Cross-cultural adaptation and analysis of the psychometric properties of the Balance Evaluation Systems Test and MiniBESTest in the elderly and individuals with Parkinson's disease: application of the Rasch model

Abstract

| Background: Older adults and individuals with neurological problems such as Parkinson's disease (PD) exhibit balance deficits that might impair their mobility and independence. The assessment of balance must be useful in identifying the presence of instability and orient interventions. Objective: To translate and perform a cross-cultural adaptation of the Balance Evaluation Systems Test (BESTest) and MiniBESTest to Brazilian Portuguese and analyze its psychometric properties. Method: The tests were translated and adapted to Portuguese according to a standard method and then subjected to a test-retest reliability assessment (10 older adults; 10 individuals with PD). The psychometric properties were assessed by the Rasch model (35 older adults; 35 individuals with PD). Results: The reliability coefficient of the tests relative to the items and subjects varied from 0.91 and 0.98, which is indicative of the stability and reproducibility of the measures. In the BESTest, the person (4.19) and item (5.36) separation index established six balance ability levels and seven levels of difficulty, respectively. In the MiniBESTest, the person (3.16) and item (6.41) separation index established four balance ability levels and nine levels of difficulty, respectively. Two items in the BESTest did not fit with the model expectations, but the construct validity was not compromised. No item in the MiniBESTest was erratic. Conclusions: The results corroborate the diagnostic and screening functions of the BESTest and MiniBESTest, respectively, and indicate that the Brazilian versions exhibit adequate reliability, construct validity, response stability, and capacity to distinguish among various balance ability levels in older adults and individuals with PD.

Reliability, validity and minimal detectable change of the Mini-BESTest in Greek participants with chronic stroke

“…This was a task that most of the participants found difficult to perform. This item has also been found to be the most difficult one among the items of BESTest in the study of Maia, Rodrigues-de-Paula, Magalhães, and Teixeira (2013). It might be possible therefore, that the participants practiced in counting backwards after the first assessment leading to a small learning effect during the second measurements.…”

The Mini-BESTest: a review of psychometric properties

“…Most of the selected papers (N = 19, 79%) focused on patients affected by neurological diseases, such as Parkinson's disease (Duncan et al, 2011;Leddy et al, 2011;Bergström et al, 2012;Duncan and Earhart, 2012;King et al, 2012;McNeely et al, 2012;Duncan et al, 2013;Mak and Auyeung, 2013;Maia et al, 2013;Combs et al, 2014;Löfgren et al, 2014;Schlenstedt et al, 2015), subacute (Chinsongkram et al, 2014) or chronic (Bergström et al, 2012;Tsang et al, 2013) poststroke, and other miscellaneous neurological diagnoses (Franchignoni et al, 2010;Padgett et al, 2012;Godi et al, 2013;Franchignoni et al, 2015). The remaining studies included aged cancer survivors (Huang et al, 2015), patients with knee arthroplasty (Chan and Pang, 2015), and healthy individuals (Maia et al, 2013;O'Hoski et al, 2014;O'Hoski et al, 2015;Yingyongyudha et al, 2015).…”

Impacto da doença de Parkinson na performance do equilíbrio em diferentes demandas atencionais

“…To obtain a good postural control, it is necessary to maintain the center of mass within the limits of stability in static or dynamic condition, as well as to control the position of the body in space 8 . For this, there is the interaction of multiple systems, which comprise biomechanical components, sensory strategies, anticipatory and reactive mechanisms, stability limits, and perceptual and cognitive system 9,10 .…”