Assessing Balance in People with Bilateral Vestibulopathy using the Mini-Balance Evaluation Systems Test (Mini-BESTest)

Abstract

Background and aim: Bilateral Vestibulopathy (BVP) leads to unsteadiness when walking, which worsens in darkness or on uneven ground, as well as oscillopsia during head or body movement. A previous review concluded that clinical balance tests that challenge multiple aspects of balance should be investigated, since simple tests struggle to distinguish between BVP and healthy participants. Our aim was (1) to test if the more comprehensive Mini-BESTest is feasible in BVP, (2) to examine how participants perform in terms of their overall and subcomponent scores and (3) to compare these scores with healthy reference data from the literature.Methods: Fifty participants with BVP completed the Mini-BESTest as part of a larger study. The Mini-BESTest has 4 components: anticipatory, reactive postural control, sensory orientation and dynamic gait. It comprises 14 items with a maximum score of 28. Falls incidence in the previous 12 months was obtained by questionnaire. To compare the overall and sub-scores between our participants with BVP and those of healthy participants from the literature (n=327; obtained via PubMed searches and contacting authors), Mann-Whitney U tests were used. Sub scores within the BVP group were also compared. Spearman correlations were used to investigate the relationships between Mini-BESTest score and age.Results: No floor or ceiling effects were observed. Participants with BVP had significantly lower Mini-BESTest total scores than the healthy group (BVP mean=20.8, Healthy mean=24.2, U(NBVP=49, NHealthy=327)=4564.00, p<0.001, d=0.52). Three sub scores of the Mini-BESTest (anticipatory, reactive postural control, sensory orientation) were significantly lower in BVP (U(NBVP=50, NHealthy=190)=2364.50, p<0.001, d=0.75; U(NBVP=49, NHealthy=190)=3737.00, p=0.028, d=0.3; U(NBVP=50, NHealthy=190)=1223.50, p<0.001, d=1.22, respectively), while the dynamic gait sub scores were not significantly different (U(NBVP=50, NHealthy=190)=4374.50, p=0.367, d=0.11). A stronger negative Spearman correlation between age and Mini-BESTest total score was found in the BVP group (ρ = -0.67; 95% CI: -0.74 to -0.35; p < 0.001) than in the healthy group (ρ = -0.32; 95% CI: -0.32 to -0.11; p < 0.001). Mini-BESTest total scores were not significantly different between participants with BVP who had and had not experienced a fall in the previous 12 months.Conclusions: Our findings illustrate that the Mini-BESTest can be used with people with BVP and confirm the commonly reported balance deficits in BVP. The negative association between age and balance was stronger in BVP, perhaps related to the age-related decline in the remaining functional sensory systems with which people with BVP compensate.

Assessing balance in people with bilateral vestibulopathy using the Mini-Balance Evaluation Systems Test (Mini-BESTest): feasibility and comparison with healthy control data

“…We also thank Ilaria Arcolin for helpful advice on Mini-BESTest sub score use and interpretation (see limitations). A preprint version of this manuscript is available at OSF Preprints [ 64 ].…”