PTCohortJournal of physical therapy science2021

Sensitivity to change and responsiveness of the Balance Evaluation Systems Test (BESTest), Mini-BESTest, and Brief-BESTest in patients with subacute cerebral infarction.

Satoshi Hasegawa, Tomoko Matsui, Mayumi Kishi and 4 others

PMID 33519078

WHAT IT FOUND

The Mini-BESTest was the best predictor of whether stroke patients would regain independent walking by discharge, with a change of 5.5 points or more indicating success.

The full BESTest and Berg Balance Scale were also useful, but the Mini-BESTest offered the clearest guidance for therapists.

Key findings

01The Mini-BESTest showed the highest responsiveness for predicting ambulatory independence at discharge, with an Area Under the Curve (AUC) of 0.82.

02A change of 5.5 points on the Mini-BESTest was the optimal cutoff score for classifying patients as having achieved ambulatory independence.

03All three versions of the BESTest and the Berg Balance Scale demonstrated significant improvement in scores from admission to discharge.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The time between the two assessments varied widely among patients, ranging from several weeks to several months, which makes it difficult to attribute changes strictly to recovery rate versus time passed. The sample size was small (30 patients), which limits the generalizability of the findings. The study was conducted in a single convalescent rehabilitation ward in Japan, which may not reflect practice in other settings or countries.

Declared interests

None declared.

The easy way to misread this

Do not assume that improvement on any balance test automatically means the patient will regain independent walking. The Mini-BESTest was the most accurate predictor, but the Berg Balance Scale had poor discriminatory power for this specific outcome.

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