Quantifying balance control after spinal cord injury: Reliability and validity of the mini-BESTest

Abstract

Context/Objective: Incomplete spinal cord injury (iSCI) causes deficits in balance control. The Mini-Balance Evaluation Systems Test (mini-BESTest) is a comprehensive measure; however, further testing of its psychometric properties among the iSCI population is needed. We evaluated the mini-BESTest’s test-retest reliability, and concurrent and convergent validity among individuals living with iSCI for more than one year.

Design: Cross-sectional study.

Setting: Rehabilitation hospital.

Participants: Twenty-one individuals with chronic motor iSCI (14 females, mean age 56.8 ± 14.0 years).

Interventions: None.

Outcome Measures: Participants completed the mini-BESTest at two sessions spaced two weeks apart. At the second session, participants performed tests of lower extremity muscle strength and quiet standing on a force platform with eyes opened (EO) and eyes closed (EC). Intraclass correlation coefficients (ICC) evaluated test-retest reliability. To evaluate concurrent and convergent validity, Pearson’s correlation coefficient (r) quantified relationships between mini-BESTest scores and measures of center of pressure (COP) velocity during EO and EC standing, and lower extremity muscle strength, respectively.

Results: Test-retest reliability of the mini-BESTest total score and sub-scale scores were high (ICC = 0.94–0.98). Mini-BESTest scores were inversely correlated with COP velocity when standing with EO (r = 0.54–0.71, P < 0.05), but not with EC. Lower extremity strength correlated strongly with mini-BESTest total scores (r = 0.73, P < 0.001).

Conclusion: The mini-BESTest has high test-retest reliability, and concurrent and convergent validity in individuals with chronic iSCI.

Keywords:

• Balance
• Measurement
• Spinal cord injury

Acknowledgements

We would like to thank Jaeeun Yoo, David Houston and Pirashanth Theventhrian for assistance with data collection.

Disclaimer statements

Contributors None.

Conflicts of interest Authors have no conflict of interests to declare.

ORCID

Kei Masani http://orcid.org/0000-0002-0207-3241

Kristin E. Musselman http://orcid.org/0000-0001-8336-8211

Additional information

Funding

This work was supported by the Ontario Neurotrauma Foundation and Rick Hansen Institute under [grant number 2016-RHI-PREV-1019].