title: Reliability and validity of the Balance Evaluation Systems Test (BESTest) in people with subacute stroke.
abstract: BACKGROUND
  The Balance Evaluation Systems Test (BESTest) is a new clinical balance assessment tool, but it has never been validated in patients with subacute stroke.
  
  
  OBJECTIVE
  The purpose of this study was to examine the reliability and validity of the BESTest in patients with subacute stroke.
  
  
  METHODS
  This was an observational reliability and validity study.
  
  
  METHODS
  Twelve patients participated in the interrater and intrarater reliability study. Convergent validity was investigated in 70 patients using the Berg Balance Scale (BBS), Postural Assessment Scale for Stroke (PASS), Community Balance and Mobility Scale (CB&M), and Mini-BESTest. The receiver operating characteristic curve was used to calculate the sensitivity, specificity, and accuracy of the BESTest, Mini-BESTest, and BBS in classifying participants into low functional ability (LFA) and high functional ability (HFA) groups based on Fugl-Meyer Assessment motor subscale scores.
  
  
  RESULTS
  The BESTest showed excellent intrarater reliability and interrater reliability (intraclass correlation coefficient=.99) and was highly correlated with the BBS (Spearman r=.96), PASS (r=.96), CB&M (r=.91), and Mini-BESTest (r=.96), indicating excellent convergent validity. No floor or 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 the HFA group. In addition, the BESTest showed high accuracy as the BBS and Mini-BESTest in separating participants into HFA and LFA groups.
  
  
  CONCLUSIONS
  Whether the results are generalizable to patients with chronic stroke is unknown.
  
  
  CONCLUSIONS
  The BESTest is reliable, valid, sensitive, and specific in assessing balance in people with subacute stroke across all levels of functional disability.
authors.affiliation: B. Chinsongkram, MS, Division of Physical Therapy, Faculty of Health Science, Srinakharinwirot University, Nakhon Nayok, Thailand, and Faculty of Physical Therapy, Rangsit University, Pathum Thani, Thailand.
authors.forename: Butsara
authors.initials: B
authors.lastname: Chinsongkram
authors.affiliation: N. Chaikeeree, MS, Division of Physical Therapy, Faculty of Health Science, Srinakharinwirot University, and Department of Physiology, Faculty of Science, Mahidol University, Bangkok, Thailand.
authors.forename: Nithinun
authors.initials: N
authors.lastname: Chaikeeree
authors.affiliation: V. Saengsirisuwan, PhD, Department of Physiology, Faculty of Science, Mahidol University.
authors.forename: Vitoon
authors.initials: V
authors.lastname: Saengsirisuwan
authors.affiliation: N. Viriyatharakij, PhD, Division of Physical Therapy, Faculty of Health Science, Srinakharinwirot University.
authors.forename: Nitaya
authors.initials: N
authors.lastname: Viriyatharakij
authors.affiliation: F.B. Horak, PhD, Balance Disorders Laboratory, Neurological Sciences Institute, Oregon Health and Science University, Beaverton, Oregon.
authors.forename: Fay B
authors.initials: FB
authors.lastname: Horak
authors.affiliation: R. Boonsinsukh, PhD, Division of Physical Therapy, Faculty of Health Science, Srinakharinwirot University, 63 moo 7 Rungsit-Nakhonnayok, Ongkharuk, Nakhon Nayok, 26120. rumpa@swu.ac.th.
authors.forename: Rumpa
authors.initials: R
authors.lastname: Boonsinsukh
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D017063:Outcome Assessment, Health Care; D004856:Postural Balance / Q000502:physiology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation