Test-retest reliability and minimal detectable change of the Balance Evaluation Systems Test and its two abbreviated versions in persons with mild to moderate spinocerebellar ataxia: A pilot study.
Yuki Kondo, Kyota Bando, Yosuke Ariake and 5 others
PMID 33136076WHAT IT FOUND
For people with mild to moderate spinocerebellar ataxia, the full BESTest is the most reliable balance assessment.
Changes must exceed 8.7 points on the full test, 4.1 on the Mini-BESTest, or 5.2 on the Brief-BESTest to count as real improvement rather than measurement error.
Key findings
01The full BESTest showed the highest test-retest reliability (ICC 0.92), followed by the Mini-BESTest (0.91) and Brief-BESTest (0.81).
02The minimal detectable change for the full BESTest total score was 8.7 points, while the abbreviated versions required smaller changes (4.1 for Mini-BESTest, 5.2 for Brief-BESTest) to exceed measurement error.
03The authors concluded the full BESTest is the best choice for assessing balance in this population, noting the Mini-BESTest may be unsuitable because patients scored lowest on the specific items it includes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The sample size was very small (n=20), falling well below the 50-100 participants recommended for reliability studies. Participants were all able to walk without assistance, so the results do not apply to people with severe SCA or those who are non-ambulatory. The Mini-BESTest and Brief-BESTest scores were extracted from the full BESTest administration rather than being tested separately, which may overestimate their independent reliability. Only one physical therapist performed all testing, so inter-rater reliability was not assessed. The study used a distribution-based method for calculating MDC, which does not account for patient-perceived meaningful change.
Declared interests
No potential conflicts of interest are reported by the authors.
The easy way to misread this
Do not use these MDC values to judge the effectiveness of a treatment. This study only measured how consistent the test scores are between two time points in stable patients; it did not test whether the scores accurately detect real clinical improvement after an intervention.