Physical and Rehabilitation Medicine Unit (F.F.), Scientific Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Varese, Italy; and Physical Medicine and Rehabilitation Unit (M.G., S.C.) and Bioengineering Unit (A.G.), Scientific Institute of Veruno, Istituti Clinici Scientifici Maugeri IRCCS, Gattico-Veruno, Novara, Italy.
J Neurol Phys Ther. 2022 Jul 1;46(3):219-226. doi: 10.1097/NPT.0000000000000401. Epub 2022 Apr 11.
The Mini-BESTest is a balance measure with robust psychometric properties widely used in people with Parkinson disease. The aim of this study was to examine-with advanced psychometric techniques-some key properties of the Mini-BESTest (including unidimensionality, functioning of rating categories, internal construct validity, reliability indexes) in a consecutive sample of individuals with Parkinson disease admitted for balance rehabilitation.
Confirmatory factor analysis and Rasch analysis (partial credit model) were performed on 193 individual raw scores of the Mini-BESTest items.
Confirmatory factor analysis fit indices and principal component analysis of the residuals confirmed the scale's unidimensionality. At Rasch analysis, the 3-level rating scale demonstrated appropriate functioning. All items fitted the Rasch model. Item response dependence was negligible. No differential item functioning was found across gender and age groups.
We confirmed and extended the evidence (demonstrated in different populations) on the general psychometric soundness of the Mini-BESTest, even when tested with rigorous statistical methods. In addition, 2 forms were created: (i) to transform raw scores into linear estimates of dynamic balance; and (ii) to compare the individual's item responses with those expected by the Rasch model (thus providing an aid for tailored interventions) and manage missing responses. Further independent studies using advanced psychometric techniques are warranted, also in people with balance disturbances of different etiology. Our study further increases the confidence in using the Mini-BESTest to assess dynamic balance in people with Parkinson disease and provides some useful additional clinical aids for interpreting the results and calculating more precise change scores.See the Supplementary Video, available at: http://links.lww.com/JNPT/A384.
Mini-BESTest 是一种平衡测量工具，具有广泛应用于帕金森病患者的强大心理计量学特性。本研究的目的是使用先进的心理计量学技术，在接受平衡康复治疗的连续帕金森病患者样本中，检查 Mini-BESTest 的一些关键特性（包括维度性、评分类别功能、内部结构有效性、可靠性指标）。
对 Mini-BESTest 项目的 193 项个体原始得分进行验证性因子分析和 Rasch 分析（部分信用模型）。
验证性因子分析拟合指数和残差的主成分分析证实了该量表的维度性。在 Rasch 分析中，3 级评分量表显示出适当的功能。所有项目均符合 Rasch 模型。项目反应依赖性可忽略不计。未发现性别和年龄组之间的差异项目功能。
我们证实并扩展了证据（在不同人群中证明），表明 Mini-BESTest 的总体心理计量学特性良好，即使使用严格的统计方法进行测试也是如此。此外，还创建了 2 种形式：（i）将原始分数转换为动态平衡的线性估计值；（ii）将个体的项目反应与 Rasch 模型预期的反应进行比较（从而为量身定制的干预提供帮助），并处理缺失的反应。需要进一步进行使用先进心理计量学技术的独立研究，也需要在具有不同病因的平衡障碍患者中进行。我们的研究进一步增强了使用 Mini-BESTest 评估帕金森病患者动态平衡的信心，并为解释结果和计算更精确的变化分数提供了一些有用的附加临床帮助。请观看补充视频，网址为：http://links.lww.com/JNPT/A384。
