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Assessing Balance Function in Patients With Total Knee Arthroplasty.
Andy C M Chan1, Marco Y C Pang2
1A.C.M. Chan, MSc, Physiotherapy Department, Hong Kong Buddhist Hospital, 10 Heng Lam St, Lok Fu Kowloon, Hong Kong. cccmz01@ha.org.hk.
Physical Therapy
|April 18, 2015
Summary
The Balance Evaluation Systems Test (BESTest) and its shorter versions, Mini-BESTest and Brief-BESTest, show excellent reliability and validity for assessing balance in total knee arthroplasty (TKA) patients. The Brief-BESTest is recommended for clinical use due to its efficiency.
Area of Science:
- Rehabilitation Medicine
- Orthopedics
- Biomedical Engineering
Background:
- The Balance Evaluation Systems Test (BESTest) is a comprehensive balance assessment tool.
- Recently developed Mini-BESTest and Brief-BESTest offer shorter alternatives.
- Evaluating balance is crucial for patients undergoing total knee arthroplasty (TKA).
Purpose of the Study:
- To assess the interrater and intrarater-interoccasion reliability, internal consistency, and validity of the BESTest, Mini-BESTest, and Brief-BESTest.
- To compare these measures with the Berg Balance Scale (BBS), Functional Gait Assessment (FGA), and Activities-specific Balance Confidence (ABC) Scale.
- To examine floor and ceiling effects of the BESTest family of measures in TKA patients.
Main Methods:
- An observational measurement study design was employed.
- Interrater reliability was established using three independent raters for 25 TKA participants.
- Intrarater-interoccasion reliability, internal consistency, and validity were assessed in larger cohorts of TKA patients using established psychometric methods.
Main Results:
- The BESTest, Mini-BESTest, and Brief-BESTest demonstrated excellent interrater reliability (ICC=.96-.99) and intrarater-interoccasion reliability (ICC=.92-.96).
- Internal consistency was high (Cronbach alpha=.96-.98), comparable to BBS and FGA.
- Moderate-to-strong correlations (r=.35-.81) with BBS, FGA, and ABC confirmed good concurrent and convergent validity, with no significant floor/ceiling effects noted for BESTest versions.
Conclusions:
- The BESTest, Mini-BESTest, and Brief-BESTest are reliable and valid tools for balance assessment in TKA patients.
- The Brief-BESTest is particularly noted for its time efficiency, making it potentially more suitable for clinical settings.
- Findings are generalizable specifically to patients with end-stage knee osteoarthritis undergoing TKA.
