Psychometric Properties of the Mini-Balance Evaluation Systems Test (Mini-BESTest) in Community-Dwelling Individuals With Chronic Stroke
Psychometric Properties of the Mini-Balance Evaluation Systems Test (Mini-BESTest) in Community-Dwelling Individuals With Chronic Stroke
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DOI：
10.2522/ptj.20120454
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发表时间：
2013-08-01
期刊：
影响因子：
3.2
通讯作者：
Pang, Marco Y. C.
中科院分区：
文献类型：
--
作者：
Tsang, Charlotte S. L.;Liao, Lin-Rong;Pang, Marco Y. C.
背景迷你平衡评估系统测试（Mini-BESTest）是一种新的平衡评估方法，但其心理测量学特性尚未在中风患者中进行专门测试。本研究的目的是检验Mini-BESTest的可靠性和有效性，以及它在根据跌倒史对中风患者进行分类时的准确性。一个观察测量研究与重测设计进行。招募了106名慢性中风患者。由同一评分员在10天内重复Mini-BEST测试，评价了试验者间的可靠性。Mini-BESTest由2名独立评定者进行，以建立评定者间可靠性。通过将Mini-BESTest分数与其他平衡测量分数相关联来评估有效性（贝格平衡量表、单腿站立、功能性前伸测试和定时“起身和行走”测试），并比较中风组和48名对照参与者之间以及跌倒者之间的Mini-BESTest评分卒中组中有25例（在过去12个月内跌倒≥ 1次福尔斯，n=25）和81例（未跌倒）。Mini-BESTest具有出色的内部一致性（Cronbach α = 0.89 - 0.94）、组内可靠性（组内相关系数[3，1] = 0.97）和评分者间可靠性（组内相关系数[2，1] = 0.96）。95%置信区间下的最小可检测变化为3.0分。Mini-BESTest与其他平衡指标密切相关。脑卒中组和对照组之间以及脑卒中组跌倒者和非跌倒者之间的Mini-BESTest总分存在显著差异。在地板和天花板效应方面，Mini-BEST测试的偏斜程度明显低于其他平衡测量，除了非瘫痪侧的单腿站立。贝格平衡量表对跌倒者的识别能力（阳性似然比=2.6）显著优于Mini-BESTest（阳性似然比=1.8）。该结果仅适用于轻度至中度慢性卒中患者。Mini-BESTest是评估慢性中风患者平衡能力的可靠有效工具。
Background. The Mini-Balance Evaluation Systems Test (Mini-BESTest) is a new balance assessment, but its psychometric properties have not been specifically tested in individuals with stroke.Objectives. The purpose of this study was to examine the reliability and validity of the Mini-BESTest and its accuracy in categorizing people with stroke based on fall history.Design. An observational measurement study with a test-retest design was conducted.Methods. One hundred six people with chronic stroke were recruited. Intrarater reliability was evaluated by repeating the Mini-BESTest within 10 days by the same rater. The Mini-BESTest was administered by 2 independent raters to establish interrater reliability. Validity was assessed by correlating Mini-BESTest scores with scores of other balance measures (Berg Balance Scale, one-leg-standing, Functional Reach Test, and Timed "Up & Go" Test) in the stroke group and by comparing Mini-BESTest scores between the stroke group and 48 control participants, and between fallers (>= 1 falls in the previous 12 months, n=25) and nonfallers (n=81) in the stroke group.Results. The Mini-BESTest had excellent internal consistency (Cronbach alpha=.89-.94), intrarater reliability (intraclass correlation coefficient [3,1] =.97), and interrater reliability (intraclass correlation coefficient [2,1] =.96). The minimal detectable change at 95% confidence interval was 3.0 points. The Mini-BESTest was strongly correlated with other balance measures. Significant differences in Mini-BESTest total scores were found between the stroke and control groups and between fallers and nonfallers in the stroke group. In terms of floor and ceiling effects, the Mini-BESTest was significantly less skewed than other balance measures, except for one-leg-standing on the nonparetic side. The Berg Balance Scale showed significantly better ability to identify fallers (positive likelihood ratio=2.6) than the Mini-BESTest (positive likelihood ratio =1.8).Limitations. The results are generalizable only to people with mild to moderate chronic stroke.Conclusions. The Mini-BESTest is a reliable and valid tool for evaluating balance in people with chronic stroke.