Comparison of measurement properties of three shortened versions of the balance evaluation system test (BESTest) in people with subacute stroke

Abstract

All short-form BESTests demonstrated excellent intra-rater and inter-rater reliability (intraclass correlation coefficient (ICC) = 0.95-0.99) and excellent concurrent validity (r = 0.93-0.96). Unlike the Brief-BESTest and Mini-BESTest, the S-BESTest and BESTest had no significant floor/ceiling effects (< 20%). The standardized response mean of all 4 BESTest versions were large, ranging between 1.19 and 1.57, indicating sufficient internal responsiveness. The area under the curve of the S-BESTest and BESTest were significantly higher than the Brief-BESTest and Mini-BESTest, reflecting better accuracy of the S-BESTest and BESTest in identifying patients with subacute stroke who had balance improvement using the minimal clinically important difference of 6 and 16 points, respectively. These findings suggest that the S-BESTest is a short-form BESTest that is appropriate for assessing balance impairments in patients with subacute stroke.