Reliability and validity of the BESTest and MiniBESTest in chronic hemiparesis
DOI:
https://doi.org/10.34024/rnc.2015.v23.8044Keywords:
Postural Balance, Disability Evaluation, Paresis, stroke, PsychometricsAbstract
Objective. To evaluate the reliability and construct validity of the Brazilian versions of the BESTest and MiniBESTest in chronic hemiparesis. Method. The test-retest and interrater reliability were assessed using the weighted kappa coefficient. The Rasch model was used for analysis of construct validity in 40 hemiparetic subjects (58.8±12.8years). Results. Moderate to almost perfect agreement was observed for the BESTest for test-retest and interrater (0.48≤Kw≤1.0; p<0.05). Strong to almost perfect agreement was observed for MiniBESTest for test-retest and interrater reliability (0.62≤Kw≤1.0; p<0.05). The items of the BESTest and MiniBESTest divided people in about three skill levels. The individuals and items stability measurement ranged from 0.89 to 0.96 for the instruments. In BESTest, the most difficult item was “sit on the floor and stand up” and in MiniBESTest “compensatory stepping correction lateral to the right.” The easier item for both instruments was “stand up on firm surface, eyes open.” The level of difficulty of the items of both instruments was appropriate for the skill level of individuals. Two items of the BESTest were erratic. In MiniBESTest were not observed erratic items. Conclusion. The Brazilian versions of the BESTtest and MiniBESTest are reliable and have adequate construct validity to evaluate balance in chronic hemiparetic individuals. It is recommended, however, caution in interpreting the total score of the BESTest.
Metrics
References
Horak FB, Wrisley DM, Frank J. The Balance Evaluation Systems Test (BESTest) to differentiate balance deficits. Phys Ther 2009;89:484-98. http://dx.doi.org/10.2522/ptj.20080071
Mancini M, Horak FB. The relevance of clinical balance assessment tools to diferenciate balance deficits. Eur J Phys Rehabil Med 2010;46:239-48.
Campbell GB, Matthews JT. An integrative review of factors associated with falls during post-stroke rehabilitation. J Nurs Scholarsh 2010;42:395-404. http://dx.doi.org/10.1111/j.1547-5069.2010.01369.x
Schmid AA, Rittman M. Consequences of poststroke falls: activity limitation, increased dependence, and the development of fear of falling. Am J OccupTher 2009;63:310-6. http://dx.doi.org/10.5014/ajot.63.3.310
Fryberg GE, Lindmark B, Lanshammar H, Borg J. Correlation between clinicalassesment and force plate measurement of postural control after stroke. J Rehabil Med 2007;39:448-53. http://dx.doi.org/10.2340/16501977-0071
Blum L, Korner-Bitensky N. Usefulness of the Berg Balance Scale in stroke rehabilitation: A sistematic review. Phys Ther 2008;88:559-66. http://dx.doi.org/10.2522/ptj.20070205
Franchignoni F, Horak F, Godi M, Nardone A, Giordano A. Using psychometric techniques to improve the Balance Evaluation Systems Test: the mini-BESTest. J Rehabil Med 2010;42:323-31. http://dx.doi.org/10.2340/16501977-0537
Leddy AL, Crowner BE, Earhart GM. Utility of the Mini-BESTest, BESTest, and BESTest sections for balance assessments in individuals with Parkinson disease. J Neurol Phys Ther 2011;35:90-7. http://dx.doi.org/10.1097/NPT.0b013e31821a620c
Parminder K, Padgett JV, Jacobs, SLK. Is the BESTest at its best? A suggested briefversion based on interrater reliability, validity, internal consistency, and theoretical construct. Phys Ther 2012;92:1197-207. http://dx.doi.org/10.2522/ptj.20120056
Maia AC, Rodrigues-de-Paula F, Magalhães LC, Teixeira RL. Cross-cultural adaptation and analysis of psychometric properties of the Balance Evaluation Systems Test and MiniBESTest in the elderly and individuals with Parkinson’s disease: application of the Rasch model. Braz J Phys Ther 2013;17:195-217. http://dx.doi.org/10.1590/S1413-35552012005000085
Portney LG, Watkins MP. Foundations of Clinical Research: Applications to Practice. 2ed. New Jersey: Prentice Hall Health, 2000, 742p.
Velozo CA, Forsyth K, Kielhofner G. Objective measurement: the influence of item response theory on research and practice. In: Kielhofner G. Research in Occupational Therapy: Methods of Inquiry for13.Linacre JM. Sample size and item calibration stability. Rasch Meas Trans 1994;7:328.
Linacre JM. Optimizing rating scale category effectiveness. J Appl Meas 2002;3:85-106.
Saliba VA, Faria CD, Laurentino GE, Cassiano JG, Teixeira-Salmela LF. Adaptação transcultural e análise das propriedades psicométricas da versão brasileira do instrumento Motor Activity Log. Rev Panam Salud Pub 2011;30:262-71. http://dx.doi.org/10.1590/S1020-49892011000900011
Neckel N, Pelliccio M, Nichols D, Hidler J. Quantification of functional weakness and abnormal synergy patterns in the lower limb of individuals with chronic stroke. J Neuroeng Rehabil 2006;3:1-11. http://dx.doi.org/10.1186/1743-0003-3-17
Teixeira-Salmela LF, Devaraj R, Olney SJ. Validation of the human activity profile instroke: a comparison of observed, proxy and self-reported scores. Disabil Rehabil 2007;29:1518-24. http://dx.doi.org/10.1080/09638280601055733
Centers for Disease Control and Prevention. Physical activity trends - United States, 1990 -1998. Morbidity and Mortality Weekly Report (MMWR) 2001;50:166-9.
Michaelsen SM, Rocha AS, Knabben RJ, Rodrigues LP, Fernandes CGC. Tradução, adaptação e confiabilidade interexaminadores do manual de administração da escala de Fugl-Meyer. Braz J Phys Ther 2011;15:80-8.
Sim J, Wright CC. The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther 2005;85:257-68.
Linacre JM, Wright BD (Endereço na Internet). Winsteps Rasch Measurement Version 3.74.0 (Software). Disponível em: http://www.winsteps.com
Chen HF, Wu CY, Lin KC, Chen HC, Chen CP, Chen CK. Rasch validation of the Streamlined Wolf Motor Function Test in people with chronic
