title: Validity, Reliability, and Ability to Identify Fall Status of the Berg Balance Scale, BESTest, Mini-BESTest, and Brief-BESTest in Patients With COPD.
abstract: BACKGROUND
  The Berg Balance Scale (BBS), Balance Evaluation Systems Test (BESTest), Mini-BESTest, and Brief-BESTest are useful in the assessment of balance. Their psychometric properties, however, have not been tested in patients with chronic obstructive pulmonary disease (COPD).
  
  
  OBJECTIVE
  This study aimed to compare the validity, reliability, and ability to identify fall status of the BBS, BESTest, Mini-BESTest, and the Brief-BESTest in patients with COPD.
  
  
  METHODS
  A cross-sectional study was conducted.
  
  
  METHODS
  Forty-six patients (24 men, 22 women; mean age=75.9 years, SD=7.1) were included. Participants were asked to report their falls during the previous 12 months and to fill in the Activity-specific Balance Confidence (ABC) Scale. The BBS and the BESTest were administered. Mini-BESTest and Brief-BESTest scores were computed based on the participants' BESTest performance. Validity was assessed by correlating balance tests with each other and with the ABC Scale. Interrater reliability (2 raters), intrarater reliability (48-72 hours), and minimal detectable changes (MDCs) were established. Receiver operating characteristics assessed the ability of each balance test to differentiate between participants with and without a history of falls.
  
  
  RESULTS
  Balance test scores were significantly correlated with each other (Spearman correlation rho=.73-.90) and with the ABC Scale (rho=.53-.75). Balance tests presented high interrater reliability (intraclass correlation coefficient [ICC]=.85-.97) and intrarater reliability (ICC=.52-.88) and acceptable MDCs (MDC=3.3-6.3 points). Although all balance tests were able to identify fall status (area under the curve=0.74-0.84), the BBS (sensitivity=73%, specificity=77%) and the Brief-BESTest (sensitivity=81%, specificity=73%) had the higher ability to identify fall status.
  
  
  CONCLUSIONS
  Findings are generalizable mainly to older patients with moderate COPD.
  
  
  CONCLUSIONS
  The 4 balance tests are valid, reliable, and valuable in identifying fall status in patients with COPD. The Brief-BESTest presented slightly higher interrater reliability and ability to differentiate participants' fall status.
authors.affiliation: C. Jácome, PT, PhD, Lab 3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro, Aveiro, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Jácome
authors.affiliation: J. Cruz, PT, MSc, Lab 3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro, and Institute for Research in Biomedicine, University of Aveiro.
authors.forename: Joana
authors.initials: J
authors.lastname: Cruz
authors.affiliation: A. Oliveira, PT, MSc, Lab 3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro, and Institute for Research in Biomedicine, University of Aveiro.
authors.forename: Ana
authors.initials: A
authors.lastname: Oliveira
authors.affiliation: A. Marques, PT, PhD, Lab 3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro, Agras do Crasto-Campus Universitário de Santiago, Edifício 30, 3810-193 Aveiro, Portugal, and Institute for Research in Biomedicine, University of Aveiro, Aveiro, Portugal. amarques@ua.pt.
authors.forename: Alda
authors.initials: A
authors.lastname: Marques
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D004856:Postural Balance / Q000502:physiology*; D011594:Psychometrics; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D015203:Reproducibility of Results; D012307:Risk Factors