Interrater and test-retest reliability and validity of the Norwegian version of the BESTest and mini-BESTest in people with increased risk of falling

Abstract

BackgroundThe Balance Evaluation Systems Test (BESTest) was developed to assess underlying systems for balance control in order to be able to individually tailor rehabilitation interventions to people with balance disorders. A short form, the Mini-BESTest, was developed as a screening test. The study aimed to assess interrater and test-retest reliability of the Norwegian version of the BESTest and the Mini-BESTest in community-dwelling people with increased risk of falling and to assess concurrent validity with the Fall Efficacy Scale-International (FES-I), and it was an observational study with a cross-sectional design.MethodsForty-two persons with increased risk of falling (elderly over 65 years of age, persons with a history of stroke or Multiple Sclerosis) were assessed twice by two raters. Relative reliability was analysed with Intraclass Correlation Coefficient (ICC), and absolute reliability with standard error of measurement (SEM) and smallest detectable change (SDC). Concurrent validity was assessed against the FES-I using Spearman’s rho.ResultsThe BESTest showed very good interrater reliability (ICC = 0.98, SEM = 1.79, SDC95 = 5.0) and test-retest reliability (rater A/rater B = ICC = 0.89/0.89, SEM = 3.9/4.3, SDC95 = 10.8/11.8). The Mini-BESTest also showed very good interrater reliability (ICC = 0.95, SEM = 1.19, SDC95 = 3.3) and test-retest reliability (rater A/rater B = ICC = 0.85/0.84, SEM = 1.8/1.9, SDC95 = 4.9/5.2). The correlations were moderate between the FES-I and both the BESTest and the Mini-BESTest (Spearman’s rho −0.51 and-0.50, p < 0.01).ConclusionThe BESTest and its short form, the Mini-BESTest, showed very good interrater and test-retest reliability when assessed in a heterogeneous sample of people with increased risk of falling. The concurrent validity measured against the FES-I showed moderate correlation. The results are comparable with earlier studies and indicate that the Norwegian versions can be used in daily clinic and in research.

Home-Based Resistance Training for Older Subjects during the COVID-19 Outbreak in Italy: Preliminary Results of a Six-Months RCT

“…The Mini-BESTest, a newer and shorter version of the original BESTest [ 38 ], is a valid tool for the assessment of dynamic balance and gait deficits in older people [ 39 ]. The Mini-BESTest showed very good inter-rater and test–retest reliability when assessed in a sample of people with increased risk of falling [ 40 ]. This instrument contains 14 items evaluating four different aspects of dynamic balance: anticipatory postural adjustments, postural responses, sensory orientation, and balance during gait.…”

Validity and reliability testing of the Spanish version of the BESTest and mini-BESTest in healthy community-dwelling elderly

“…The presence of floor and ceiling effects was defined as 15% or more of the participants having the lowest or respectively the highest possible score on the BESTest and the Mini-BESTest [ 24 ].…”

Group-Based Individualized Comprehensive Core Stability Intervention Improves Balance in Persons With Multiple Sclerosis: A Randomized Controlled Trial

“…29 The TIS-NV is a modified version of the original Trunk Impairment Scale, which has been validated and tested for reliability in people with MS. 30 The Mini-BESTest measures balance in standing and walking. The translated Norwegian version has good reliability and validity for people with MS. 31 It assesses 4 subitems: anticipatory postural control, reactive postural control, somatosensory orientation, and dynamic walking, with 14 tasks altogether. Each task is scored from 0 to 2, with a total score from 0 to 28 (0 = severe problem).…”

“…Each task is scored from 0 to 2, with a total score from 0 to 28 (0 = severe problem). 31 The PGIC-Balance is scored on a 7-point Likert scale, and the question was as follows: “How do you perceive your balance now compared to before the 6-week training period or standard care?” The PGIC-Balance measures how participants perceive a change in balance (1 = much worse, 4 = no change, and 7 = greatly improved). 32 A questionnaire was filled in by both groups during the 6 weeks of GroupCoreDIST or standard care; it asked about self-reported level of physical activity (number of half-hours per week), number of physical therapy sessions per week, exacerbation of symptoms, change in medications, and general well-being (level 1–5, with 1 being best).…”