Open AccessPsychometric properties of Brief‐Balance Evaluation Systems Test (Brief‐ BEST est) in evaluating balance performance in individuals with chronic stroke
Author(s) -
Huang Meizhen,
Pang Marco Y. C.
Publication year - 2017
Publication title -
brain and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.915
H-Index - 41
ISSN - 2162-3279
DOI - 10.1002/brb3.649
Subject(s) - berg balance scale , cronbach's alpha , stroke (engine) , convergent validity , physical therapy , ceiling effect , psychology , balance (ability) , physical medicine and rehabilitation , observational study , psychometrics , concurrent validity , medicine , internal consistency , clinical psychology , mechanical engineering , alternative medicine , pathology , engineering
Objective To examine the psychometric properties of the Brief‐Balance Evaluation Systems Test (Brief‐ BEST est) in individuals with chronic stroke. Materials and Methods 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‐ BEST est, Berg balance scale ( BBS ), Postural Assessment Scale for Stroke Patients ( PASS ), Fugl‐Meyer Motor Assessment ( FMA ), Chedoke‐McMaster Stroke Assessment ( CMSA ), Montreal Cognitive Assessment (Mo CA ), and Geriatric Depression Scale ( GDS ). Two raters (rater 1 and 2) provided the Brief‐ BEST est 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‐ BEST est again by rater 1 to establish intra‐rater reliability. The Brief‐ BEST est scores of the stroke group were also compared with those of the control group [ n = 27, mean ( SD ) age: 56.7 (7.7) years]. Results The Brief‐ BEST est had no substantial floor and ceiling effects, good intra‐rater ( ICC 2,1 = 0.974) and inter‐rater ( ICC 2,1 = 0.980) reliability and internal consistency (Cronbach's alpha = 0.818). The minimal detectable change at 95% confidence level was 2 points. The Brief‐ BEST est showed moderate to very strong correlations with other balance ( BBS and PASS ) and motor impairment ( FMA , CMSA ) measures ( r s = .547–.911, p < .001), thus revealing good concurrent and convergent validity. Its correlation with measures that evaluated other constructs was weaker (Mo CA : r s = .437, p = .002) or non‐significant ( GDS : r s = −0.152, p = .292), thus showing good discriminant validity. Good known‐groups validity was established, as the Brief‐ BEST est 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). Conclusions The Brief‐ BEST est has good reliability and validity in assessing balance function in individuals with chronic stroke.