The Mini-Balance Evaluation Systems Test (Mini-BESTest)

The Balance Evaluation Systems Test (BESTest) was developed to identify the postural control system(s) that underly poor functional balance, enabling physiotherapists to target treatment to a person’s specific balance deficit. The BESTest consists of 36 items grouped into six subsections: biomechanical constraints, stability limits/verticality, transitions/anticipatory postural control, reactive postural control, sensory orientation and stability in gait. A limitation of the BESTest is the time to administer it (30 to 45 minutes). Therefore, a shorter version of the BESTest was developed via a Rasch analysis – the Mini-Balance Evaluation Systems Test (Mini-BESTest). The Mini-BESTest includes four subscales: transitions/anticipatory postural control, reactive postural control, sensory orientation and stability in gait. Each item is rated on a three-point ordinal scale (0 = severe to 2 = normal). Variations in the literature exist between the number of items (14 versus 16) and maximum points attainable (24 versus 32). King and Horak clarified this, stating that the MiniBESTest consists of 14 items, with a maximum score of 28 points. The Mini-BESTest takes 10 to 15 minutes to administer. Reliability and validity: With one exception, the reliability of the Mini-BESTest is excellent to good, with ICC values >0.90 for people with mixed diagnoses, stroke and Parkinson’s disease. The Mini-BEST test is reported to have high content validity. Multiple studies have demonstrated its criterion-related validity. Strong and statistically significant correlations exist between the Mini-BESTest and the BESTest in Parkinson’s disease, and to other balance and gait measures for people with various conditions, including the Timed Up-and-Go test and the Berg Balance Scale. Weaker correlations exist between the Mini-