Using psychometric techniques to improve the Balance Evaluation Systems Test: the mini-BESTest

Abstract

Objective To improve, with the aid of psychometric analysis, the Balance Evaluation System’s Test (BESTest), a tool designed to analyse several postural control systems that may contribute to poor functional balance in adults. Methods We examined performance of the BESTest in a convenience sample of 115 consecutive adult patients with diverse neurological diagnoses and disease severity, referred to rehabilitation for balance disorders. Factor (both explorative and confirmatory) and Rasch analysis were used to process the data in order to produce a new, reduced and coherent balance measurement tool. Results Factor analysis selected 24 out of the 36 original BESTest items likely to represent the unidimensional construct of ‘dynamic balance’. Rasch analysis was then used to: 1) improve the rating categories, and 2) delete 10 items (misfitting or showing local dependency). The model consisting of the remaining 14 tasks was verified with confirmatory factor analysis to meet the stringent requirements of modern measurement. Conclusion The new 14-item scale (dubbed mini-BESTest) focuses on dynamic balance, can be conducted in 10-15 minutes, and contains items belonging evenly to four of the six sections from the original BESTest. Further studies are needed to confirm the usefulness of the mini-BESTest in clinical settings.

Psychometric properties of Brief‐Balance Evaluation Systems Test (Brief‐BESTest) in evaluating balance performance in individuals with chronic stroke

“…Despite its excellent psychometric properties in various populations (Chinsongkram et al., 2014; Horak et al., 2009; Jacobs & Kasser, 2012; Leddy, Crowner, & Earhart, 2011a), there are concerns with redundancy of items and long administration time involved (40–60 min) (Horak et al., 2009; Padgett, Jacobs, & Kasser, 2012). To address these limitations, the 14‐item Mini‐BESTest was developed (Franchignoni, Horak, Godi, Nardone, & Giordano, 2010). However, one limitation of the Mini‐BESTest is that it only assesses dynamic balance (Leddy, Crowner, & Earhart, 2011b; Padgett et al., 2012), with two of the six subsystems (i.e., “biomechanical constraints” and “stability limits/verticality”) in the original BESTest being omitted (Franchignoni et al., 2010).…”

“…To address these limitations, the 14‐item Mini‐BESTest was developed (Franchignoni, Horak, Godi, Nardone, & Giordano, 2010). However, one limitation of the Mini‐BESTest is that it only assesses dynamic balance (Leddy, Crowner, & Earhart, 2011b; Padgett et al., 2012), with two of the six subsystems (i.e., “biomechanical constraints” and “stability limits/verticality”) in the original BESTest being omitted (Franchignoni et al., 2010). Thus, the Brief‐BESTest, which has been more recently developed, retains the theoretical basis of the original BESTest (Padgett et al., 2012).…”

The Effects of a Therapeutic Yoga Program on Postural Control, Mobility, and Gait Speed in Community-Dwelling Older Adults

“…The MBT contains both unique assessment tools and components of the Berg Balance Scale, TUG, Ataxia Test Battery, Dynamic Gait Index, and the modified Clinical Test of Sensory Integration of Balance. 33 The inclusion of these various components gives the MBT high consistency and reliability. 32 Participants also underwent a gait speed assessment.…”

Are the Effects of Community-Based Dance on Parkinson Disease Severity, Balance, and Functional Mobility Reduced with Time? A 2-Year Prospective Pilot Study

“…26 This tool comprises 14 balance tasks, which are scored on a scale of 0-2. A score of 2 on an item represents no impairment in balance.…”