Reliability and minimal detectable change of the mini-BESTest in adults with spinal cord injury in a rehabilitation setting

ABSTRACT

Background: The mini-Balance Evaluation Systems Test (mini-BESTest) is a valid tool for assessing standing balance in people with spinal cord injury (SCI). Its reliability has not yet been investigated with this population.

Objective: To assess the test-retest and inter-rater reliability of the mini-BESTest in adults with SCI in a rehabilitation setting.

Methods: Twenty-three participants admitted in a rehabilitation center following an SCI (mean age = 52.2 years, SD = 14.5; 13/23 tetraplegia; 14/23 traumatic injury) and able to stand 30 seconds without help were recruited. They were evaluated twice with the mini-BESTest to establish the test-retest reliability (interval of 1 to 2 days). One of the two sessions was video-recorded to establish the inter-rater reliability (3 physiotherapists). Intraclass correlation coefficients (ICC_2,1), weighted kappa (K_w) and Kendall’s W were used to determine reliability of total score and individual items. Minimal detectable changes (MDC) were computed. Results. The mini-BESTest total scores showed excellent test-retest (ICC = 0.94) and inter-rater (ICC = 0.96) reliability. Reliability of 50% of the individual items was acceptable to excellent (Κ_w and W = 0.35–1.00). The MDC of the mini-BESTest total score was 4 points.

Conclusion: The mini-BESTest is a reliable tool to assess standing balance in adults with an SCI. A minimal change of 4 points on the total scale is needed to be confident that the change is not a measurement error between two sessions or two raters.

KEYWORDS:

• Reliability
• Mini-BESTest
• balance
• spinal cord injuries
• rehabilitation

Acknowledgments

Audrey Roy received a scholarship from the Ordre Professionnel de la Physiothérapie du Québec, the Université de Montréal and the Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR). The authors acknowledge Jean-François Lemay, Catherine Dansereau and the clinicians of the IURDPM for their collaboration throughout the project.

Declaration of Interest

The authors report no conflict of interest.

Additional information

Funding

This work was supported by the Ordre Professionnel de la Physiothérapie du Québec;Center for Interdisciplinary Research in Rehabilitation of Greater Montreal;Université de Montréal;