Objetivo. Avaliar a confiabilidade e validade das versões brasileiras do BESTest e MiniBESTest em hemiparéticos crônicos. Método. As confiabilidades teste-reteste e interexaminadores foram avaliadas pelo coeficiente kappa ponderado. A validade de construto foi analisada através do modelo Rasch em 40 hemiparéticos (58,8±12,8anos). Resultados. As confiabilidades teste-reteste e interexaminadores apresentaram concordância de moderada a quase perfeita para o BESTest (0,48≤Kw≤1,0; p<0,05) e forte a quase perfeita para o MiniBESTest (0,62≤Kw≤1,0; p<0,05). Os itens dos instrumentos dividiram as pessoas em, aproximadamente, três níveis de habilidade. A estabilidade das medidas dos indivíduos e dos itens variou de 0,89 a 0,96 para os instrumentos. No BESTest, o item mais difícil foi “sentar no chão e levantar” e no MiniBESTest “correção com passo lateral à direita”. O item mais fácil para ambos foi “permanecer de olhos abertos, superfície firme”. O nível de dificuldade dos itens dos instrumentos foi apropriado para o nível de habilidade dos indivíduos. Dois itens do BESTest apresentaram padrão errático. No MiniBESTest não houve item errático. Conclusões. As versões brasileiras do BESTest e do MiniBESTest são confiáveis e válidas para a avaliação do equilíbrio em hemiparéticos crônicos. Recomenda-se atenção quanto aos itens erráticos e cautela na interpretação do escore total do BESTest.
Introduction Hemiparesis is a common post-stroke impairment often associated with balance deficits. Standardized instruments for balance assessment may be useful in identifying individuals at risk of falling and evaluating intervention outcomes. Objectives To identify instruments with adequate psychometric properties and clinical application to assess balance in hemiparetic cases within the scope of physiotherapy and to verify tools most frequently used in studies that evaluated the effects of therapeutic interventions in order to improve the balance of hemiparetic patients. Methods A search was conducted in the Medline, Lilacs, PEDro, and Web of Science databases by two independent researchers, who selected and analyzed studies that evaluated the reliability and validity of balance assessment instruments and intervention results. Results and discussion The Berg Balance Scale was the most frequently used instrument in the intervention studies. Nine single-task tests (timed up and go, functional reach test, step test, four-square step test, side step test, supported standing balance, standing arm raise, static tandem standing, and weight shifting) and six multiple-task tests (Berg balance scale, Brunel balance assessment, Fugl-Meyer Assessment/balance section, mini balance evaluation systems test, and postural assessment scale for stroke patients) demonstrated adequate psychometric properties and clinical applications to assess balance in hemiparetic individuals. Conclusions The Berg Balance Scale had the most widely studied psychometric properties and was the most frequently used scale in the intervention studies. Further studies are required to validate and adapt other instruments for the Brazilian population.
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