Responsiveness of the Mini-Balance Evaluation System Test in Type 2 Diabetic Patients with Peripheral Neuropathy

Area of Science:

• Neurology
• Gerontology
• Physical Therapy

Background:

• Balance impairment is a significant concern for individuals with type 2 diabetes and peripheral neuropathy.
• The Mini-BESTest is a tool for balance assessment, but its responsiveness in this specific patient group requires further investigation.
• Limited literature exists on the Mini-BESTest's utility in type 2 diabetic patients experiencing peripheral neuropathy.

Purpose of the Study:

• To evaluate the responsiveness of the Mini-BESTest in type 2 diabetic patients with peripheral neuropathy.
• To determine the minimal important change (MIC) of the Mini-BESTest after a four-week balance exercise program.
• To establish the clinical utility of the Mini-BESTest as an outcome measure for this population.

Main Methods:

• A prospective, single-group, pretest-posttest design was employed.
• Forty-eight participants with type 2 diabetes and peripheral neuropathy underwent a four-week intervention of foot care and balance exercises.
• Responsiveness was assessed using distribution-based (effect size, standard response mean, SEM, MDC95) and anchor-based (Global Rating of Change scale) methods.

Main Results:

• Mini-BESTest scores significantly improved post-intervention (p < 0.001), demonstrating high responsiveness.
• Key metrics included an effect size of 3.9, a standard response mean of 4.32, SEM of 0.73, and MDC95 of 2.03 points.
• A cutoff score of ≥5 points on the Mini-BESTest effectively discriminated between improved and non-improved participants.

Conclusions:

• The Mini-BESTest exhibits high responsiveness in type 2 diabetic patients with peripheral neuropathy, supported by both distribution- and anchor-based methods.
• A minimal important change of ≥5 points is proposed for the Mini-BESTest.
• The Mini-BESTest is a valuable outcome measure for evaluating balance improvements in this patient cohort.