Test-Retest Reliability, Validity, and Minimal Detectable Change of the Balance Evaluation Systems Test to Assess...

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Individuals with multiple sclerosis (MS) experience balance deficits leading to falls.
• Existing balance tests for older adults are insufficient for differentiating fallers from non-fallers with MS.
• The Balance Evaluation Systems Test (BESTest) assesses body systems contributing to imbalance and fall risk.

Purpose of the Study:

• Evaluate the test-retest reliability and construct validity of the BESTest for assessing balance in individuals with MS.
• Compare the diagnostic accuracy of the BESTest and Berg Balance Scale (BBS) in identifying fallers.
• Determine the minimal detectable change (MDC) of the BESTest in the MS population.

Main Methods:

• Twenty individuals with MS were recruited, with data collected on age, disease onset, and fall history.
• Participants completed the Expanded Disability Status Scale, University of Illinois at Chicago Fear of Falling Measure, BESTest, and BBS.
• Twelve participants underwent retesting to establish the BESTest's test-retest reliability.

Main Results:

• The BESTest exhibited strong test-retest reliability (ICC [3,1] = 0.98, P = .01) and high correlation with the BBS (r = 0.94, P = .01).
• The BBS showed poor accuracy in identifying fallers.
• The BESTest demonstrated moderate sensitivity (0.89) for identifying fallers with a cutoff score of 81%.
• The MDC for the BESTest was determined to be approximately 9.7% to 11.5%.

Conclusions:

• The BESTest is a reliable and valid tool for measuring functional balance in individuals with moderate MS.
• The BESTest offers superior diagnostic utility compared to the BBS for identifying fall risk in MS.
• A change of at least 10% in BESTest score suggests a genuine alteration in balance performance for individuals with MS.