title: Assessing Balance Function in Patients With Total Knee Arthroplasty.
abstract: BACKGROUND
  The Balance Evaluation Systems Test (BESTest) is a relatively new balance assessment tool. Recently, the Mini-BESTest and the Brief-BESTest, which are shortened versions of the BESTest, were developed.
  
  
  OBJECTIVE
  The purpose of this study was to estimate interrater and intrarater-interoccasion reliability, internal consistency, concurrent and convergent validity, and floor and ceiling effects of the 3 BESTests and other related measures, namely, the Berg Balance Scale (BBS), Functional Gait Assessment (FGA), and Activities-specific Balance Confidence (ABC) Scale, among patients with total knee arthroplasty (TKA).
  
  
  METHODS
  This was an observational measurement study.
  
  
  METHODS
  To establish interrater reliability, the 3 BESTests were administered by 3 independent raters to 25 participants with TKA. Intrarater-interoccasion reliability was evaluated in 46 participants with TKA (including the 25 individuals who participated in the interrater reliability experiments) by repeating the 3 BESTests, BBS, and FGA within 1 week by the same rater. Internal consistency of each test also was assessed with Cronbach alpha. Validity was assessed in another 46 patients with TKA by correlating the 3 BESTests with BBS, FGA, and ABC. The floor and ceiling effects also were examined.
  
  
  RESULTS
  The 3 BESTests demonstrated excellent interrater reliability (intraclass correlation coefficient [ICC] [2,1]=.96-.99), intrarater-interoccasion reliability (ICC [2,1]=.92-.96), and internal consistency (Cronbach alpha=.96-.98). These values were comparable to those for the BBS and FGA. The 3 BESTests also showed moderate-to-strong correlations with the BBS, FGA, and ABC (r=.35-.81), thus demonstrating good concurrent and convergent validity. No significant floor and ceiling effects were observed, except for the BBS.
  
  
  CONCLUSIONS
  The results are generalizable only to patients with TKA due to end-stage knee osteoarthritis.
  
  
  CONCLUSIONS
  The 3 BESTests have good reliability and validity for evaluating balance in people with TKA. The Brief-BESTest is the least time-consuming and may be more useful clinically.
authors.affiliation: A.C.M. Chan, MSc, Physiotherapy Department, Hong Kong Buddhist Hospital, 10 Heng Lam St, Lok Fu Kowloon, Hong Kong. cccmz01@ha.org.hk.
authors.forename: Andy C M
authors.initials: AC
authors.lastname: Chan
authors.affiliation: M.Y.C. Pang, PhD, Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
authors.forename: Marco Y C
authors.initials: MY
authors.lastname: Pang
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D005684:Gait / Q000502:physiology*; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D020370:Osteoarthritis, Knee / Q000503:physiopathology* / Q000523:psychology / Q000601:surgery*; D004856:Postural Balance / Q000502:physiology*; D011594:Psychometrics; D015203:Reproducibility of Results; D020377:Self Efficacy