title: Psychometric properties of Brief-Balance Evaluation Systems Test (Brief-BESTest) in evaluating balance performance in individuals with chronic stroke.
abstract: To examine the psychometric properties of the Brief-Balance Evaluation Systems Test (Brief-BESTest) in individuals with chronic stroke.
  
  
  
  This was an observational study with repeated measurements involving 50 participants with chronic stroke [mean (SD) age: 59.2 (7.3) years]. Each participant with stroke was evaluated with the Brief-BESTest, Berg balance scale (BBS), Postural Assessment Scale for Stroke Patients (PASS), Fugl-Meyer Motor Assessment (FMA), Chedoke-McMaster Stroke Assessment (CMSA), Montreal Cognitive Assessment (MoCA), and Geriatric Depression Scale (GDS). Two raters (rater 1 and 2) provided the Brief-BESTest scores of the first 27 participants independently to establish inter-rater reliability. After 15 min of rest, the same 27 participants were evaluated with the Brief-BESTest again by rater 1 to establish intra-rater reliability. The Brief-BESTest scores of the stroke group were also compared with those of the control group [n= 27, mean (SD) age: 56.7 (7.7) years].
  
  
  
  The Brief-BESTest had no substantial floor and ceiling effects, good intra-rater (ICC2,1= 0.974) and inter-rater (ICC2,1= 0.980) reliability and internal consistency (Cronbach's alpha = 0.818). The minimal detectable change at 95% confidence level was 2 points. The Brief-BESTest showed moderate to very strong correlations with other balance (BBS and PASS) and motor impairment (FMA, CMSA) measures (rs= .547-.911,p< .001), thus revealing good concurrent and convergent validity. Its correlation with measures that evaluated other constructs was weaker (MoCA:rs= .437,p= .002) or non-significant (GDS:rs= -0.152,p= .292), thus showing good discriminant validity. Good known-groups validity was established, as the Brief-BESTest was effective in distinguishing participants with stroke from controls (cutoff score: <18, area under curve: 0.942), and individuals with stroke who required assistive device for their outdoor mobility from those who did not (cutoff score <14, area under curve: 0.810).
  
  
  
  The Brief-BESTest has good reliability and validity in assessing balance function in individuals with chronic stroke.
authors.affiliation: Department of Rehabilitation Sciences The Hong Kong Polytechnic University Hong Kong Hong Kong.
authors.forename: Meizhen
authors.initials: M
authors.lastname: Huang
authors.affiliation: Department of Rehabilitation Sciences The Hong Kong Polytechnic University Hong Kong Hong Kong.
authors.forename: Marco Y C
authors.identifier: 0000-0003-1652-8945
authors.initials: MY
authors.lastname: Pang
mesh_terms: D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology*; D011594:Psychometrics / Q000295:instrumentation*; D015203:Reproducibility of Results; D020521:Stroke / Q000503:physiopathology*
keywords: balance; psychometrics; rehabilitation; stroke