title: Comparison of reliability, validity, and responsiveness of the mini-BESTest and Berg Balance Scale in patients with balance disorders.
abstract: BACKGROUND
  Recently, a new tool for assessing dynamic balance impairments has been presented: the 14-item Mini-BESTest.
  
  
  OBJECTIVE
  The aim of this study was to compare the psychometric performance of the Mini-BESTest and the Berg Balance Scale (BBS).
  
  
  METHODS
  A prospective, single-group, observational design was used in the study.
  
  
  METHODS
  Ninety-three participants (mean age=66.2 years, SD=13.2; 53 women, 40 men) with balance deficits were recruited. Interrater (3 raters) and test-retest (1-3 days) reliability were calculated using intraclass correlation coefficients (ICCs). Responsiveness and minimal important change were assessed (after 10 sessions of physical therapy) using both distribution-based and anchor-based methods (external criterion: the 15-point Global Rating of Change [GRC] scale).
  
  
  RESULTS
  At baseline, neither floor effects nor ceiling effects were found in either the Mini-BESTest or the BBS. After treatment, the maximum score was found in 12 participants (12.9%) with BBS and in 2 participants (2.1%) with Mini-BESTest. Test-retest reliability for total scores was significantly higher for the Mini-BESTest (ICC=.96) than for the BBS (ICC=.92), whereas interrater reliability was similar (ICC=.98 versus .97, respectively). The standard error of measurement (SEM) was 1.26 and the minimum detectable change at the 95% confidence level (MDC(95)) was 3.5 points for Mini-BESTest, whereas the SEM was 2.18 and the MDC(95) was 6.2 points for the BBS. In receiver operating characteristic curves, the area under the curve was 0.92 for the Mini-BESTest and 0.91 for the BBS. The best minimal important change (MIC) was 4 points for the Mini-BESTest and 7 points for the BBS. After treatment, 38 participants evaluated with the Mini-BESTest and only 23 participants evaluated with the BBS (out of the 40 participants who had a GRC score of ≥ 3.5) showed a score change equal to or greater than the MIC values.
  
  
  CONCLUSIONS
  The consecutive sampling method drawn from a single rehabilitation facility and the intrinsic weakness of the GRC for calculating MIC values were limitations of the study.
  
  
  CONCLUSIONS
  The 2 scales behave similarly, but the Mini-BESTest appears to have a lower ceiling effect, slightly higher reliability levels, and greater accuracy in classifying individual patients who show significant improvement in balance function.
authors.affiliation: Posture and Movement Laboratory, Division of Physical Medicine and Rehabilitation, Salvatore Maugeri Foundation-IRCCS, Veruno, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Godi
authors.forename: Franco
authors.initials: F
authors.lastname: Franchignoni
authors.forename: Marco
authors.initials: M
authors.lastname: Caligari
authors.forename: Andrea
authors.initials: A
authors.lastname: Giordano
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Turcato
authors.forename: Antonio
authors.initials: A
authors.lastname: Nardone
mesh_terms: D000368:Aged; D002493:Central Nervous System Diseases / Q000503:physiopathology* / Q000534:rehabilitation*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D004856:Postural Balance / Q000502:physiology*; D011446:Prospective Studies; D011594:Psychometrics; D012372:ROC Curve; D015203:Reproducibility of Results