Citation

Chinsongkram B, Chaikeeree N, Saengsirisuwan V, Viriyatharakij N, Horak FB, Boonsinsukh R. Phys. Ther. 2014; 94(11): 1632-1643.

Affiliation

R. Boonsinsukh, PhD, Division of Physical Therapy, Faculty of Health Science, Srinakharinwirot University, 63 moo 7 Rungsit-Nakhonnayok, Ongkharuk, Nakhon Nayok, 26120.

Copyright

(Copyright © 2014, American Physical Therapy Association)

DOI

10.2522/ptj.20130558

PMID

24925073

Abstract

BACKGROUND: The Balance Evaluation Systems Test (BESTest) is new clinical balance assessment tool but it has never been validated in patients with subacute stroke.

OBJECTIVE: To examine the reliability and validity of the BESTest in patients with subacute stroke.

DESIGN: An observational reliability and validity study.

METHODS: Twelve patients participated in the interrater and intrarater reliability study. The convergent validity was studied in seventy patients using the Berg Balance Scale (BBS), Postural Assessment Scale for Stroke (PASS), Community Balance and Mobility Scale (CB&M) and Mini-BESTest as the references. The Receiver Operating Characteristics curve was used to calculate the sensitivity, specificity and accuracy of the scale in classifying patients into low (LFA) and high functional ability level (HFA) based on the Fugl- Meyer Assessment motor subscale.

RESULTS: The BESTest showed excellent intrarater reliability and interrater reliability (ICC = 0.99) and was highly correlated with the BBS (Spearman Rank r=0.96), PASS (r=0.96), CB&M (r=0.91) and Mini-BESTest (r=0.96), indicating excellent convergent validity. No floor and ceiling effects were observed with the BESTest. In contrast, the Mini-BESTest and CB&M had a floor effect in the LFA group, and the BBS and PASS demonstrated responsive ceiling effects in HFA. In addition, the BESTest showed high accuracy as the BBS and Mini-BESTest in separating patients into HFA and LFA group. LIMITATION: Unknown generalization to patients with chronic stroke.

CONCLUSION: The BESTest is reliable, valid, and sensitive and specific in assessing balance in persons with subacute stroke across all levels of functional disability.

Language: en