Which Balance Evaluation Systems Test sections best distinguish levels of post-stroke functional walking status?
Kazuhiro Miyata, Satoshi Hasegawa, Hiroki Iwamoto and 4 others
PMID 34486068WHAT IT FOUND
The Stability in Gait section of the BESTest best identifies stroke patients who can walk in the community.
A score of 73.8% on this section accurately distinguishes limited from unlimited community walkers. Other sections help identify those restricted to household walking.
Key findings
01The Stability in Gait section of the BESTest was the only section with high accuracy (AUROC 0.908) for distinguishing limited community ambulators from unlimited community ambulators.
02A cut-off score of 73.8% on the Stability in Gait section had 80.5% sensitivity and 89.3% specificity for identifying unlimited community ambulators.
03All six BESTest sections showed moderate accuracy in distinguishing household ambulators from limited community ambulators.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was retrospective and used only univariate analyses, so confounding factors may have affected the results. The number of household ambulators was small (n=17), which may limit the reliability of cut-off scores for this specific group. Participants were inpatients receiving intensive rehabilitation, so results may not generalize to community-dwelling individuals with stroke. Sex distribution was uneven (mostly men), and sex differences in postural control may have influenced the results. Intra-hospital reliability of the BESTest assessments was not evaluated, although therapists were trained.
Declared interests
The authors have no conflicts of interest to declare.
The easy way to misread this
Do not assume that high BESTest section scores guarantee safety for community walking. The study found that cut-off scores for limited community ambulators were often below those associated with fall risk, meaning patients could meet walking speed criteria but still be at risk of falling.