Interrater and test-retest reliability and validity of the Norwegian version of the BESTest and mini-BESTest in people with increased risk of falling

Charlotta Hamre,Pernille Botolfsen,Jorunn L Helbostad,Gro Gujord Tangen

doi:10.1186/s12877-017-0480-x

Abstract

BackgroundThe Balance Evaluation Systems Test (BESTest) was developed to assess underlying systems for balance control in order to be able to individually tailor rehabilitation interventions to people with balance disorders. A short form, the Mini-BESTest, was developed as a screening test. The study aimed to assess interrater and test-retest reliability of the Norwegian version of the BESTest and the Mini-BESTest in community-dwelling people with increased risk of falling and to assess concurrent validity with the Fall Efficacy Scale-International (FES-I), and it was an observational study with a cross-sectional design.MethodsForty-two persons with increased risk of falling (elderly over 65 years of age, persons with a history of stroke or Multiple Sclerosis) were assessed twice by two raters. Relative reliability was analysed with Intraclass Correlation Coefficient (ICC), and absolute reliability with standard error of measurement (SEM) and smallest detectable change (SDC). Concurrent validity was assessed against the FES-I using Spearman’s rho.ResultsThe BESTest showed very good interrater reliability (ICC = 0.98, SEM = 1.79, SDC95 = 5.0) and test-retest reliability (rater A/rater B = ICC = 0.89/0.89, SEM = 3.9/4.3, SDC95 = 10.8/11.8). The Mini-BESTest also showed very good interrater reliability (ICC = 0.95, SEM = 1.19, SDC95 = 3.3) and test-retest reliability (rater A/rater B = ICC = 0.85/0.84, SEM = 1.8/1.9, SDC95 = 4.9/5.2). The correlations were moderate between the FES-I and both the BESTest and the Mini-BESTest (Spearman’s rho −0.51 and-0.50, p < 0.01).ConclusionThe BESTest and its short form, the Mini-BESTest, showed very good interrater and test-retest reliability when assessed in a heterogeneous sample of people with increased risk of falling. The concurrent validity measured against the FES-I showed moderate correlation. The results are comparable with earlier studies and indicate that the Norwegian versions can be used in daily clinic and in research.

Highlights

The Balance Evaluation Systems Test (BESTest) was developed to assess underlying systems for balance control in order to be able to individually tailor rehabilitation interventions to people with balance disorders
Outcome measures based on a systems approach for motor control are more helpful when the purpose of the assessment is to determine the underlying causes of the balance deficit [9]
Descriptive statistics A sample of 42 community-dwelling people, 28 women, and 15 men participated; elderly persons (n = 20), persons diagnosed with stroke (n = 12) and persons with Multiple Sclerosis (MS) (n = 10)

Summary

Introduction

The Balance Evaluation Systems Test (BESTest) was developed to assess underlying systems for balance control in order to be able to individually tailor rehabilitation interventions to people with balance disorders. Outcome measures based on a systems approach for motor control are more helpful when the purpose of the assessment is to determine the underlying causes of the balance deficit [9]. The Balance Evaluation Systems Test (BESTest) was developed to assess and to differentiate between 6 underlying balance systems contributing to balance control using a “systems model of motor control” as the theoretical framework [2]. It is divided into 6 sections; I. The Mini-BESTest contains items from 4 of the 6 sections from the BESTest (sections III, IV, V and VI)

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