Moderate Positive Correlation

Abstract Background The MIDAS is the most used questionnaire to evaluate migraine-related disability, but its utility to assess treatment response remains unclear. Our aim was to estimate the MIDAS’ minimal important change (MIC) value and its responsiveness. Methods A total of 103 patients were enrolled in a non-pharmacological, preference-based clinical trial. MIDAS and global rating of self-perceived change (GRoC) scores were collected at baseline, after 5 weeks of treatment, 4-weeks and 3-months follow-up after treatment. Anchor-based approaches were used to establish MIC values and responsiveness. Findings In all 3 timepoint comparisons, MIDAS presented a MIC of 4.5 points. A moderate positive correlation was identified between the MIDAS change and GRoC scores. The area under the curve ranged from 0.63 to 0.68. Conclusions This study showed that MIDAS has a limited responsiveness to change. A change of 4.5 points or more represents a clinically important change for patients with high frequent migraine and chronic migraine receiving non-pharmacological treatment.

scholarly journals Determining minimal important change for the thyroid-related quality of life questionnaire ThyPRO

2021 ◽  
Author(s):  
Selma Flora Nordqvist ◽  
Victor Brun Boesen ◽  
Åse Krogh Rasmussen ◽  
Ulla Feldt-Rasmussen ◽  
Laszlo Hegedüs ◽  
...  
Keyword(s):  
Area Under The Curve ◽  
Patient Reported Outcome ◽  
Important Change ◽  
Reliable Change Index ◽  
Global Rating ◽  
Minimal Important Change ◽  
Life Questionnaire ◽  
Reliable Change ◽  
Patient Reported ◽  
The Individual

Objective: ThyPRO is the standard thyroid patient-reported outcome (PRO). The change in scores that patients perceive as important remains to be ascertained. The purpose of this study was to determine values for minimal important change (MIC) for ThyPRO. Methods: A total of 435 patients treated for benign thyroid diseases completed ThyPRO at baseline and 6 weeks following treatment initiation. At 6-weeks follow-up, patients also completed Global Rating of Change items. For each 0-100 scale, two MIC values were identified: an MIC for groups, using the ROC curve method and an MIC for individual patients, using the reliable change Index. Results: ROC analyses provided group-MIC estimates of 6.3 to 14.3 (score range 0-100). Evaluation of area under the curve (AUC) supported the robustness for 9 of 14 scales (AUC > 0.7). Reliable change index estimates of individual-MIC were 8.0 to 21.1. For all scales but two, the individual-MIC values were larger than the group-MIC values. Conclusions: Interpretability of ThyPRO was improved by the establishment of MIC values, which was 6.3 to 14.3 for groups and 8.0 to 21.1 for individuals. Thus, estimates of which changes are clinically relevant, are now available for future studies. We recommend using MIC values found by ROC analyses to evaluate changes in groups of patients, whereas MIC values identified by a dual criterion, including the reliability of changes, should be used for individual patients, e.g. to identify individual responders in clinical studies or practice.

scholarly journals Cross-cultural translation and validation of the Spanish version of the patellofemoral pain and osteoarthritis subscale of the KOOS (KOOS-PF)

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Juan Pablo Martinez-Cano ◽  
Daniel Vernaza-Obando ◽  
Julián Chica ◽  
Andrés Mauricio Castro
Keyword(s):  
Intraclass Correlation ◽  
Patellofemoral Pain ◽  
Spanish Version ◽  
Minimal Detectable Change ◽  
Global Rating ◽  
Minimal Important Change ◽  
Specific Patient ◽  
Retest Reliability ◽  
Patient Reported ◽  
Test Retest Reliability

Abstract Objective The aim of this study was to translate to Spanish the patellofemoral pain and osteoarthritis subscale of the knee injury and osteoarthritis outcome score (KOOS-PF) and validate this Spanish version of a disease-specific patient-reported outcome measure (PROM) for patellofemoral pain. Results The KOOS-PF was translated to Spanish and sixty patients with patellofemoral pain and/or osteoarthritis accepted to complete the questionnaire. 1-week later 58 patients answered the questions again for the test–retest reliability validation and finally 55 patients completed 1-month later for the responsiveness assessment. The Spanish version showed very good internal consistency (Cronbach’s alpha: 0.93) and test–retest reliability (intraclass correlation coefficient: 0.82). Responsiveness was confirmed, showing a strong correlation with the global rating of change (GROC) score (r 0.64). The minimal detectable change was 11.1 points, the minimal important change was 17.2 points, and there were no floor or ceiling effects for the score.

Responsiveness and longitudinal validity of the Persian version of COMI to physiotherapy in patients with non-specific chronic low back pain

2020 ◽  
Vol 20 (3) ◽  
pp. 483-490
Author(s):  
Shiva Komesh ◽  
Noureddin Nakhostin Ansari ◽  
Soofia Naghdi ◽  
Parisa Alaei ◽  
Scott Hasson ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Area Under The Curve ◽  
Important Change ◽  
Global Rating ◽  
Low Back ◽  
Operating Characteristics ◽  
Smallest Detectable Change ◽  
Clinically Important Change ◽  
Longitudinal Validity

AbstractBackground and aimsThe Core Outcome Measures Index (COMI) is a short, self-reported questionnaire for assessing important outcomes in patients with low back pain (LBP). The present study was conducted to explore the responsiveness and longitudinal validity of the Persian COMI (COMI-P) in patients with non-specific chronic LBP.MethodsIn this prospective cohort study of patients with non-specific chronic LBP receiving physiotherapy, patients completed a booklet containing the COMI-P, Persian Functional Rating Index (FRI-P), and a visual analogue scale (VAS) for pain before and after the end of ten-sessions of physiotherapy. Patients also completed a global rating of change scale (GRCS) at the end of the physiotherapy. Responsiveness was examined by means of internal responsiveness methods [t-test, standard effect size (SES); standardized response mean (SRM), and Guyatt responsiveness index (GRI)] and external responsiveness methods [correlation with external criteria and receiver operating characteristics (ROC) curve].ResultsFifty patients with a mean age of 50.62 ± 13.8 years participated. The paired t-test showed significant changes in COMI-P scores (p < 0.001). The effect sizes for COMI-P were large (range 0.96–1.23). The score changes for the COMI-P revealed significant correlations with FRI-P (r = 0.67, p < 0.001), the VAS (r = 0.65, p < 0.001), and the GRCS (r = 0.34, p = 0.02). The COMI-P change scores showed excellent correlation with the dichotomized smallest detectable change (SDC) criterion (r = 0.83, p < 0.001). The ROC area under the curve for the COMI-P based on the dichotomized SDC criterion was perfect. The minimal clinically important change was estimated 2.15 points (sensitivity 94% and specificity 100%).ConclusionsThe COMI-P appears to have responsiveness and longitudinal validity in detecting changes after physiotherapy for non-specific chronic LBP. An improvement of 2.15 points in COMI-P total score is required to be interpreted as minimally clinically important change in individual patients.

scholarly journals Interrater Reliability of the Berg Balance Scale When Used by Clinicians of Various Experience Levels to Assess People With Lower Limb Amputations

2014 ◽  
Vol 94 (3) ◽  
pp. 371-378 ◽  
Author(s):  
Christopher K. Wong
Keyword(s):  
Lower Limb ◽  
Interrater Reliability ◽  
Clinical Training ◽  
Intraclass Correlation ◽  
Berg Balance Scale ◽  
Intrarater Reliability ◽  
Rater Reliability ◽  
Study Objective ◽  
Balance Scale ◽  
Scale Scores

Background People with lower limb amputations frequently have impaired balance ability. The Berg Balance Scale (BBS) has excellent psychometric properties for people with neurologic disorders and elderly people dwelling in the community. A Rasch analysis demonstrated the validity of the BBS for people with lower limb amputations of all ability strata, but rater reliability has not been tested. Objective The study objective was to determine the interrater reliability and intrarater reliability of BBS scores and the differences in scores assigned by testers with various levels of experience when assessing people with lower limb amputations. Design This reliability study of video-recorded single-session BBS assessments had a cross-sectional design. Methods From a larger study of people with lower limb amputations, 5 consecutively recruited participants using prostheses were video recorded during an in-person BBS assessment. Sixteen testers independently rated the video-recorded assessments. Testers were 3 physical therapists, 1 occupational therapist, 3 third-year and 4 second-year doctor of physical therapy (DPT) students, and 5 first-year DPT students without clinical training. Rater reliability was calculated using intraclass correlation coefficients (ICC [2,k]). Differences in scores assigned by testers with various levels of experience were determined by use of an analysis of variance with Tukey post hoc tests. Results The average age of the participants was 53.0 years (SD=15.7). Amputations had occurred at the ankle disarticulation, transtibial, and transfemoral levels because of vascular, trauma, and medical etiologies an average of 8.2 years earlier (SD=7.9). Berg Balance Scale scores spanned all ability strata. Interrater reliability (ICC [2,k]=.99) and intrarater reliability of scores determined in person and through video-recorded assessments by the same testers (ICC [2,k]=.99) were excellent. For participants with the lowest levels of ability, licensed professionals assigned lower scores than did DPT students without clinical training. Limitations Intrarater reliability calculations were based on 2 testers. Conclusions Berg Balance Scale scores assigned to people using prostheses by testers with various levels of clinical experience had excellent interrater reliability and intrarater reliability.

Short Berg Balance Scale — correlation to static and dynamic balance and applicability among the aged

2012 ◽  
Vol 24 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Ulla Hohtari-Kivimäki ◽  
Marika Salminen ◽  
Tero Vahlberg ◽  
Sirkka-Liisa Kivelä
Keyword(s):  
Dynamic Balance ◽  
Berg Balance Scale ◽  
Balance Scale

scholarly journals Effects of application of texture insoles on the balance of subjects with Multiple Sclerosis

2017 ◽  
Vol 16 (1) ◽  
pp. 9-16
Author(s):  
Wildja De Lima Gomes ◽  
Thais Botossi Scalha ◽  
Lucas Brino Mota ◽  
Viviane Almeida Kuroda ◽  
Juliana Cintra Garrafa ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Dynamic Balance ◽  
Step Length ◽  
Berg Balance Scale ◽  
Measuring Instruments ◽  
Balance Scale ◽  
Functional Gait ◽  
Dynamic Gait Index ◽  
Dynamic Gait ◽  
Gait Index

Objective: The aim of this study was to evaluate the effects on static and dynamic balance after the use of textured insoles. Method: Fifteen subjects with multiple sclerosis were evaluated before using the insoles, after using them for 1 month, and after 2 months without using, them using the following measuring instruments: the Berg Balance Scale, Dynamic Gait Index, and 10-meter Walk Test, a means of functional gait assessment. Results: Improvement was observed in the Berg Balance Scale and Dynamic Gait Index scores, walking time, number of steps and step length after using the insoles for 1 month. The improvement in Berg Balance Scale score remained after two months without the insoles and there were no changes in gait speed. Conclusion: The use of textured insoles was effective as an intervention to improve static and dynamic balance in patients with multiple sclerosis.

scholarly journals Cross-Cultural Translation and Validation of the Spanish Version of the Patellofemoral Pain and Osteoarthritis Subscale of the KOOS (KOOS-PF)

2021 ◽  
Author(s):  
Juan Pablo Martinez-Cano ◽  
Daniel Vernaza-Obando ◽  
Julián Chica ◽  
Andrés Mauricio Castro
Keyword(s):  
Correlation Coefficient ◽  
Internal Consistency ◽  
Intraclass Correlation ◽  
Patellofemoral Pain ◽  
Important Change ◽  
Spanish Version ◽  
Minimal Detectable Change ◽  
Minimal Important Change ◽  
Detectable Change ◽  
Test Retest Reliability

Abstract Background: Patellofemoral pain is a very common complaint in orthopedic sports medicine clinics. Disease-specific patient-reported outcome measures (PROMs) are useful for research and clinical practice; thus, it is important to have validated translations available for new PROMs. This study aims to translate and validate the Spanish version of the patellofemoral pain and osteoarthritis subscale of the knee injury and osteoarthritis outcome score (KOOS-PF).Methods: The KOOS-PF was translated and culturally adapted to Spanish following current guidelines, which included translation, back-translation, conciliation and pilot studies. Patients with a diagnosis of patellofemoral pain and/or osteoarthritis from one medical center were invited to participate and complete the questionnaire. The evaluation of the score included internal consistency (Cronbach´s alpha), floor and ceiling effects, measurement error, minimal detectable change and minimal important change. For test-retest reliability, the intraclass correlation coefficient (ICC) was used, and for responsiveness, the global rating of change (GROC) scale was measured one month later.Results: Sixty patients with patellofemoral pain and/or osteoarthritis were included in the study. The Spanish version showed very good internal consistency (Cronbach’s alpha: 0.93) and test-retest reliability (intraclass correlation coefficient: 0.82). Responsiveness was confirmed, with the KOOS-PF demonstrating a strong correlation with the GROC score (r 0.64). The minimal detectable change was 11.1 points, the minimal important change was 17.2 points, and there were no floor or ceiling effects for the score.Conclusions: The Spanish version of the KOOS-PF demonstrated very good measurement properties, including internal consistency, reliability and responsiveness. The KOOS-PF can be used in Spanish-speaking patients for clinical and research purposes in patellofemoral pain and osteoarthritis.Trial registration: Fundación Valle del Lili, Biomedical Research Ethical Committee: No. 01438.

scholarly journals Validity, Reliability, and Ability to Identify Fall Status of the Berg Balance Scale, BESTest, Mini-BESTest, and Brief-BESTest in Patients With COPD

2016 ◽  
Vol 96 (11) ◽  
pp. 1807-1815 ◽  
Author(s):  
Cristina Jácome ◽  
Joana Cruz ◽  
Ana Oliveira ◽  
Alda Marques
Keyword(s):  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Berg Balance Scale ◽  
Performance Validity ◽  
Operating Characteristics ◽  
Intrarater Reliability ◽  
Balance Test ◽  
Balance Scale ◽  
Balance Tests ◽  
Abc Scale

Abstract Background The Berg Balance Scale (BBS), Balance Evaluation Systems Test (BESTest), Mini-BESTest, and Brief-BESTest are useful in the assessment of balance. Their psychometric properties, however, have not been tested in patients with chronic obstructive pulmonary disease (COPD). Objective This study aimed to compare the validity, reliability, and ability to identify fall status of the BBS, BESTest, Mini-BESTest, and the Brief-BESTest in patients with COPD. Design A cross-sectional study was conducted. Methods Forty-six patients (24 men, 22 women; mean age=75.9 years, SD=7.1) were included. Participants were asked to report their falls during the previous 12 months and to fill in the Activity-specific Balance Confidence (ABC) Scale. The BBS and the BESTest were administered. Mini-BESTest and Brief-BESTest scores were computed based on the participants' BESTest performance. Validity was assessed by correlating balance tests with each other and with the ABC Scale. Interrater reliability (2 raters), intrarater reliability (48–72 hours), and minimal detectable changes (MDCs) were established. Receiver operating characteristics assessed the ability of each balance test to differentiate between participants with and without a history of falls. Results Balance test scores were significantly correlated with each other (Spearman correlation rho=.73–.90) and with the ABC Scale (rho=.53–.75). Balance tests presented high interrater reliability (intraclass correlation coefficient [ICC]=.85–.97) and intrarater reliability (ICC=.52–.88) and acceptable MDCs (MDC=3.3–6.3 points). Although all balance tests were able to identify fall status (area under the curve=0.74–0.84), the BBS (sensitivity=73%, specificity=77%) and the Brief-BESTest (sensitivity=81%, specificity=73%) had the higher ability to identify fall status. Limitations Findings are generalizable mainly to older patients with moderate COPD. Conclusions The 4 balance tests are valid, reliable, and valuable in identifying fall status in patients with COPD. The Brief-BESTest presented slightly higher interrater reliability and ability to differentiate participants' fall status.

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