Measurement Properties of the BESTest Scale in People With Neurological Conditions: A Systematic Review With Meta-Analysis.

IF 3.5 4区医学 Q1 ORTHOPEDICS Physical Therapy Pub Date : 2024-12-12 DOI:10.1093/ptj/pzae178

Ilaria Arcolin, Marica Giardini, Federica Tagliabue, Valeria Belluscio, Fay Horak, Marco Godi

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Abstract

Objective: People with neurological conditions (PwNC) frequently fall, mainly due to balance impairments. Among the scales assessing balance, the Balance Evaluation System Test (BESTest) is one of the most comprehensive in evaluating all components of postural control. This study aimed to systematically review and summarize the measurement properties of the BESTest in PwNC.

Methods: Embase, MEDLINE, ScienceDirect, Scopus, and PEDro were searched up to December 2023. Studies assessing at least 1 BESTest measurement property in PwNC were included. Methodological quality of studies was assessed with the COSMIN Risk of Bias checklist. Overall rating and level of evidence for each property were given according to COSMIN criteria. Where possible, meta-analysis was performed.

Results: Thirty-six studies (1749 PwNC) were included. The BESTest demonstrated a high quality of evidence supporting good reliability (intraclass correlation coefficients = 0.96-0.98 for total score, and 0.70-0.98 for subsections), internal consistency, and measurement error. High quality levels of responsiveness, and content and construct validity were also found. However, evidence for structural validity was insufficient to be sure the BESTest actually tests several, or 1, balance constructs. Criterion validity cannot be evaluated. While translated into different languages, cross-cultural validity has never been assessed in PwNC. Evidence to support use of the BESTest for specific neurological conditions is limited to Parkinson disease and stroke, due to the small sample sizes and number of studies in other populations.

Conclusion: This systematic review provided high quality evidence supporting the reliability, content and construct validity, and responsiveness of the BESTest to intervention, being able to detect balance changes and to differentiate heterogeneous PwNC based on fall history, falling risk, and physical performance. However, low-quality evidence was found when considering each neurological condition alone. To comprehensively understand the BESTest measurement properties, future studies are needed with larger samples for each neurological condition, especially assessing cross-cultural and structural validity.

Impact: Assessing balance is crucial for fall risk prevention. The BESTest has been demonstrated to be a reliable, responsive, and valid scale usable in clinical setting for assessing balance in PwNC.

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神经系统疾病患者最佳量表的测量特性：一项荟萃分析的系统综述。

目的：神经系统疾病（PwNC）患者经常跌倒，主要是由于平衡障碍。在评估平衡的量表中，平衡评估系统测试（BESTest）是评估姿势控制各组成部分最全面的量表之一。本研究旨在系统地回顾和总结best在PwNC中的测量特性。方法：Embase、MEDLINE、ScienceDirect、Scopus、PEDro等数据库检索至2023年12月。在PwNC中评估至少1个best测量特性的研究被纳入。采用COSMIN偏倚风险检查表评估研究的方法学质量。根据COSMIN标准给出每个属性的总体评级和证据水平。在可能的情况下，进行meta分析。结果：纳入36项研究（1749 PwNC）。BESTest证明了高质量的证据支持良好的信度（总分的类内相关系数= 0.96-0.98，分段的相关系数为0.70-0.98）、内部一致性和测量误差。高质量水平的反应，内容和结构效度也被发现。然而，结构效度的证据不足以确保BESTest实际上测试了几个或1个平衡结构。标准效度无法评估。虽然被翻译成不同的语言，但在PwNC中从未评估过跨文化效度。由于其他人群的样本量小且研究数量多，支持使用BESTest治疗特定神经系统疾病的证据仅限于帕金森病和中风。结论：本系统综述提供了高质量的证据，支持BESTest的可靠性、内容和结构效度，以及对干预的反应性，能够检测平衡变化，并根据跌倒史、跌倒风险和身体表现区分异质PwNC。然而，当单独考虑每一种神经系统疾病时，发现了低质量的证据。为了全面了解best测量特性，未来需要对每种神经系统疾病进行更大样本的研究，特别是评估跨文化和结构效度。影响：评估平衡对于预防跌倒风险至关重要。BESTest已被证明是一种可靠、反应灵敏、有效的量表，可用于临床评估PwNC的平衡。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Physical Therapy Multiple-

CiteScore

7.10

自引率

0.00%

发文量

187

审稿时长

4-8 weeks

期刊介绍： Physical Therapy (PTJ) engages and inspires an international readership on topics related to physical therapy. As the leading international journal for research in physical therapy and related fields, PTJ publishes innovative and highly relevant content for both clinicians and scientists and uses a variety of interactive approaches to communicate that content, with the expressed purpose of improving patient care. PTJ"s circulation in 2008 is more than 72,000. Its 2007 impact factor was 2.152. The mean time from submission to first decision is 58 days. Time from acceptance to publication online is less than or equal to 3 months and from acceptance to publication in print is less than or equal to 5 months.