Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
BMC Musculoskelet Disord. 2023 May 17;24(1):391. doi: 10.1186/s12891-023-06504-9.
Balance assessment scales are important clinical tests to identify balance impairments. Chronic pain (> 3 months) is associated with impaired dynamic balance; however, very few balance assessment scales are psychometrically evaluated for the population. The purpose of this study was to evaluate the construct validity and internal consistency of the Mini-BESTest for individuals with chronic pain in specialized pain care.
In this cross-sectional study, 180 individuals with chronic pain (> 3 months) were assessed with the Mini-BESTest and included in the analyses. For construct validity, five alternative factor structures were evaluated using a confirmatory factor analysis. In addition, we tested the a priori hypotheses about convergent validity with the 10-meter walk test, and divergent validity with the Brief Pain Inventory (BPI): pain intensity, the Tampa Scale of Kinesiophobia-11 (TSK-11), and the Pain Catastrophizing Scale (PCS-SW). Internal consistency was evaluated for the model with the best fit.
A one-factor model with added covariance via the modification indices showed adequate fit indices. In line with our hypotheses, Mini-BESTest showed convergent validity (r = > 0.70) with the 10-meter walk test, and divergent validity (r = < 0.50) with BPI pain intensity, TSK-11, and PCS-SW. Internal consistency for the one-factor model was good (α = 0.92).
Our study supported the construct validity and internal consistency of the Mini-BESTest for measuring balance in individuals with chronic pain, who were referred to specialized pain care. The one-factor model showed an adequate fit. In comparison, models with subscales did not reach convergence, or showed high correlations between subscales, implying that Mini-BESTest is measuring one construct in this sample. We, therefore, propose using the total score, instead of subscale scores, for individuals with chronic pain. However, further studies are necessary to establish the reliability of the Mini-BESTest in the population.
平衡评估量表是识别平衡障碍的重要临床测试。慢性疼痛（>3 个月）与动态平衡受损有关；然而，很少有平衡评估量表针对该人群进行心理测量评估。本研究的目的是评估专门的疼痛护理中慢性疼痛患者的 Mini-BESTest 的结构效度和内部一致性。
在这项横断面研究中，对 180 名患有慢性疼痛（>3 个月）的患者进行了 Mini-BESTest 评估，并将其纳入分析。为了评估结构效度，使用验证性因子分析评估了五种替代因子结构。此外，我们还测试了与 10 米步行测试的会聚效度的先验假设，以及与简明疼痛量表（BPI）的发散效度：疼痛强度、运动恐惧量表-11（TSK-11）和疼痛灾难化量表（PCS-SW）。对于具有最佳拟合的模型，评估了内部一致性。
通过修正指标添加协方差的单因素模型显示出适当的拟合指数。与我们的假设一致，Mini-BESTest 显示与 10 米步行测试具有会聚效度（r>0.70），与 BPI 疼痛强度、TSK-11 和 PCS-SW 具有发散效度（r<0.50）。单因素模型的内部一致性良好（α=0.92）。
我们的研究支持 Mini-BESTest 在专门的疼痛护理中测量慢性疼痛患者平衡的结构效度和内部一致性。单因素模型显示出适当的拟合。相比之下，具有子量表的模型没有收敛，或者子量表之间存在高度相关性，这表明在该样本中，Mini-BESTest 正在测量一个结构。因此，我们建议在慢性疼痛患者中使用总分，而不是子量表分数。然而，还需要进一步的研究来确定 Mini-BESTest 在人群中的可靠性。
