title: Cohort Study Comparing the Berg Balance Scale and the Mini-BESTest in People Who Have Multiple Sclerosis and Are Ambulatory.
abstract: BACKGROUND
  The Berg Balance Scale (BBS) is a balance measure commonly used for people with multiple sclerosis (MS). The Mini-BESTest is an alternative based on balance systems.
  
  
  OBJECTIVE
  The study objective was to compare the BBS and the Mini-BESTest for sensitivity to change, likelihood ratios for walking aid use and falls, and associations with clinical variables in people who have MS and are ambulatory.
  
  
  METHODS
  This was a cohort study with measurements before and after exposure to 8 weeks of routine physical therapy intervention.
  
  
  METHODS
  For 52 participants who had a primary diagnosis of MS and who were independently mobile, with or without an aid, demographic details and a history of falls and near falls were collected. Participants completed the Mini-BESTest, Multiple Sclerosis Impact Scale-29, Multiple Sclerosis Walking Scale-12, BBS, Modified Fatigue Impact Scale, and Six-Minute Walk Test.
  
  
  RESULTS
  No participant started with a baseline Mini-BESTest maximum score of 28, whereas 38.5% (n=20) started with a baseline BBS maximum score of 56. Statistically significant changes in the Mini-BESTest score (X̅=5.31, SD=3.5) and the BBS score (X̅=1.4, SD=1.9) were demonstrated. Effect sizes for the Mini-BESTest and the BBS were 0.70 and 0.37, respectively; standard response means for the Mini-BESTest and the BBS were 1.52 and 0.74, respectively. Areas under the receiver operating characteristic curves for the Mini-BESTest and the BBS were 0.88 and 0.77, respectively, for detecting mobility device use and 0.88 and 0.75, respectively, for detecting self-reported near falls. The Mini-BESTest had a higher correlation for each secondary measure than did the BBS.
  
  
  CONCLUSIONS
  This study involved a sample of convenience; 61% of the participants did not use a walking aid. The order of testing was not randomized, and fall status was obtained through retrospective recall.
  
  
  CONCLUSIONS
  The Mini-BESTest had a lower ceiling effect and higher values on responsiveness tests. These findings suggest that the Mini-BESTest may be better at detecting changes in balance in people who have MS, are ambulatory, and have relatively little walking disability.
authors.affiliation: E. Ross, MSc, Department of Clinical Therapies, University of Limerick, Limerick, Ireland, and St. James Hospital, Dublin, Ireland.
authors.forename: Elaine
authors.initials: E
authors.lastname: Ross
authors.affiliation: H. Purtill, PhD, Department of Mathematics and Statistics, University of Limerick.
authors.forename: Helen
authors.initials: H
authors.lastname: Purtill
authors.affiliation: M. Uszynski, PhD, Department of Clinical Therapies, University of Limerick, and Multiple Sclerosis Society of Ireland, Galway, Ireland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Uszynski
authors.affiliation: S. Hayes, PhD, Department of Clinical Therapies, University of Limerick.
authors.forename: Sara
authors.initials: S
authors.lastname: Hayes
authors.affiliation: B. Casey, BScPhysio, Department of Clinical Therapies, University of Limerick.
authors.forename: Blathin
authors.initials: B
authors.lastname: Casey
authors.affiliation: C. Browne, BScPhysio, Department of Clinical Therapies, University of Limerick.
authors.forename: Catherine
authors.initials: C
authors.lastname: Browne
authors.affiliation: S. Coote, PhD, Department of Clinical Therapies and Health Research Institute, University of Limerick, Health Sciences Building, Limerick, Ireland. susan.coote@ul.ie.
authors.forename: Susan
authors.initials: S
authors.lastname: Coote
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009103:Multiple Sclerosis / Q000503:physiopathology* / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D004856:Postural Balance / Q000502:physiology*; D011594:Psychometrics; D015203:Reproducibility of Results