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Published on: December 16, 2022
Diagnostic and prognostic accuracy of Berg Balance Scale and Mini-Balance Evaluation Systems Test in individuals with
Sota Kobayashi1,2, Tomohiko Kamo3, Hirofumi Ogihara4
1Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Niigata, Japan.
Background:
Cutoff values for the Berg Balance Scale (BBS) and the Mini-Balance Evaluation Systems Test (Mini-BESTest) are available, but the recommendation for each reference standard is unclear.
Purpose:
To investigate the diagnostic and prognostic accuracy of the BBS and the Mini-BESTest cutoff values for each reference standard in individuals with stroke.
Material And Methods:
A systematic search was conducted of 6 databases and the reference list of included articles through December 24, 2025. We included the diagnostic and predictive accuracy studies reporting cutoff values and the sensitivity and specificity of the BBS or Mini-BESTest in individuals with stroke, across all the reported reference standards. Two reviewers independently extracted data from the included studies and assessed quality assessment using the QUADAS-2 tool. Meta-analysis was performed for reference standards with ≥2 studies.
Results:
Fifty-five studies involving 6865 participants were included. The studies used 23 different reference standards. A high risk of bias was identified in 48 studies. For diagnosis of independent walking, the BBS showed higher accuracy (area under the curve [AUC] 0.917, sensitivity 88.0%, specificity 85.1%) than the Mini-BESTest (AUC 0.790, sensitivity 73.6%, specificity 80.2%). For community ambulation, the Mini-BESTest showed higher accuracy (AUC 0.882, sensitivity 80.0%, specificity 83.4%) than the BBS (AUC 0.844, sensitivity 81.4%, specificity 74.6%). For the prediction of independent walking, the BBS showed higher accuracy (AUC 0.858, sensitivity 77.8%, specificity 80.5%), whereas the Mini-BESTest was not analyzed because only one study was available. For the prediction of falling, the BBS showed moderate accuracy (AUC 0.704, sensitivity 61.8%, specificity 71.1%), whereas the Mini-BESTest was not analyzed because only one study was available.
Conclusions:
The BBS showed good accuracy for diagnosing and predicting walking independence, although most studies were at high risk of bias. Clinicians may consider selecting between the BBS and Mini-BESTest according to the outcome of interest.
