Is the Brief-BESTest Brief Enough? Suggested Modifications Based on Structural Validity and Internal Consistency

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• The Brief Balance Evaluation Systems Test (Brief-BESTest) is a potential tool for balance assessment.
• Further clarification of its psychometric properties is needed, particularly in neurological populations.

Purpose of the Study:

• To evaluate the structural validity, convergent validity, discriminant validity, and internal consistency of the Brief-BESTest.
• To assess the Brief-BESTest's performance in neurological patients with balance disorders.

Main Methods:

• A cross-sectional study involving 416 neurological patients with balance disorders.
• Patients completed the Brief-BESTest, Activities-Specific Balance Confidence Scale (ABC 5-levels), and simple balance tests.
• Confirmatory factor analysis was used to assess structural validity, correlation analyses for convergent validity, and receiver operating characteristics for discriminant validity. Internal consistency was measured using Cronbach's alpha and coefficient omega.

Main Results:

• A modified model (model 3) of the Brief-BESTest demonstrated superior structural validity.
• The Brief-BESTest showed good convergent validity with the ABC 5-levels (Spearman ρ = 0.61).
• The modified Brief-BESTest exhibited acceptable accuracy in distinguishing fallers from non-fallers and demonstrated good internal consistency (Cronbach's α = 0.92, ω > 0.80 for model 3).

Conclusions:

• The Brief-BESTest, with specific modifications, is a valid and reliable tool for balance assessment in patients with various balance disorders.
• The refined Brief-BESTest offers improved utility for clinical evaluation of balance in neurological conditions.