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Published in: BMC Geriatrics 1/2017

Open Access 01-12-2017 | Research Article

Interrater and test-retest reliability and validity of the Norwegian version of the BESTest and mini-BESTest in people with increased risk of falling

Authors: Charlotta Hamre, Pernille Botolfsen, Gro Gujord Tangen, Jorunn L. Helbostad

Published in: BMC Geriatrics | Issue 1/2017

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Abstract

Background

The Balance Evaluation Systems Test (BESTest) was developed to assess underlying systems for balance control in order to be able to individually tailor rehabilitation interventions to people with balance disorders. A short form, the Mini-BESTest, was developed as a screening test. The study aimed to assess interrater and test-retest reliability of the Norwegian version of the BESTest and the Mini-BESTest in community-dwelling people with increased risk of falling and to assess concurrent validity with the Fall Efficacy Scale-International (FES-I), and it was an observational study with a cross-sectional design.

Methods

Forty-two persons with increased risk of falling (elderly over 65 years of age, persons with a history of stroke or Multiple Sclerosis) were assessed twice by two raters. Relative reliability was analysed with Intraclass Correlation Coefficient (ICC), and absolute reliability with standard error of measurement (SEM) and smallest detectable change (SDC). Concurrent validity was assessed against the FES-I using Spearman’s rho.

Results

The BESTest showed very good interrater reliability (ICC = 0.98, SEM = 1.79, SDC95 = 5.0) and test-retest reliability (rater A/rater B = ICC = 0.89/0.89, SEM = 3.9/4.3, SDC95 = 10.8/11.8). The Mini-BESTest also showed very good interrater reliability (ICC = 0.95, SEM = 1.19, SDC95 = 3.3) and test-retest reliability (rater A/rater B = ICC = 0.85/0.84, SEM = 1.8/1.9, SDC95 = 4.9/5.2). The correlations were moderate between the FES-I and both the BESTest and the Mini-BESTest (Spearman’s rho −0.51 and-0.50, p < 0.01).

Conclusion

The BESTest and its short form, the Mini-BESTest, showed very good interrater and test-retest reliability when assessed in a heterogeneous sample of people with increased risk of falling. The concurrent validity measured against the FES-I showed moderate correlation. The results are comparable with earlier studies and indicate that the Norwegian versions can be used in daily clinic and in research.
Literature
1.
go back to reference Shumway-Cook A, Woollacott MH. Motor control: translating research into clinical practice. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2012. Shumway-Cook A, Woollacott MH. Motor control: translating research into clinical practice. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2012.
2.
3.
go back to reference Huxham FE, Goldie PA, Patla AE. Theoretical considerations in balance assessment. Aust J Physiother. 2001;47(2):89–100.CrossRefPubMed Huxham FE, Goldie PA, Patla AE. Theoretical considerations in balance assessment. Aust J Physiother. 2001;47(2):89–100.CrossRefPubMed
4.
go back to reference Loughlin JL, Robitaille Y, Boivin JF, Suissa S. Incidence of and risk factors for falls and injurious among the community-dwelling elderly. Am J Epidemiol. 1993;137(3):342–54.CrossRef Loughlin JL, Robitaille Y, Boivin JF, Suissa S. Incidence of and risk factors for falls and injurious among the community-dwelling elderly. Am J Epidemiol. 1993;137(3):342–54.CrossRef
5.
go back to reference Kerse N, Parag V, Feigin VL, McNaughton H, Hakkett ML, Bennett DA. Falls after stroke: results from the Auckland regional community stroke (ARCOS) study, 2002–2003. Stroke. 2008;39(6):1890–3.CrossRefPubMed Kerse N, Parag V, Feigin VL, McNaughton H, Hakkett ML, Bennett DA. Falls after stroke: results from the Auckland regional community stroke (ARCOS) study, 2002–2003. Stroke. 2008;39(6):1890–3.CrossRefPubMed
6.
go back to reference Matsuda PN, Shumway-Cook A, Bamer A, Johnson SL, Amtmann D, Kraft GH. Falls in multiple sclerosis. PMR. 2011;3(7):624–32. Matsuda PN, Shumway-Cook A, Bamer A, Johnson SL, Amtmann D, Kraft GH. Falls in multiple sclerosis. PMR. 2011;3(7):624–32.
7.
go back to reference Avin KG, Hanke TA, Kirk-Sanchez N, McDonough CM, Shubert TE, Hardage J, Hartley G. Academy of Geriatric physical therapy of the American physical therapy a: management of falls in community-dwelling older adults: clinical guidance statement from the Academy of Geriatric physical therapy of the American Physical Therapy Association. Phys Ther. 2015;95(6):815–34.CrossRefPubMedPubMedCentral Avin KG, Hanke TA, Kirk-Sanchez N, McDonough CM, Shubert TE, Hardage J, Hartley G. Academy of Geriatric physical therapy of the American physical therapy a: management of falls in community-dwelling older adults: clinical guidance statement from the Academy of Geriatric physical therapy of the American Physical Therapy Association. Phys Ther. 2015;95(6):815–34.CrossRefPubMedPubMedCentral
8.
go back to reference Sibley KM, Howe T, Lamb SE, Lord SR, Maki BE, Rose DJ, Scott V, Stathokostas L, Straus SE, Jaglal SB. Recommendations for a core outcome set for measuring standing balance in adult populations: a consensus-based approach. PLoS One. 2015;10(3):e0120568.CrossRefPubMedPubMedCentral Sibley KM, Howe T, Lamb SE, Lord SR, Maki BE, Rose DJ, Scott V, Stathokostas L, Straus SE, Jaglal SB. Recommendations for a core outcome set for measuring standing balance in adult populations: a consensus-based approach. PLoS One. 2015;10(3):e0120568.CrossRefPubMedPubMedCentral
9.
go back to reference Mancini M, Horak FB. The relevance of clinical balance assessment tools to differentiate balance deficits. Eur J Phys Rehabil Med. 2010;46(2):239–48.PubMedPubMedCentral Mancini M, Horak FB. The relevance of clinical balance assessment tools to differentiate balance deficits. Eur J Phys Rehabil Med. 2010;46(2):239–48.PubMedPubMedCentral
10.
go back to reference Franchignoni F, Horak F, Godi M, Nardone A, Giordano A. Using psychometric techniques to improve the balance evaluation systems test: the mini-BESTest. J Rehabil Med. 2010;42(4):323–31.CrossRefPubMedPubMedCentral Franchignoni F, Horak F, Godi M, Nardone A, Giordano A. Using psychometric techniques to improve the balance evaluation systems test: the mini-BESTest. J Rehabil Med. 2010;42(4):323–31.CrossRefPubMedPubMedCentral
11.
go back to reference Leddy AL, Crowner BE, Earhart GM. Functional gait assessment and balance evaluation system test: reliability, validity, sensitivity, and specificity for identifying individuals with Parkinson disease who fall. Phys Ther. 2011;91(1):102–13.CrossRefPubMedPubMedCentral Leddy AL, Crowner BE, Earhart GM. Functional gait assessment and balance evaluation system test: reliability, validity, sensitivity, and specificity for identifying individuals with Parkinson disease who fall. Phys Ther. 2011;91(1):102–13.CrossRefPubMedPubMedCentral
12.
go back to reference Godi M, Franchignoni F, Caligari M, Giordano A, Turcato AM, Nardone A. Comparison of reliability, validity, and responsiveness of the mini-BESTest and berg balance scale in patients with balance disorders. Phys Ther. 2013;93(2):158–67.CrossRefPubMed Godi M, Franchignoni F, Caligari M, Giordano A, Turcato AM, Nardone A. Comparison of reliability, validity, and responsiveness of the mini-BESTest and berg balance scale in patients with balance disorders. Phys Ther. 2013;93(2):158–67.CrossRefPubMed
13.
go back to reference Dahl S, Jørgensen L. Intra-and inter-rater reliability of the mini-balance evaluation systems test in individuals with stroke. Int J Phys Med Rehabil. 2014;2(177):2. Dahl S, Jørgensen L. Intra-and inter-rater reliability of the mini-balance evaluation systems test in individuals with stroke. Int J Phys Med Rehabil. 2014;2(177):2.
14.
go back to reference Maia AC, Rodrigues-de-Paula F, Magalhaes LC, Teixeira RL. Cross-cultural adaptation and analysis of the psychometric properties of the balance evaluation systems test and MiniBESTest in the elderly and individuals with Parkinson's disease: application of the Rasch model. Brazilian J Phys Ther. 2013;17(3):195–217.CrossRef Maia AC, Rodrigues-de-Paula F, Magalhaes LC, Teixeira RL. Cross-cultural adaptation and analysis of the psychometric properties of the balance evaluation systems test and MiniBESTest in the elderly and individuals with Parkinson's disease: application of the Rasch model. Brazilian J Phys Ther. 2013;17(3):195–217.CrossRef
15.
go back to reference Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C. Development and initial validation of the falls efficacy scale-international (FES-I). Age Ageing. 2005;34(6):614–9.CrossRefPubMed Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C. Development and initial validation of the falls efficacy scale-international (FES-I). Age Ageing. 2005;34(6):614–9.CrossRefPubMed
16.
go back to reference Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25(24):3186–91.CrossRef Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25(24):3186–91.CrossRef
17.
go back to reference Lin Y-H, Chen C-Y, Chiu P-K. Cross-cultural research and back-translation. Sport J. 2005;8(4):108–21. Lin Y-H, Chen C-Y, Chiu P-K. Cross-cultural research and back-translation. Sport J. 2005;8(4):108–21.
18.
go back to reference Polit DF, Beck CT: Nursing research: generating and assessing evidence for nursing practice. Philadelphia: Lippincott Williams & Wilkins; 2008. Polit DF, Beck CT: Nursing research: generating and assessing evidence for nursing practice. Philadelphia: Lippincott Williams & Wilkins; 2008.
20.
go back to reference Helbostad JL, Taraldsen K, Granbo R, Yardley L, Todd CJ, Sletvold O. Validation of the falls efficacy scale-international in fall-prone older persons. Age Ageing. 2010;39(2):259.CrossRefPubMed Helbostad JL, Taraldsen K, Granbo R, Yardley L, Todd CJ, Sletvold O. Validation of the falls efficacy scale-international in fall-prone older persons. Age Ageing. 2010;39(2):259.CrossRefPubMed
21.
go back to reference Moe-Nilssen R, Nordin E, Lundin-Olsson L. Work package 3 of European Community research Network prevention of falls Network E: criteria for evaluation of measurement properties of clinical balance measures for use in fall prevention studies. J Eval Clin Pract. 2008;14(2):236–40.CrossRefPubMed Moe-Nilssen R, Nordin E, Lundin-Olsson L. Work package 3 of European Community research Network prevention of falls Network E: criteria for evaluation of measurement properties of clinical balance measures for use in fall prevention studies. J Eval Clin Pract. 2008;14(2):236–40.CrossRefPubMed
22.
go back to reference Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol. 2010;63(7):737–45.CrossRefPubMed Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol. 2010;63(7):737–45.CrossRefPubMed
23.
go back to reference Walter SD, Eliasziw M, Donner A. Sample size and optimal designs for reliability studies. Stat Med. 1998;17(1):101–10.CrossRefPubMed Walter SD, Eliasziw M, Donner A. Sample size and optimal designs for reliability studies. Stat Med. 1998;17(1):101–10.CrossRefPubMed
24.
go back to reference De Vet HC, Terwee CB, Mokkink LB, Knol DL. Measurement in medicine: a practical guide. Cambridge: Cambridge University Press; 2011.CrossRef De Vet HC, Terwee CB, Mokkink LB, Knol DL. Measurement in medicine: a practical guide. Cambridge: Cambridge University Press; 2011.CrossRef
25.
go back to reference Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86(2):420–8.CrossRefPubMed Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86(2):420–8.CrossRefPubMed
27.
go back to reference Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34–42.CrossRefPubMed Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34–42.CrossRefPubMed
28.
go back to reference Huang MH, Miller K, Fredrickson K, Shilling T. Reliability, validity, and minimal detecable change of balance evaluation systems test and its short version in older cancer survivors: a pilot study. J Geriatr Phys Ther. 2016;39:58–63. Huang MH, Miller K, Fredrickson K, Shilling T. Reliability, validity, and minimal detecable change of balance evaluation systems test and its short version in older cancer survivors: a pilot study. J Geriatr Phys Ther. 2016;39:58–63.
29.
go back to reference Chan AC, Pang MY. Assessing balance function in patients with Total knee Arthroplasty. Phys Ther. 2015;95(10):1397–407.CrossRefPubMed Chan AC, Pang MY. Assessing balance function in patients with Total knee Arthroplasty. Phys Ther. 2015;95(10):1397–407.CrossRefPubMed
30.
go back to reference Tsang CS, Liao LR, Chung RC, Pang MY. Psychometric properties of the mini-balance evaluation systems test (mini-BESTest) in community-dwelling individuals with chronic stroke. Phys Ther. 2013;93(8):1102–15.CrossRefPubMed Tsang CS, Liao LR, Chung RC, Pang MY. Psychometric properties of the mini-balance evaluation systems test (mini-BESTest) in community-dwelling individuals with chronic stroke. Phys Ther. 2013;93(8):1102–15.CrossRefPubMed
31.
go back to reference Bortz 2nd WM. A conceptual framework of frailty: a review. J Gerontol A Biol Sci Med Sci. 2002;57(5):M283–8.CrossRefPubMed Bortz 2nd WM. A conceptual framework of frailty: a review. J Gerontol A Biol Sci Med Sci. 2002;57(5):M283–8.CrossRefPubMed
32.
go back to reference Powell LE, Myers AM. The activities-specific balance confidence (ABC) scale. J Gerontol A Biol Sci Med Sci. 1995;50A(1):M28–34.CrossRefPubMed Powell LE, Myers AM. The activities-specific balance confidence (ABC) scale. J Gerontol A Biol Sci Med Sci. 1995;50A(1):M28–34.CrossRefPubMed
33.
go back to reference Rodrigues LC, Marques AP, Barros PB, Michaelsen SM. Reliability of the balance evaluation systems test (BESTest) and BESTest sections for adults with hemiparesis. Brazilian J Phys Ther. 2014;18(3):276–81.CrossRef Rodrigues LC, Marques AP, Barros PB, Michaelsen SM. Reliability of the balance evaluation systems test (BESTest) and BESTest sections for adults with hemiparesis. Brazilian J Phys Ther. 2014;18(3):276–81.CrossRef
34.
go back to reference Moore DS, Ellis R, Kosma M, Fabre JM, McCarter KS, Wood RH. Comparison of the validity of four fall-related psychological measures in a community-based falls risk screening. Res Q Exerc Sport. 2011;82(3):545–54.CrossRefPubMed Moore DS, Ellis R, Kosma M, Fabre JM, McCarter KS, Wood RH. Comparison of the validity of four fall-related psychological measures in a community-based falls risk screening. Res Q Exerc Sport. 2011;82(3):545–54.CrossRefPubMed
35.
go back to reference Ashburn A, Hyndman D, Pickering R, Yardley L, Harris S. Predicting people with stroke at risk of falls. Age Ageing. 2008;37(3):270–6.CrossRefPubMed Ashburn A, Hyndman D, Pickering R, Yardley L, Harris S. Predicting people with stroke at risk of falls. Age Ageing. 2008;37(3):270–6.CrossRefPubMed
36.
go back to reference Finlayson ML, Peterson EW, Cho CC. Risk factors for falling among people aged 45 to 90 years with multiple sclerosis. Arch Phys Med Rehabil. 2006;87(9):1274–9. quiz 87CrossRefPubMed Finlayson ML, Peterson EW, Cho CC. Risk factors for falling among people aged 45 to 90 years with multiple sclerosis. Arch Phys Med Rehabil. 2006;87(9):1274–9. quiz 87CrossRefPubMed
Metadata
Title
Interrater and test-retest reliability and validity of the Norwegian version of the BESTest and mini-BESTest in people with increased risk of falling
Authors
Charlotta Hamre
Pernille Botolfsen
Gro Gujord Tangen
Jorunn L. Helbostad
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2017
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-017-0480-x

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