Jørgensen Vivien, Opheim Arve, Halvarsson Alexandra, Franzén Erika, Roaldsen Kirsti Skavberg
Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden, and Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen N-1450, Norway.
Department of Research, Sunnaas Rehabilitation Hospital.
Phys Ther. 2017 Jun 1;97(6):677-687. doi: 10.1093/ptj/pzx030.
The Berg Balance Scale (BBS) has several constraints-ceiling effect, low responsiveness, and uncertain predictability of falls-in neurological populations. The Mini-BESTest, which has not yet been validated in spinal cord injury (SCI) populations, has shown no ceiling effect, slightly better responsiveness, and could in some neurological populations predict falls.
Validate and compare psychometric performances of the BBS and Mini-BESTest in individuals with chronic SCI.
Cross-sectional validation study.
Forty-six individuals able to walk 10 meters (85% American Spinal Injury Association Impairment Scale grade D) with mean age of 55±17 years and median 7 years (range: 1-41) postinjury were included. Floor/ceiling effects were inspected; internal consistency, construct validity, and receiver operating characteristics were analyzed.
The Mini-BESTest had no ceiling effect; 28% of participants achieved the maximum score on the BBS. Both scales showed excellent internal consistency (α > .93). Strong correlations between both scales (r s = 0.90, P < .001) and between both scales and Timed Up and Go (r s > .70), Spinal Cord Independence Measure-mobility items (r s > .80), and 10-Meter Walk Test (r s > .80) support high construct validity. Both scales could differentiate community walkers without walking aids from participants using aids (AUC > .86) and individuals with low/high concerns about falling (AUC > 0.79) but not recurrent (>2 falls/year) and infrequent fallers (AUC < 0.55). The BBS and Mini-BESTest separated 2 and more than 3 different levels of balance control, respectively.
Small sample.
Both the BBS and Mini-BESTest were found to be valid scales for assessing balance control in individuals with chronic SCI. The Mini-BESTest may be preferable for this group primarily due to the lack of a ceiling effect.
伯格平衡量表（BBS）在神经疾病人群中存在一些局限性——天花板效应、低反应性以及跌倒预测的不确定性。简短伯格平衡量表（Mini-BESTest）尚未在脊髓损伤（SCI）人群中得到验证，该量表没有天花板效应，反应性稍好，并且在一些神经疾病人群中能够预测跌倒。
验证并比较BBS和Mini-BESTest在慢性SCI个体中的心理测量学性能。
横断面验证研究。
纳入46名能够行走10米的个体（85%为美国脊髓损伤协会损伤量表D级），平均年龄55±17岁，损伤后中位数为7年（范围：1 - 41年）。检查地板/天花板效应；分析内部一致性、结构效度和受试者工作特征。
Mini-BESTest没有天花板效应；28%的参与者在BBS上获得了最高分。两个量表均显示出极好的内部一致性（α>.93）。两个量表之间（rs = 0.90，P<.001）以及两个量表与计时起立行走测试（rs>.70）、脊髓独立测量-运动项目（rs>.80）和10米步行测试（rs>.80）之间的强相关性支持了较高的结构效度。两个量表都能够区分无需辅助器具的社区步行者与使用辅助器具的参与者（AUC>.86）以及对跌倒有低/高担忧的个体（AUC>0.79），但无法区分跌倒频繁者（每年>2次跌倒）和偶尔跌倒者（AUC<0.55）。BBS和Mini-BESTest分别区分出2个及3个以上不同水平的平衡控制。
样本量小。
BBS和Mini-BESTest均被发现是评估慢性SCI个体平衡控制的有效量表。Mini-BESTest可能更适合该群体，主要是因为它没有天花板效应。
