Department of Physical Therapy, Ibaraki Prefectural University of Health Science, 300-0394 Inashiki-gun, Japan. E-mail:
J Rehabil Med. 2021 Sep 24;53(9):jrm00230. doi: 10.2340/16501977-2870.
To determine which sections of the Balance Evaluation Systems Test (BESTest) distinguish levels of post-stroke functional walking status and to establish their cut-off scores.
A retrospective cross-sectional study.
The BESTest was administered to 87 stroke patients who were able to walk without physical assistance upon discharge from the hospital. Subjects were divided into 3 functional walking status groups: namely, household ambulators, limited community ambulators, and unlimited community ambulators. The receiver operating characteristic curve was determined and the cut-off score and area under the receiver operating characteristic curve (AUROC) of each section calculated.
In the comparison of household and limited community ambulators, the accuracies of all BESTest sections were moderate (AUROC>0.7), and the cut-off scores were 36.1-78.6%. In the comparison of limited and unlimited community ambulators, one section (stability in gait) had high accuracy (AUROC=0.908, cut-off scores=73.8%) and 3 sections (biomechanical constraints, anticipatory postural adjustments, and postural response) had moderate accuracy (AUROC=0.8120-0.834, cut-off scores=75.0-83.4%).
This study demonstrated that different sections of the BESTest had different abilities to discriminate levels of post-stroke functional walking status, and identified cut-off values for targeted improvement.
确定平衡评估系统测试（BESTest）的哪些部分能够区分脑卒中后功能性行走水平，并确定其截断分数。
回顾性横断面研究。
对 87 名脑卒中后出院时无需身体辅助即可行走的患者进行 BESTest 测试。将受试者分为 3 个功能性行走状态组：即家庭助行器、有限社区助行器和无限社区助行器。确定受试者工作特征曲线，并计算各部分的截断分数和受试者工作特征曲线下面积（AUROC）。
在家庭助行器和有限社区助行器的比较中，所有 BESTest 部分的准确性均为中度（AUROC>0.7），截断分数为 36.1-78.6%。在有限社区助行器和无限社区助行器的比较中，有一个部分（步态稳定性）具有较高的准确性（AUROC=0.908，截断分数=73.8%），有 3 个部分（生物力学限制、预期姿势调整和姿势反应）具有中度准确性（AUROC=0.8120-0.834，截断分数=75.0-83.4%）。
本研究表明，BESTest 的不同部分区分脑卒中后功能性行走水平的能力不同，并确定了针对性改善的截断值。
