Citation

Marques A, Almeida S, Carvalho J, Cruz J, Oliveira A, Jácome C. Arch. Phys. Med. Rehabil. 2016; 97(12): 2166-2173.e1.

Affiliation

Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal.

Copyright

(Copyright © 2016, Elsevier Publishing)

DOI

10.1016/j.apmr.2016.07.011

PMID

27497826

Abstract

OBJECTIVE: The reliability, validity and ability to identify fall status of the Balance Evaluation Systems Test (BESTest), Mini-BESTest and Brief-BESTest with the Berg Balance Scale (BBS) in older people living in the community was assessed.

DESIGN: Cross-sectional. SETTING: Community centers. PARTICIPANTS: 122 older adults (76±9 years) participated. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Participants reported on falls history in the preceding year and completed the Activities-specific Balance Confidence (ABC) Scale. BBS, BESTest and the Five times sit-to-stand test were administered. Interrater (two physiotherapists) and test-retest relative (48-72h) and absolute reliability were explored with the Intraclass correlation coefficient (ICC) equation (2,1) and the Bland and Altman method. Minimal detectable changes at the 95% confidence level (MDC95) were established. Validity was assessed by correlating the balance tests with each other and with the ABC Scale (Spearman correlation coefficients - rho). Receiver operating characteristics assessed the ability of each balance test to differentiate between people with and without a history of falls.

RESULTS: All balance tests presented good to excellent interrater (ICC 0.71-0.93) and test-retest (ICC 0.50-0.82) relative reliability, with no evidence of bias. MDC95 values were 4.6, 9, 3.8 and 4.1 points for the BBS, BESTest, Mini-BESTest and Brief-BESTest, respectively. All tests were significantly correlated with each other (rho=0.83-0.96) and with the ABC Scale (rho=0.46-0.61). Acceptable ability to identify fall status (areas under the curve 0.71-0.78) was found for all tests. Cut-off points were 48.5, 82, 19.5 and 12.5 points for BBS, BESTest, Mini-BESTest and Brief-BESTest, respectively.

CONCLUSIONS: All balance tests are reliable, valid and able to identify fall status in older people living in the community therefore, the choice of which test to use will depend on the level of balance impairment, purpose and time availability.

Copyright © 2016. Published by Elsevier Inc.

Language: en