Reliability and validity of the Balance Evaluation Systems Test (BESTest) in people with subacute stroke

Butsara Chinsongkram, Nithinun Chaikeeree, Vitoon Saengsirisuwan, Nitaya Viriyatharakij, Fay Horak, Rumpa Boonsinsukh

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background. The Balance Evaluation Systems Test (BESTest) is a new clinical balance assessment tool, but it has never been validated in patients with subacute stroke.

Objective. The purpose of this study was to examine the reliability and validity of the BESTest in patients with subacute stroke.

Design. This was an observational reliability and validity study.

Methods. Twelve patients participated in the interrater and intrarater reliability study. Convergent validity was investigated in 70 patients using the Berg Balance Scale (BBS), Postural Assessment Scale for Stroke (PASS), Community Balance and Mobility Scale (CB&M), and Mini-BESTest. The receiver operating characteristic curve was used to calculate the sensitivity, specificity, and accuracy of the BESTest, Mini- BESTest, and BBS in classifying participants into low functional ability (LFA) and high functional ability (HFA) groups based on Fugl-Meyer Assessment motor subscale scores.

Results. The BESTest showed excellent intrarater reliability and interrater reliability (intraclass correlation coefficient=.99) and was highly correlated with the BBS (Spearman r=.96), PASS (r=.96), CB&M (r=.91), and Mini-BESTest (r=.96), indicating excellent convergent validity. No floor or ceiling effects were observed with the BESTest. In contrast, the Mini-BESTest and CB&M had a floor effect in the LFA group, and the BBS and PASS demonstrated responsive ceiling effects in the HFA group. In addition, the BESTest showed high accuracy as the BBS and Mini-BESTest in separating participants into HFA and LFA groups.

Limitation. Whether the results are generalizable to patients with chronic stroke is unknown.

Conclusion. The BESTest is reliable, valid, sensitive, and specific in assessing balance in people with subacute stroke across all levels of functional disability.

Original languageEnglish (US)
Pages (from-to)1632-1643
Number of pages12
JournalPhysical Therapy
Volume94
Issue number11
DOIs
StatePublished - Nov 1 2014

Fingerprint

Reproducibility of Results
Stroke
Postural Balance
ROC Curve
Sensitivity and Specificity

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Medicine(all)

Cite this

Chinsongkram, B., Chaikeeree, N., Saengsirisuwan, V., Viriyatharakij, N., Horak, F., & Boonsinsukh, R. (2014). Reliability and validity of the Balance Evaluation Systems Test (BESTest) in people with subacute stroke. Physical Therapy, 94(11), 1632-1643. https://doi.org/10.2522/ptj.20130558

Reliability and validity of the Balance Evaluation Systems Test (BESTest) in people with subacute stroke. / Chinsongkram, Butsara; Chaikeeree, Nithinun; Saengsirisuwan, Vitoon; Viriyatharakij, Nitaya; Horak, Fay; Boonsinsukh, Rumpa.

In: Physical Therapy, Vol. 94, No. 11, 01.11.2014, p. 1632-1643.

Research output: Contribution to journalArticle

Chinsongkram, B, Chaikeeree, N, Saengsirisuwan, V, Viriyatharakij, N, Horak, F & Boonsinsukh, R 2014, 'Reliability and validity of the Balance Evaluation Systems Test (BESTest) in people with subacute stroke', Physical Therapy, vol. 94, no. 11, pp. 1632-1643. https://doi.org/10.2522/ptj.20130558
Chinsongkram B, Chaikeeree N, Saengsirisuwan V, Viriyatharakij N, Horak F, Boonsinsukh R. Reliability and validity of the Balance Evaluation Systems Test (BESTest) in people with subacute stroke. Physical Therapy. 2014 Nov 1;94(11):1632-1643. https://doi.org/10.2522/ptj.20130558
Chinsongkram, Butsara ; Chaikeeree, Nithinun ; Saengsirisuwan, Vitoon ; Viriyatharakij, Nitaya ; Horak, Fay ; Boonsinsukh, Rumpa. / Reliability and validity of the Balance Evaluation Systems Test (BESTest) in people with subacute stroke. In: Physical Therapy. 2014 ; Vol. 94, No. 11. pp. 1632-1643.
@article{6a8072072ef44fbb9809b7b83d592481,
title = "Reliability and validity of the Balance Evaluation Systems Test (BESTest) in people with subacute stroke",
abstract = "Background. The Balance Evaluation Systems Test (BESTest) is a new clinical balance assessment tool, but it has never been validated in patients with subacute stroke.Objective. The purpose of this study was to examine the reliability and validity of the BESTest in patients with subacute stroke.Design. This was an observational reliability and validity study.Methods. Twelve patients participated in the interrater and intrarater reliability study. Convergent validity was investigated in 70 patients using the Berg Balance Scale (BBS), Postural Assessment Scale for Stroke (PASS), Community Balance and Mobility Scale (CB&M), and Mini-BESTest. The receiver operating characteristic curve was used to calculate the sensitivity, specificity, and accuracy of the BESTest, Mini- BESTest, and BBS in classifying participants into low functional ability (LFA) and high functional ability (HFA) groups based on Fugl-Meyer Assessment motor subscale scores.Results. The BESTest showed excellent intrarater reliability and interrater reliability (intraclass correlation coefficient=.99) and was highly correlated with the BBS (Spearman r=.96), PASS (r=.96), CB&M (r=.91), and Mini-BESTest (r=.96), indicating excellent convergent validity. No floor or ceiling effects were observed with the BESTest. In contrast, the Mini-BESTest and CB&M had a floor effect in the LFA group, and the BBS and PASS demonstrated responsive ceiling effects in the HFA group. In addition, the BESTest showed high accuracy as the BBS and Mini-BESTest in separating participants into HFA and LFA groups.Limitation. Whether the results are generalizable to patients with chronic stroke is unknown.Conclusion. The BESTest is reliable, valid, sensitive, and specific in assessing balance in people with subacute stroke across all levels of functional disability.",
author = "Butsara Chinsongkram and Nithinun Chaikeeree and Vitoon Saengsirisuwan and Nitaya Viriyatharakij and Fay Horak and Rumpa Boonsinsukh",
year = "2014",
month = "11",
day = "1",
doi = "10.2522/ptj.20130558",
language = "English (US)",
volume = "94",
pages = "1632--1643",
journal = "Physical Therapy",
issn = "0031-9023",
publisher = "American Physical Therapy Association",
number = "11",

}

TY - JOUR

T1 - Reliability and validity of the Balance Evaluation Systems Test (BESTest) in people with subacute stroke

AU - Chinsongkram, Butsara

AU - Chaikeeree, Nithinun

AU - Saengsirisuwan, Vitoon

AU - Viriyatharakij, Nitaya

AU - Horak, Fay

AU - Boonsinsukh, Rumpa

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Background. The Balance Evaluation Systems Test (BESTest) is a new clinical balance assessment tool, but it has never been validated in patients with subacute stroke.Objective. The purpose of this study was to examine the reliability and validity of the BESTest in patients with subacute stroke.Design. This was an observational reliability and validity study.Methods. Twelve patients participated in the interrater and intrarater reliability study. Convergent validity was investigated in 70 patients using the Berg Balance Scale (BBS), Postural Assessment Scale for Stroke (PASS), Community Balance and Mobility Scale (CB&M), and Mini-BESTest. The receiver operating characteristic curve was used to calculate the sensitivity, specificity, and accuracy of the BESTest, Mini- BESTest, and BBS in classifying participants into low functional ability (LFA) and high functional ability (HFA) groups based on Fugl-Meyer Assessment motor subscale scores.Results. The BESTest showed excellent intrarater reliability and interrater reliability (intraclass correlation coefficient=.99) and was highly correlated with the BBS (Spearman r=.96), PASS (r=.96), CB&M (r=.91), and Mini-BESTest (r=.96), indicating excellent convergent validity. No floor or ceiling effects were observed with the BESTest. In contrast, the Mini-BESTest and CB&M had a floor effect in the LFA group, and the BBS and PASS demonstrated responsive ceiling effects in the HFA group. In addition, the BESTest showed high accuracy as the BBS and Mini-BESTest in separating participants into HFA and LFA groups.Limitation. Whether the results are generalizable to patients with chronic stroke is unknown.Conclusion. The BESTest is reliable, valid, sensitive, and specific in assessing balance in people with subacute stroke across all levels of functional disability.

AB - Background. The Balance Evaluation Systems Test (BESTest) is a new clinical balance assessment tool, but it has never been validated in patients with subacute stroke.Objective. The purpose of this study was to examine the reliability and validity of the BESTest in patients with subacute stroke.Design. This was an observational reliability and validity study.Methods. Twelve patients participated in the interrater and intrarater reliability study. Convergent validity was investigated in 70 patients using the Berg Balance Scale (BBS), Postural Assessment Scale for Stroke (PASS), Community Balance and Mobility Scale (CB&M), and Mini-BESTest. The receiver operating characteristic curve was used to calculate the sensitivity, specificity, and accuracy of the BESTest, Mini- BESTest, and BBS in classifying participants into low functional ability (LFA) and high functional ability (HFA) groups based on Fugl-Meyer Assessment motor subscale scores.Results. The BESTest showed excellent intrarater reliability and interrater reliability (intraclass correlation coefficient=.99) and was highly correlated with the BBS (Spearman r=.96), PASS (r=.96), CB&M (r=.91), and Mini-BESTest (r=.96), indicating excellent convergent validity. No floor or ceiling effects were observed with the BESTest. In contrast, the Mini-BESTest and CB&M had a floor effect in the LFA group, and the BBS and PASS demonstrated responsive ceiling effects in the HFA group. In addition, the BESTest showed high accuracy as the BBS and Mini-BESTest in separating participants into HFA and LFA groups.Limitation. Whether the results are generalizable to patients with chronic stroke is unknown.Conclusion. The BESTest is reliable, valid, sensitive, and specific in assessing balance in people with subacute stroke across all levels of functional disability.

UR - http://www.scopus.com/inward/record.url?scp=84908408867&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84908408867&partnerID=8YFLogxK

U2 - 10.2522/ptj.20130558

DO - 10.2522/ptj.20130558

M3 - Article

C2 - 24925073

AN - SCOPUS:84908408867

VL - 94

SP - 1632

EP - 1643

JO - Physical Therapy

JF - Physical Therapy

SN - 0031-9023

IS - 11

ER -