Cited by 1,081Balance, Gait, and Falls PreventionPsychometric Methodologies and TestingStroke Rehabilitation and Recovery

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Using psychometric techniques to improve the Balance Evaluation Systems Test: the mini-BESTest

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Franchignoni, F, Horak, F, Godi, M, Nardone, A, Giordano, A·2010·Journal of Rehabilitation Medicine

DOI 10.2340/16501977-0537PMC PMC3228839

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Abstract

OBJECTIVE: To improve, with the aid of psychometric analysis, the Balance Evaluation Systems Test (BESTest), a tool designed to analyse several postural control systems that may contribute to poor functional balance in adults. METHODS: Performance of the BESTest was examined in a convenience sample of 115 consecutive adult patients with diverse neurological diagnoses and disease severity, referred to rehabilitation for balance disorders. Factor (both explorative and confirmatory) and Rasch analysis were used to process the data in order to produce a new, reduced and coherent balance measurement tool. RESULTS: Factor analysis selected 24 out of the 36 original BESTest items likely to represent the unidimensional construct of "dynamic balance". Rasch analysis was then used to: (i) improve the rating categories, and (ii) delete 10 items (misfitting or showing local dependency). The model consisting of the remaining 14 tasks was verified with confirmatory factor analysis to meet the stringent requirements of modern measurement. CONCLUSION: The new 14-item scale (dubbed mini-BESTest) focuses on dynamic balance, can be conducted in 10-15 min, and contains items belonging evenly to 4 of the 6 sections from the original BESTest. Further studies are needed to confirm the usefulness of the mini-BESTest in clinical settings.

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Additional file 6 of Auditory rhythmical cueing to improve gait in community-dwelling stroke survivors (ACTIVATE): a pilot randomised controlled trial
Shaw, L., McCue, P., Brown, P. E., Buckley, C., Del Din, S., Francis, R. P., Hunter, H., Lambert, A., Lord, S., Price, C. I. M., et al. (2022) · Figshare · doi:10.6084/m9.figshare.21547181
Additional file 5 of Effects of lower extremity constraint-induced movement therapy on gait and balance of chronic hemiparetic patients after stroke: description of a study protocol for a randomized controlled clinical trial
Menezes-Oliveira, E., da Silva Matuti, G., de Oliveira, C. B., de Freitas, S. F., Kawamura, C. M., Lopes, J. A. F., & Arida, R. M. (2021) · Figshare · doi:10.6084/m9.figshare.15020510
Additional file 8 of Effects of lower extremity constraint-induced movement therapy on gait and balance of chronic hemiparetic patients after stroke: description of a study protocol for a randomized controlled clinical trial
Menezes-Oliveira, E., da Silva Matuti, G., de Oliveira, C. B., de Freitas, S. F., Kawamura, C. M., Lopes, J. A. F., & Arida, R. M. (2021) · Figshare · doi:10.6084/m9.figshare.15020519
Additional file 1 of Design of the STEPS trial: a phase II randomized controlled trial evaluating eHealth-supported motor-cognitive home training for Parkinson’s disease
Leavy, B., Sedhed, J., Kalbe, E., Åkesson, E., Franzén, E., & Johansson, H. (2024) · Figshare · doi:10.6084/m9.figshare.26622688
Additional file 2 of Multiple N-of-1 trials to investigate hypoxia therapy in Parkinson’s disease: study rationale and protocol
Daalen, J. M. J., Meinders, M. J., Giardina, F., Roes, K. C. B., Stunnenberg, B. C., Mathur, S., Ainslie, P. N., Thijssen, D. H. J., & Bloem, B. R. (2022) · Figshare · doi:10.6084/m9.figshare.20315866
Additional file 1 of Balance telerehabilitation and wearable technology for people with Parkinson’s disease (TelePD trial)
Silva‐Batista, C., Wilhelm, J. L., Scanlan, K. T., Stojak, M., Carlson‐Kuhta, P., Chen, S., Liu, W., de la Huerta, T. N. G., Horak, F. B., Mancini, M., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26626561
Self-citation
Additional file 6 of Effects of lower extremity constraint-induced movement therapy on gait and balance of chronic hemiparetic patients after stroke: description of a study protocol for a randomized controlled clinical trial
Menezes-Oliveira, E., da Silva Matuti, G., de Oliveira, C. B., de Freitas, S. F., Kawamura, C. M., Lopes, J. A. F., & Arida, R. M. (2021) · Figshare · doi:10.6084/m9.figshare.15020513
Additional file 1 of Multiple N-of-1 trials to investigate hypoxia therapy in Parkinson’s disease: study rationale and protocol
Daalen, J. M. J., Meinders, M. J., Giardina, F., Roes, K. C. B., Stunnenberg, B. C., Mathur, S., Ainslie, P. N., Thijssen, D. H. J., & Bloem, B. R. (2022) · Figshare · doi:10.6084/m9.figshare.20315863
Additional file 2 of Balance Right in Multiple Sclerosis (BRiMS): a feasibility randomised controlled trial of a falls prevention programme
Gunn, H., Stevens, K. N., Creanor, S., Andrade, J., Paul, L., Miller, L., Green, C., Ewings, P., Barton, A., Berrow, M., et al. (2021) · Figshare · doi:10.6084/m9.figshare.13515533
Additional file 3 of Balance Right in Multiple Sclerosis (BRiMS): a feasibility randomised controlled trial of a falls prevention programme
Gunn, H., Stevens, K. N., Creanor, S., Andrade, J., Paul, L., Miller, L., Green, C., Ewings, P., Barton, A., Berrow, M., et al. (2021) · Figshare · doi:10.6084/m9.figshare.13515536
Additional file 9 of Effects of lower extremity constraint-induced movement therapy on gait and balance of chronic hemiparetic patients after stroke: description of a study protocol for a randomized controlled clinical trial
Menezes-Oliveira, E., da Silva Matuti, G., de Oliveira, C. B., de Freitas, S. F., Kawamura, C. M., Lopes, J. A. F., & Arida, R. M. (2021) · Figshare · doi:10.6084/m9.figshare.15020522
Additional file 1 of Feasibility of a specific task-oriented training versus its combination with manual therapy on balance and mobility in people post stroke at the chronic stage: study protocol for a pilot randomised controlled trial
Traxler, K., Schinabeck, F., Baum, E., Klotz, E., & Seebacher, B. (2021) · Figshare · doi:10.6084/m9.figshare.15058063
Additional file 4 of Effects of lower extremity constraint-induced movement therapy on gait and balance of chronic hemiparetic patients after stroke: description of a study protocol for a randomized controlled clinical trial
Menezes-Oliveira, E., da Silva Matuti, G., de Oliveira, C. B., de Freitas, S. F., Kawamura, C. M., Lopes, J. A. F., & Arida, R. M. (2021) · Figshare · doi:10.6084/m9.figshare.15020507
Additional file 1 of Characteristics of balance performance in the Chinese elderly by age and gender
Wu, H., Wei, Y., Miao, X., Li, X., Feng, Y., Yuan, Z., Zhou, P., Ye, X., Zhu, J., Jiang, Y., et al. (2021) · Figshare · doi:10.6084/m9.figshare.16869886
Additional file 3 of Design of the STEPS trial: a phase II randomized controlled trial evaluating eHealth-supported motor-cognitive home training for Parkinson’s disease
Leavy, B., Sedhed, J., Kalbe, E., Åkesson, E., Franzén, E., & Johansson, H. (2024) · Figshare · doi:10.6084/m9.figshare.26622694
Additional file 1 of Minimal detectable change of gait and balance measures in older neurological patients: estimating the standard error of the measurement from before-after rehabilitation data thanks to the linear mixed-effects models
Caronni, A., Picardi, M., Scarano, S., Rota, V., Guidali, G., Bolognini, N., & Corbo, M. (2024) · Figshare · doi:10.6084/m9.figshare.25530166
Additional file 2 of Design of the STEPS trial: a phase II randomized controlled trial evaluating eHealth-supported motor-cognitive home training for Parkinson’s disease
Leavy, B., Sedhed, J., Kalbe, E., Åkesson, E., Franzén, E., & Johansson, H. (2024) · Figshare · doi:10.6084/m9.figshare.26622691
Additional file 3 of Auditory rhythmical cueing to improve gait in community-dwelling stroke survivors (ACTIVATE): a pilot randomised controlled trial
Shaw, L. C., McCue, P., Brown, P. E., Buckley, C., Din, S. D., Francis, R. P., Hunter, H., Lambert, A., Lord, S., Price, C. I. M., et al. (2022) · Figshare · doi:10.6084/m9.figshare.21547172
Additional file 1 of Construct validity of the Mini-BESTest in individuals with chronic pain in specialized pain care
Wagner, S., Bring, A., & Åsenlöf, P. (2023) · Figshare · doi:10.6084/m9.figshare.22914512
Additional file 5 of Auditory rhythmical cueing to improve gait in community-dwelling stroke survivors (ACTIVATE): a pilot randomised controlled trial
Shaw, L., McCue, P., Brown, P. E., Buckley, C., Din, S. D., Francis, R. P., Hunter, H., Lambert, A., Lord, S., Price, C. I. M., et al. (2022) · Figshare · doi:10.6084/m9.figshare.21547178
Additional file 4 of Balance Right in Multiple Sclerosis (BRiMS): a feasibility randomised controlled trial of a falls prevention programme
Gunn, H., Stevens, K. N., Creanor, S., Andrade, J., Paul, L., Miller, L., Green, C., Ewings, P., Barton, A., Berrow, M., et al. (2021) · Figshare · doi:10.6084/m9.figshare.13515539
Additional file 1 of Transcranial alternating current stimulation improves quality of life in Parkinson’s disease: study protocol for a randomized, double-blind, controlled trial
Zhang, H., Hou, T., Jin, Z.-H., Zhang, T., Wang, Y.-H., Cheng, Z., Liu, Y.-H., Fang, J.-P., 闫红娇, Zhen, Y., et al. (2024) · Figshare · doi:10.6084/m9.figshare.25449027
Additional file 2 of Mobile health technology, exercise adherence and optimal nutrition post rehabilitation among people with Parkinson’s Disease (mHEXANUT) – a randomized controlled trial protocol
Alnes, S. R., Lærum‐Onsager, E., Bye, A., Vistven, A., Franzén, E., Holst, M., & Brovold, T. (2023) · Figshare · doi:10.6084/m9.figshare.22610003
Additional file 1 of Feasibility of a novel eHealth intervention for Parkinson’s disease targeting motor-cognitive function in the home
Sedhed, J., Johansson, H., Andersson, N., Åkesson, E., Kalbe, E., Franzén, E., & Leavy, B. (2024) · Figshare · doi:10.6084/m9.figshare.25556567
Additional file 1 of Development and validation of a machine learning-based fall-related injury risk prediction model using nationwide claims database in Korean community-dwelling older population
Heo, K.-N., Seok, J. Y., Ah, Y., Kim, K.-I., Lee, S.-B., & Lee, J.-Y. (2023) · Figshare · doi:10.6084/m9.figshare.24792274
Additional file 2 of Feasibility of a specific task-oriented training versus its combination with manual therapy on balance and mobility in people post stroke at the chronic stage: study protocol for a pilot randomised controlled trial
Traxler, K., Schinabeck, F., Baum, E., Klotz, E., & Seebacher, B. (2021) · Figshare · doi:10.6084/m9.figshare.15058066
Additional file 2 of Transcranial alternating current stimulation improves quality of life in Parkinson’s disease: study protocol for a randomized, double-blind, controlled trial
Zhang, H., Hou, T., Jin, Z.-H., Zhang, T., Wang, Y.-H., Cheng, Z., Liu, Y.-H., Fang, J.-P., 闫红娇, Zhen, Y., et al. (2024) · Figshare · doi:10.6084/m9.figshare.25449179
Additional file 1 of Protocol for a randomised controlled feasibility study of psychologically informed vestibular rehabilitation for people with persistent dizziness: INVEST trial
Herdman, D., Norton, S., Pavlou, M., Murdin, L. J., & Moss-Morris, R. E. (2021) · Figshare · doi:10.6084/m9.figshare.15179486

Authors: Franchignoni, F., Horak, F., Godi, M., Nardone, A., & Giordano, A.
Affiliations: Fondazione Salvatore Maugeri (IT)
Oregon Health & Science University (US)
Università degli Studi del Piemonte Orientale “Amedeo Avogadro” (IT)
ORCID: Franchignoni, F
Horak, F
Godi, M
Nardone, A
Giordano, A
Venue: Journal of Rehabilitation Medicine
Publisher: MJS Publishing, Medical Journals Sweden AB
Published: 2010
Volume: 42
Issue: 4
Pages: 323-331
ISSN: 1650-1977 (ISSN-L)
DOI: 10.2340/16501977-0537
PMC: PMC3228839
OpenAlex: W2156121997
Cited by: 1,081
References: 42
Citations by year: 2026: 86 · 2025: 112 · 2024: 109 · 2023: 95 · 2022: 97 · 2021: 114 · 2020: 93 · 2019: 82 · 2018: 55 · 2017: 51 · 2016: 46 · 2015: 37 · 2014: 31 · 2013: 29 · 2012: 27
FWCI: 58.89
Type: journal article
Language: en
Open access: gold
doi.org
Locations: Journal of Rehabilitation Medicine (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (5r37ag006457-28)
National Institute on Aging (R37-AG006457, R01AG006457, AG 06457)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
Keywords: Balance Evaluation Systems Test, Mini-BESTest, dynamic balance, postural control, balance disorders, neurorehabilitation, psychometric validation, Rasch analysis, factor analysis, item reduction, local dependence
MeSH terms: Adult, Aged, Postural Balance, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Psychometrics, Vestibular Diseases, Gait Disorders, Neurologic

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Using psychometric techniques to improve the Balance Evaluation Systems Test: the mini-BESTest

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