TY - JOUR
T1 - Comparison of measurement properties of three shortened versions of the balance evaluation system test (BESTest) in people with subacute stroke
AU - Winairuk, Thitimard
AU - Pang, Marco Y.C.
AU - Saengsirisuwan, Vitoon
AU - Horak, Fay B.
AU - Boonsinsukh, Rumpa
N1 - Funding Information:
Funding: This study was supported by the Thailand Research Fund (grant number RSA5580002) and the National Research Council of Thailand (grant number 073/2560).
Publisher Copyright:
© 2019 Foundation of Rehabilitation Information.
PY - 2019
Y1 - 2019
N2 - Objectives: To examine the reliability, validity and responsiveness of 3 different short versions of the Balance Evaluation Systems Test (BESTest: SBESTest, Brief-BESTest and Mini-BESTest) in patients with subacute stroke. Design: A prospective cohort study. Participants: Patients with subacute stroke. Methods: Patients were assessed using the full BESTest. Scores of 3 short-form BESTests were later extracted. The intra-rater and inter-rater reliability (n = 12) were gathered from 5 raters. Concurrent validity was assessed with the Berg Balance Scale (BBS). Floor/ceiling effect, internal responsiveness and external responsiveness with the BBS (n = 70) were assessed at baseline, 2 weeks and 4 weeks post-rehabilitation. Results and conclusion: All short-form BESTests demonstrated excellent intra-rater and inter-rater reliability (intraclass correlation coefficient (ICC) = 0.95-0.99) and excellent concurrent validity (r = 0.93-0.96). Unlike the Brief-BESTest and Mini-BESTest, the S-BESTest and BESTest had no significant foor/ceiling effects (< 20%). The standardized response mean of all 4 BESTest versions were large, ranging between 1.19 and 1.57, indicating sufficient internal responsiveness. The area under the curve of the S-BESTest and BESTest were significantly higher than the Brief-BESTest and Mini-BESTest, reflecting better accuracy of the S-BESTest and BESTest in identifying patients with subacute stroke who had balance improvement using the minimal clinically important difference of 6 and 16 points, respectively. These findings suggest that the S-BESTest is a short-form BESTest that is appropriate for assessing balance impairments in patients with subacute stroke.
AB - Objectives: To examine the reliability, validity and responsiveness of 3 different short versions of the Balance Evaluation Systems Test (BESTest: SBESTest, Brief-BESTest and Mini-BESTest) in patients with subacute stroke. Design: A prospective cohort study. Participants: Patients with subacute stroke. Methods: Patients were assessed using the full BESTest. Scores of 3 short-form BESTests were later extracted. The intra-rater and inter-rater reliability (n = 12) were gathered from 5 raters. Concurrent validity was assessed with the Berg Balance Scale (BBS). Floor/ceiling effect, internal responsiveness and external responsiveness with the BBS (n = 70) were assessed at baseline, 2 weeks and 4 weeks post-rehabilitation. Results and conclusion: All short-form BESTests demonstrated excellent intra-rater and inter-rater reliability (intraclass correlation coefficient (ICC) = 0.95-0.99) and excellent concurrent validity (r = 0.93-0.96). Unlike the Brief-BESTest and Mini-BESTest, the S-BESTest and BESTest had no significant foor/ceiling effects (< 20%). The standardized response mean of all 4 BESTest versions were large, ranging between 1.19 and 1.57, indicating sufficient internal responsiveness. The area under the curve of the S-BESTest and BESTest were significantly higher than the Brief-BESTest and Mini-BESTest, reflecting better accuracy of the S-BESTest and BESTest in identifying patients with subacute stroke who had balance improvement using the minimal clinically important difference of 6 and 16 points, respectively. These findings suggest that the S-BESTest is a short-form BESTest that is appropriate for assessing balance impairments in patients with subacute stroke.
KW - Cerebrovascular disease
KW - Minimal clinically important difference
KW - Patient-reported outcome measures
KW - Physical therapist
KW - Postural balance
KW - Psychometric
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U2 - 10.2340/16501977-2589
DO - 10.2340/16501977-2589
M3 - Article
C2 - 31448806
AN - SCOPUS:85072943456
VL - 51
SP - 683
EP - 691
JO - Journal of Rehabilitation Medicine
JF - Journal of Rehabilitation Medicine
SN - 1650-1977
IS - 9
ER -