Reliability, validity and minimal detectable change of the Mini-BESTest in Greek participants with chronic stroke

ABSTRACT

Objectives: This study aimed to investigate the psychometric characteristics of reliability, validity and ability to detect change of a newly developed balance assessment tool, the Mini-BESTest, in Greek patients with stroke. Design: A prospective, observational design study with test-retest measures was conducted. Methods: A convenience sample of 21 Greek patients with chronic stroke (14 male, 7 female; age of 63 ± 16 years) was recruited. Two independent examiners administered the scale, for the inter-rater reliability, twice within 10 days for the test-retest reliability. Bland Altman Analysis for repeated measures assessed the absolute reliability and the Standard Error of Measurement (SEM) and the Minimum Detectable Change at 95% confidence interval (MDC_95%) were established. The Greek Mini-BESTest (Mini-BESTest_GR) was correlated with the Greek Berg Balance Scale (BBS_GR) for assessing the concurrent validity and with the Timed Up and Go (TUG), the Functional Reach Test (FRT) and the Greek Falls Efficacy Scale-International (FES-I_GR) for the convergent validity. Results: The Mini-BESTestGR demonstrated excellent inter-rater reliability (ICC (95%CI) = 0.997 (0.995–0.999, SEM = 0.46) with the scores of two raters within the limits of agreement (mean_dif = −0.143 ± 0.727, p > 0.05) and test-retest reliability (ICC (95%CI) = 0.966 (0.926–0.988), SEM = 1.53). Additionally, the Mini-BESTest_GR yielded very strong to moderate correlations with BBS_GR (r = 0.924, p < 0.001), TUG (r = −0.823, p < 0.001), FES-I_GR (r = −0.734, p < 0.001) and FRT (r = 0.689, p < 0.001). MDC₉₅ was 4.25 points. Conclusion: The exceptionally high reliability and the equally good validity of the Mini-BESTest_GR, strongly support its utility in Greek people with chronic stroke. Its ability to identify clinically meaningful changes and falls risk need further investigation.

KEYWORDS:

• Balance
• Mini-BESTest
• reliability
• validity
• stroke
• Greek

Acknowledgments

Initially, we would like to thank Dr Horak for giving us the permission to adapt and use the Mini-BESTest into Greek. We also thank the physiotherapists who kindly accepted to administer the scale and all patients for their voluntary participation in the balance assessment; without them this research would not be completed. Part of the results has been orally presented at the 24th Panhellenic Scientific Conference of Physiotherapy, PSF, Athens, Greece (5-7th December 2014) and to the 5th Pancypriot Conference of Physiotherapy, Nicosia, Cyprus (5-6th March 2016).

Declaration of Interest

Authors report no declarations of interest