Reliability, validity and minimal detectable change of the Mini-BESTest in Greek participants with chronic stroke

This study aimed to investigate the psychometric characteristics of reliability, validity and ability to detect change of a newly developed balance assessment tool, the Mini-BESTest, in Greek patients with stroke.

A prospective, observational design study with test-retest measures was conducted.

A convenience sample of 21 Greek patients with chronic stroke (14 male, 7 female; age of 63 ± 16 years) was recruited. Two independent examiners administered the scale, for the inter-rater reliability, twice within 10 days for the test-retest reliability. Bland Altman Analysis for repeated measures assessed the absolute reliability and the Standard Error of Measurement (SEM) and the Minimum Detectable Change at 95% confidence interval (MDC_95%) were established. The Greek Mini-BESTest (Mini-BESTest_GR) was correlated with the Greek Berg Balance Scale (BBS_GR) for assessing the concurrent validity and with the Timed Up and Go (TUG), the Functional Reach Test (FRT) and the Greek Falls Efficacy Scale-International (FES-I_GR) for the convergent validity.

The Mini-BESTestGR demonstrated excellent inter-rater reliability (ICC (95%CI) = 0.997 (0.995-0.999, SEM = 0.46) with the scores of two raters within the limits of agreement (mean_dif = -0.143 ± 0.727, p > 0.05) and test-retest reliability (ICC (95%CI) = 0.966 (0.926-0.988), SEM = 1.53). Additionally, the Mini-BESTest_GR yielded very strong to moderate correlations with BBS_GR (r = 0.924, p < 0.001), TUG (r = -0.823, p < 0.001), FES-I_GR (r = -0.734, p < 0.001) and FRT (r = 0.689, p < 0.001). MDC₉₅ was 4.25 points.

The exceptionally high reliability and the equally good validity of the Mini-BESTest_GR, strongly support its utility in Greek people with chronic stroke. Its ability to identify clinically meaningful changes and falls risk need further investigation.