The sensitivity and specificity of the balance evaluation systems test-BESTest in determining risk of fall in stroke patients

Şahin, İlknur Ezgi; Güçlü-Gündüz, Arzu; Yazıcı, Gökhan; Özkul, Çağla; Volkan-Yazici, Melek; Nazlıel, Bijen; Tekindal, Mustafa Agâh

doi:10.3233/nre-182558

Cited by 23 publications

(34 citation statements)

References 19 publications

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“…The cut-off scores obtained in this study can be thought of as target scores for acquiring the ability to walk to a limited extent in the community from originally only being able to walk in the household. However, all cut-off scores except for stability limits and verticality section were below the cut-off score for predicting falls in individuals with stroke ( 12 , 26 ). In addition, for anticipatory postural adjustments and sensory orientation sections, the scores were highly discrete, and the potential risk of falling was likely to remain even if the person had the walking status of a limited community ambulator.…”

Section: Discussionmentioning

confidence: 77%

“…Positive and negative predictive values were calculated for each section of the BESTest. The sample size needed for this study was estimated based on an alpha level of 0.05, a power of 0.80, and an AUROC of 0.739, taken from a previous study showing the discriminant accuracy of the section of the BESTest ( 12 ). It was determined that a sample size of 16 participants was required for each group.…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, the BESTest assessment results can be used to select interventions that focus on the specific deficits identified in each patient. Reports about the sections of the BESTest are increasing; for instance, each section of the BESTest is reported to have low to moderate accuracy as a fall prediction tool, and the relationships of scores with falls vary among the BESTest sections ( 12 , 13 ). Effective rehabilitation of postural control to improve walking ability and prevent falls requires a better understanding of the relationship of walking to postural control.…”

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confidence: 99%

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Which Balance Evaluation Systems Test sections best distinguish levels of post-stroke functional walking status?

Miyata

Hasegawa²,

Iwamoto³

et al. 2021

J Rehabil Med

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Objective To determine which sections of the Balance Evaluation Systems Test (BESTest) distinguish levels of post-stroke functional walking status and to establish their cut-off scores. Design A retrospective cross-sectional study. Subjects and methods The BESTest was administered to 87 stroke patients who were able to walk without physical assistance upon discharge from the hospital. Subjects were divided into 3 functional walking status groups: namely, household ambulators, limited community ambulators, and unlimited community ambulators. The receiver operating characteristic curve was determined and the cut-off score and area under the receiver operating characteristic curve (AUROC) of each section calculated. Results In the comparison of household and limited community ambulators, the accuracies of all BESTest sections were moderate (AUROC>0.7), and the cut-off scores were 36.1–78.6%. In the comparison of limited and unlimited community ambulators, one section (stability in gait) had high accuracy (AUROC=0.908, cut-off scores=73.8%) and 3 sections (biomechanical constraints, anticipatory postural adjustments, and postural response) had moderate accuracy (AUROC=0.812–0.834, cut-off scores=75.0–83.4%). Conclusion This study demonstrated that different sections of the BESTest had different abilities to discriminate levels of post-stroke functional walking status, and identified cut-off values for targeted improvement. LAY ABSTRACT The Balance Evaluation Systems Test (BESTest), a clinical postural control measure, categorizes postural control systems in 6 different sections. This study investigated which sections of the BESTest distinguish levels of post-stroke functional walking status, which, in turn, is based on walking speed. Among the slower walkers, all sections of the BESTest showed moderate relationships to categories of walking status. Among the faster walkers, 4 sections showed moderate to strong relationships and 2 sections showed weak relationships. This study may have clinical implications for rehabilitation aimed at improving functional walking status in individuals with stroke. These findings will help rehabilitation professionals assess postural control in relation to stroke patients’ ability to walk in different settings (e.g. their household or the community) and determine which postural control systems should be prioritized in therapeutic interventions.

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Section: Discussionmentioning

confidence: 77%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Which Balance Evaluation Systems Test sections best distinguish levels of post-stroke functional walking status?

Miyata

Hasegawa²,

Iwamoto³

et al. 2021

J Rehabil Med

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“…In support of this hypothesis, a significant negative correlation was found between the total dynamic sitting test COG trajectory length and the BESTest total score. Although balance function is said to decrease with age, 17,21) BESTest total scores in elderly women were similarly low. 17) Furthermore, in the current study, there was a negative correlation between the dynamic sitting test COG total trajectory length and the BESTest total score, suggesting that the decline in dynamic trunk balance ability may be associated with a low BESTest score.…”

Section: Discussionmentioning

confidence: 99%

“… 16 ) The BESTest has excellent interrater reliability with a mixed population of individuals with neurological disorders and balance limitations, and it has excellent test–retest reliability for individuals with Parkinson’s disease. 17 , 18 ) In addition, there are reports that the relation between fall risk and BESTest score of healthy elderly people depends on age, and the fall risk detection is reliable. 19 , 20 ) However, there is no report on the relationship between BESTest scores and trunk balance evaluated by dynamic sitting.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Dynamic Trunk Balance and the Balance Evaluation Systems Test in Elderly Women

Takahashi

Saito

Matsunaga

et al. 2020

PRM

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Objective: Falls are major contributors to elderly subjects becoming bedridden. Consequently, it is important to evaluate and minimize the risk of falls in the elderly. Trunk stability is important for balance function and is related to fall prevention in elderly women. We developed a balance-measuring device that uses a dynamic sitting position to safely measure balance function. The Balance Evaluation Systems Test (BESTest) is useful method to assess balance function, a recently developed balance evaluation test that can detect minor balance problems not captured by previous tests. The purpose of the present study was to examine the relationship between dynamic trunk balance and findings of the BESTest in elderly women. Methods: Thirty-one healthy women aged 60 years or more participated in this study. The evaluation items were the BESTest total score, scores for each of the six elements of the BESTest, dynamic sitting balance, static postural balance, and muscle strength. Results: The mean total BESTest score was 85.4 points. The mean total trajectory length of the center of gravity (COG) during the dynamic sitting balance test was 1447.5 mm. A negative correlation (r=-0.481, P= 0.006) was observed between the total COG trajectory length and the BESTest score. A negative correlation was also found between the total COG trajectory length and biomechanical constraints (r=-0.492, P=0.005) and anticipatory postural adjustments (r=-0.532, P=0.002). There were no correlations between the dynamic sitting balance total COG trajectory length and the stationary standing COG trajectory length or muscle strength. Conclusions: In elderly women, the total COG trajectory length during dynamic sitting was negatively correlated with the BESTest total score.

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Assessment of 13 in silico pathogenicity methods on cancer-related variants

Yazar

Ozbek

2022

Computers in Biology and Medicine

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The sensitivity and specificity of the balance evaluation systems test-BESTest in determining risk of fall in stroke patients

Cited by 23 publications

References 19 publications

Which Balance Evaluation Systems Test sections best distinguish levels of post-stroke functional walking status?

Which Balance Evaluation Systems Test sections best distinguish levels of post-stroke functional walking status?

Relationship between Dynamic Trunk Balance and the Balance Evaluation Systems Test in Elderly Women

Assessment of 13 in silico pathogenicity methods on cancer-related variants

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