Preliminary Validation of a Short Version of the Balance Evaluation Systems Test in Cancer Survivors Living in the Community

Abstract

Background: The utilization of standardized outcomes measures is essential in evidence-based practice. Balance impairments are common sequelae associated with cancer. There is a lack of evidence supporting the psychometric properties of balance tests in cancer survivors. Balance Evaluation Systems Test (BESTest) is a comprehensive tool for balance, but its length limits its utility in clinical settings. Purpose: This study's aim was to develop and validate a short version of the BESTest in cancer survivors. Methods: This was a cross-sectional study conducted at a university-based laboratory. Forty-three cancer survivors (age = 66.7 ± 8.55 years) living in the community and without a neurologic diagnosis participated. The BESTest and the Activity-specific Balance Confidence (ABC) scale were administered. The Cronbach α and item-total correlations were calculated for the BESTest to identify each item's contribution to the total score and to create a new test (BESTest-6). Spearman correlations examined concurrent validity of the BESTest, BESTest-6, ABC scale, and ABC-6. Results: Six items from the BESTest with the highest item-total correlations, hip/trunk lateral strength, lateral functional reach, single-leg stance, backward compensatory stepping, standing on foam eyes closed, and Timed Up and Go, were included in the BESTest-6. Scores of the BESTest-6 correlated significantly with those of the BESTest, ABC scale, and ABC-6 (P < .05). Discussion and Conclusion: The BESTest-6 demonstrated good-excellent concurrent validity with the BESTest and ABC-6 in community-dwelling cancer survivors 55 years or older. Each item in the BESTest-6 represents a different category of balance skills. Assessment of balance using the BESTest-6 can assist clinicians in developing a plan of care that targets specific balance impairments.