Reliability and Fall Risk Detection for the BESTest and Mini-BESTest in Older Adults.
Eric Anson, Elizabeth Thompson, Lei Ma and 1 others
PMID 28448278WHAT IT FOUND
The BESTest and Mini-BESTest are stable over four weeks in older adults with balance problems, so a drop in score likely reflects a real change rather than test error.
However, neither test reliably identified people who had fallen in the past year.
Key findings
01Test scores remained stable over a four-week period for both the BESTest and the Mini-BESTest, with no significant change over time.
02Neither the BESTest nor the Mini-BESTest could distinguish between participants who had reported a fall in the previous year and those who had not.
03The minimum detectable change is 8.9 points for the BESTest and 4.0 points for the Mini-BESTest.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Fallers were identified by self-report of falls in the past year, not by prospective tracking, which may have misclassified participants. The study population had non-specific balance problems, so results may not apply to patients with diagnosed neurological conditions like Parkinson's disease. Physical activity levels and health status changes during the four weeks were not measured, which could have influenced balance scores. The study did not test whether these measures can predict future falls, only whether they identified past fallers.
The easy way to misread this
Do not assume that a low score on the BESTest or Mini-BESTest automatically means a patient is at high risk for falling. In this study, neither test could reliably tell fallers from non-fallers. Use these scores to track changes over time, not to diagnose fall risk.