Phyu Sitt Nyein, Wanpen Sawitri, Chatchawan Uraiwan
Human Movement Sciences, School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medicine Sciences, Khon Kaen University, Khon Kaen, Thailand.
J Multidiscip Healthc. 2022 Dec 29;15:3015-3028. doi: 10.2147/JMDH.S392058. eCollection 2022.
Mini-BESTest is an instrument for assessing the balance impairment; however, the use of the Mini-BESTest in type 2 diabetic patients with peripheral neuropathy is not well documented in the literature. The aim of this study was to examine the responsiveness and the minimal important change (MIC) of the Mini-BESTest after four weeks of the balance exercises.
A prospective single group pretest-posttest design was applied, and forty-eight type 2 diabetic patients with peripheral neuropathy were participated (mean age of 59.04 ± 7.533 years; 3 males and 45 females). All participants were given an intervention program including foot care and balance exercises (50-minute sessions, three times a week for four weeks). The responsiveness of the Mini-BESTest was determined using two approaches: 1) the distribution-based method evaluating the change scores (pre- and post-intervention), the effect size (ES), the standard response mean (SRM), the standard error of measurement (SEM) and the minimum detectable change (MDC) and 2) the anchor-based method evaluating the MIC using the Global Rating of Change scale (GRC) as an external criterion.
After the balance exercises treatment, the Mini-BESTest scores significantly improved (p < 0.001) with an ES of 3.9 and SRM of 4.32. SEM was 0.73 and MDC was 2.03 points. The area under the receiver operating characteristic (ROC) curve corresponded to 81%. The cutoff point of the Mini-BESTest was ≥5 points corresponding to the GRC ≤3 versus >3 for the discrimination of the Mini-BESTest between improvement and no improvement after exercises.
The Mini-BESTest can be demonstrated as high responsiveness according to the determination of the distribution-based and the anchor-based methods. The MIC of the Mini-BESTest was taken as ≥5 points and could be used as an outcome measure for the discriminated evaluation of type 2 diabetic patients with peripheral neuropathy.
Mini-BESTest是一种用于评估平衡功能障碍的工具；然而，在2型糖尿病合并周围神经病变患者中使用Mini-BESTest的情况在文献中记载较少。本研究的目的是探讨平衡训练四周后Mini-BESTest的反应性和最小重要变化（MIC）。
采用前瞻性单组前后测设计，48例2型糖尿病合并周围神经病变患者参与研究（平均年龄59.04±7.533岁；男性3例，女性45例）。所有参与者均接受包括足部护理和平衡训练的干预方案（每次50分钟，每周三次，共四周）。Mini-BESTest的反应性通过两种方法确定：1）基于分布的方法，评估变化分数（干预前后）、效应量（ES）、标准反应均值（SRM）、测量标准误（SEM）和最小可检测变化（MDC）；2）基于锚定的方法，使用变化总体评定量表（GRC）作为外部标准评估MIC。
平衡训练治疗后，Mini-BESTest评分显著改善（p<0.001），ES为3.9，SRM为4.32。SEM为0.73，MDC为2.03分。受试者工作特征（ROC）曲线下面积为81%。Mini-BESTest的截断点为≥5分，对应GRC≤3表示训练后有改善，GRC>3表示无改善，用于区分Mini-BESTest训练后是否有改善。
根据基于分布和基于锚定的方法的测定，Mini-BESTest具有较高的反应性。Mini-BESTest的MIC为≥5分，可作为2型糖尿病合并周围神经病变患者鉴别评估的结局指标。
