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Phys Ther. 2013 Apr;93(4):542-50. doi: 10.2522/ptj.20120302. Epub 2012 Nov 21.

Comparative utility of the BESTest, mini-BESTest, and brief-BESTest for predicting falls in individuals with Parkinson disease: a cohort study.

Author information

1
Program in Physical Therapy, Department of Anatomy & Neurobiology, Washington University School of Medicine, St Louis, Missouri 63108, USA.

Abstract

BACKGROUND:

The newly developed brief-balance evaluation system test (brief-BESTest) may be useful for measuring balance and predicting falls in individuals with Parkinson disease (PD).

OBJECTIVES:

The purposes of this study were: (1) to describe the balance performance of those with PD using the brief-BESTest, (2) to determine the relationships among the scores derived from the 3 versions of the BESTest (i.e., full BESTest, mini-BESTest, and brief-BESTest), and (3) to compare the accuracy of the brief-BESTest with that of the mini-BESTest and BESTest in identifying recurrent fallers among people with PD.

DESIGN:

This was a prospective cohort study.

METHODS:

Eighty participants with PD completed a baseline balance assessment. All participants reported a fall history during the previous 6 months. Fall history was again collected 6 months (n=51) and 12 months (n=40) later.

RESULTS:

At baseline, participants had varying levels of balance impairment, and brief-BESTest scores were significantly correlated with mini-BESTest (r=.94, P<.001) and BESTest (r=.95, P<.001) scores. Six-month retrospective fall prediction accuracy of the Brief-BESTest was moderately high (area under the curve [AUC]=0.82, sensitivity=0.76, and specificity=0.84). Prospective fall prediction accuracy over 6 months was similarly accurate (AUC=0.88, sensitivity=0.71, and specificity=0.87), but was less sensitive over 12 months (AUC=0.76, sensitivity=0.53, and specificity=0.93).

LIMITATIONS:

The sample included primarily individuals with mild to moderate PD. Also, there was a moderate dropout rate at 6 and 12 months.

CONCLUSIONS:

All versions of the BESTest were reasonably accurate in identifying future recurrent fallers, especially during the 6 months following assessment. Clinicians can reasonably rely on the brief-BESTest for predicting falls, particularly when time and equipment constraints are of concern.

PMID:
23174567
PMCID:
PMC3613340
DOI:
10.2522/ptj.20120302
[Indexed for MEDLINE]
Free PMC Article
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