Validation of the BESTest for Measuring Balance in People With Multiple Sclerosis

Abstract

Background: Evaluation of balance disorders and differentiation of the populations with deficits is necessary for treatment and rehabilitation. The BESTest is used to evaluate balance and posture in various populations and has been shown to distinguish between different neurological populations. This study investigated the validity of the BESTest in measuring balance in the people with multiple sclerosis (PwMS). Methods: A cross-sectional study conducted with 34 participants including 17 PwMS (42.64 ±7.8 years old, score 1-5 on the Expanded Disability Status Scale) and 17 healthy controls (42.33±8.65 years old). After a comprehensive medical history, subjective clinical balance assessment (via BESTest) was performed. Then objective measures of balance domains of Anticipatory Postural Adjustments (APAs) and Sensory Orientation were assessed using a force plate, with sway, velocity and the area of sway outcomes calculated. Correlations between the subjective and objective measures of balance were computed. Results: The anterior-posterior and the medio-lateral sway, sway velocity in the AP direction, and area of displacement were significantly different between the two groups (P<0.005). Significant correlations were found between the BESTest scores with anterior-posterior and medio-lateral sway, sway velocity in anterior-posterior direction, and area of displacement in anterior-posterior direction (p<0.005). Conclusions: Results indicated that the BESTest assessment tool has a high accuracy and sensitivity to assess balance function in PwMS. It can be used as an outcome measure to test postural balance disorders in these people.