Division of Physical Medicine and Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Veruno, Italy.
Department of Electronics, Information and Bioengineering, Neuroengineering and Medical Robotics Laboratory, Politecnico di Milano, Milan, Italy.
Phys Ther. 2019 Nov 25;99(11):1562-1573. doi: 10.1093/ptj/pzz103.
The Brief Balance Evaluation Systems Test (Brief-BESTest) could be a useful tool for balance assessment. Although some psychometric characteristics have been examined, others still need to be clarified.
The objective was to assess the structural validity, convergent validity, discriminant validity, and internal consistency of the Brief-BESTest in neurological patients.
This was a cross-sectional study.
Data were from 416 patients with neurological disease and related balance disorders. Patients were assessed with the 5-levels Activities-Specific Balance Confidence Scale (ABC 5-levels), Brief-BESTest, and some simple balance tests (ie, 1-leg stance, Timed "Up & Go" test, functional reach, and a fall history questionnaire). Three Brief-BESTest models were examined through confirmatory factor analysis, and the following indexes were calculated: Comparative Fit Index, Tucker-Lewis Index, and root-mean-square error of approximation. Convergent validity was assessed by calculating the correlation between Brief-BESTest and ABC 5-levels total scores. Receiver operating characteristics assessed the ability of each model to differentiate between people with falls and those without falls. Internal consistency was measured with Cronbach α and coefficient ω.
Confirmatory factor analysis showed model 3 (Comparative Fit Index = 0.97; Tucker-Lewis Index = 0.95; root-mean-square error of approximation = 0.05), with item 1 removed and error covariance between items 3 and 4 and between items 5 and 6, to have a significantly better structure than models 1 and 2. The correlation between Brief-BESTest and ABC 5-levels was 0.61 (Spearman ρ) for all 3 models. The area under the curve of the receiver operating characteristics showed an acceptable accuracy (0.72) in distinguishing patients with a history of falls from those without a history of falls (95% confidence interval = 0.66-0.78) for all models and was superior to the areas under the curve of other simple balance tests (1-leg stance, Timed "Up & Go" test, functional reach). Cronbach α was good for Brief-BESTest models 1 (0.92) and 3 (0.92), but ω was greater than 0.80 only for model 3.
The sample was heterogeneous.
The Brief-BESTest, after some changes, shows good validity and internal consistency in patients affected by different balance disorders.
简短平衡评估系统测试（Brief-BESTest）可能是一种有用的平衡评估工具。尽管已经检查了一些心理测量学特征，但其他特征仍需要澄清。
本研究旨在评估神经科患者中 Brief-BESTest 的结构效度、收敛效度、判别效度和内部一致性。
这是一项横断面研究。
数据来自 416 名患有神经疾病和相关平衡障碍的患者。患者使用 5 级活动特异性平衡信心量表（ABC 5 级）、Brief-BESTest 和一些简单的平衡测试（即单腿站立、计时“起身和行走”测试、功能性伸展和跌倒史问卷）进行评估。通过验证性因子分析检查了三个 Brief-BESTest 模型，并计算了以下指标：比较拟合指数、塔克-刘易斯指数和近似均方根误差。通过计算 Brief-BESTest 与 ABC 5 级总分之间的相关性来评估收敛效度。受试者工作特征评估了每个模型区分跌倒患者和非跌倒患者的能力。内部一致性通过 Cronbach α 和系数 ω 进行测量。
验证性因子分析表明，模型 3（比较拟合指数=0.97；塔克-刘易斯指数=0.95；近似均方根误差=0.05），删除项目 1，并在项目 3 和 4 以及项目 5 和 6 之间建立误差协方差，与模型 1 和模型 2 相比，结构显著更好。所有 3 个模型中，Brief-BESTest 与 ABC 5 级之间的相关性为 0.61（Spearman ρ）。受试者工作特征曲线下面积显示，所有模型在区分有跌倒史和无跌倒史的患者方面具有可接受的准确性（0.72）（95%置信区间=0.66-0.78），优于其他简单平衡测试（单腿站立、计时“起身和行走”测试、功能性伸展）的曲线下面积。Cronbach α 对于 Brief-BESTest 模型 1（0.92）和模型 3（0.92）是良好的，但只有模型 3 的 ω 大于 0.80。
样本具有异质性。
经过一些修改，Brief-BESTest 在受不同平衡障碍影响的患者中表现出良好的有效性和内部一致性。
