Using psychometric techniques to improve the Balance Evaluation Systems Test: the mini-BESTest

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Psychometrics

Background:

• The Balance Evaluation Systems Test (BESTest) is a comprehensive tool for assessing postural control systems contributing to functional balance deficits in adults.
• Existing tools may require significant time for administration and analysis, potentially limiting their clinical utility.
• Psychometric refinement is crucial for developing accurate and efficient balance assessment tools.

Purpose of the Study:

• To enhance the Balance Evaluation Systems Test (BESTest) through rigorous psychometric analysis.
• To develop a more concise and clinically feasible measurement tool for dynamic balance.
• To improve the assessment of postural control in adult neurological populations.

Main Methods:

• A convenience sample of 115 adult patients with various neurological conditions and balance disorders was recruited.
• Exploratory and confirmatory factor analyses were employed to identify key items related to dynamic balance.
• Rasch analysis was utilized to refine rating scales and remove non-fitting items, leading to a reduced item set.

Main Results:

• Factor analysis identified 24 items from the original 36 that best represented the construct of dynamic balance.
• Rasch analysis further reduced the scale by removing 10 items and improving rating categories, resulting in a 14-item scale.
• Confirmatory factor analysis validated the final 14-item model, meeting modern measurement standards.

Conclusions:

• A new 14-item scale, the mini-BESTest, was developed, focusing on dynamic balance assessment.
• The mini-BESTest can be administered in 10-15 minutes and comprises items from four sections of the original BESTest.
• Further research is recommended to validate the clinical utility and application of the mini-BESTest in diverse patient populations.