Abstract
Background: To evaluate aspects of validity and feasibility of the Mini Balance Evaluation Systems Test (Mini-BESTest), for use in a specialized rehabilitation facility on a regular basis. Design: Descriptive cross-sectional study. Methods: A total of 29 physiotherapists (PT) tested 38 male and 21 female patients 20-76 years of age with spinal cord injury (n=20), traumatic brain injury (n=17), acquired brain injury (n=9), multiple trauma (n=6) and other neurological diagnosis (n=7). Dynamic balance was assessed with the Mini- BESTest. Fall history, fear of falling (single-item question), fall concerns (FES-I) and PT's evaluation of the Mini-BESTtest were surveyed by structured questionnaires. Pearson's correlation coefficient (Pearson's r) was used to determine the correlation between the total score for the Mini-BESTest and the total score for the FES-I. Results: The median score on the Mini-BESTest was 22 (1-28) points. There were no differences in Mini- BESTest score between fallers and non-fallers, between subjects with high or low fall concerns or between diagnostic groups. Patients with independent walking had a significantly better dynamic balance than those in need of assistance. The correlation between dynamic balance and fall concerns was low (r=- 0.388). The PTs experienced that the MiniBESTest was feasible for use in the rehabilitation setting. However, two testers should be present when testing patients with severe physical and /or cognitive impairments and the results should be supplemented with fall history, fall-related concerns, diagnosisspecific information, and data on activity limitations and participation restrictions. Conclusion: The Mini-BESTest proved to be a feasible clinical tool for assessing dynamic balance in specialized neurological rehabilitation with some precautions. The results apply primarily for patients with moderately impaired balance control.
Highlights
Within specialized rehabilitation facilities, patients are in need of complex rehabilitation following spinal cord injury, brain injury, stroke, multiple trauma, burns or other neurological diseases
There was no significant difference in MiniBESTest score between fallers and non-fallers (p=0.49), between patients afraid of falling and those not afraid of falling (p=0.43), or between diagnostic groups (p = 0.67)
A significant difference (p=
Summary
Patients are in need of complex rehabilitation following spinal cord injury, brain injury, stroke, multiple trauma, burns or other neurological diseases. Impaired balance control, increased risk of falling and further disability due to this, are common challenges for a large part of the patients. To improve balance control through a variety of rehabilitation actions, are important objectives and it is essential to use reliable, valid, clinically feasible and applicable assessment methods. The psychological impact of a fall may be considerable, leading to fear of falling, imposing constraints on functioning and activity, and increasing dependence on assistance and aids, limiting independence [2]. This is a concern in rehabilitation, fall prevention, assessment and training of balance control is important during rehabilitation. The objective of clinical testing of balance control is to assess the risk of falling, assess changes over time and to identify disorders in the different subsystems involved in balance control
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