Quantifying balance control after spinal cord injury: Reliability and validity of the mini-BESTest

Context/Objective: Incomplete spinal cord injury (iSCI) causes deficits in balance control. The Mini-Balance Evaluation Systems Test (mini-BESTest) is a comprehensive measure; however, further testing of its psychometric properties among the iSCI population is needed. We evaluated the mini-BESTest's test-retest reliability, and concurrent and convergent validity among individuals living with iSCI for more than one year. Design: Cross-sectional study. Setting: Rehabilitation hospital. Participants: Twenty-one individuals with chronic motor iSCI (14 females, mean age 56.8 ± 14.0 years). Interventions: None. Outcome Measures: Participants completed the mini-BESTest at two sessions spaced two weeks apart. At the second session, participants performed tests of lower extremity muscle strength and quiet standing on a force platform with eyes opened (EO) and eyes closed (EC). Intraclass correlation coefficients (ICC) evaluated test-retest reliability. To evaluate concurrent and convergent validity, Pearson's correlation coefficient (r) quantified relationships between mini-BESTest scores and measures of center of pressure (COP) velocity during EO and EC standing, and lower extremity muscle strength, respectively. Results: Test-retest reliability of the mini-BESTest total score and sub-scale scores were high (ICC = 0.94-0.98). Mini-BESTest scores were inversely correlated with COP velocity when standing with EO (r = 0.54-0.71, P < 0.05), but not with EC. Lower extremity strength correlated strongly with mini-BESTest total scores (r = 0.73, P < 0.001). Conclusion: The mini-BESTest has high test-retest reliability, and concurrent and convergent validity in individuals with chronic iSCI.