RESUMO
Introduction: The aim of this study was to compare the clinical applicability of the Mini-Balance Evaluation Systems Test and the Berg Balance Scale for measuring balance in inpatients with subacute stroke. Methods: This was a prospective observational study which included 58 consecutive patients admitted to a convalescent rehabilitation hospital with a first-ever stroke and who met the inclusion/exclusion criteria. The Mini-Balance Evaluation Systems Test and the Berg Balance Scale were used to assess patient balance at admission and discharge. The ceiling and floor effects and responsiveness of each balance score were examined. In addition, receiver operating characteristic analysis based on each balance score at admission was used to examine its discriminative power to predict ambulatory independence and falls during hospitalization. Results: The mean (standard deviation) change between admission and discharge for each balance scale was 4.4 (4.7) for the Mini-Balance Evaluation Systems Test and 8.3 (10.0) for the Berg Balance Scale, with standard response means, a measure of responsiveness of 0.9 (large) and 0.8 (medium), respectively. Each balance score at admission almost equally predicted gait independence and fallers during hospitalization. On the contrary, only the distribution of scores on the Berg Balance Scale at discharge showed a ceiling effect, with 25 patients (43%) obtaining a perfect score. Discussion: The Mini-Balance Evaluation Systems Test may be useful as a balance measure for inpatients with subacute stroke because it is less susceptible to ceiling effects and more responsive than the Berg Balance Scale.
RESUMO
OBJECTIVE: The objective of the current study was to evaluate the reliability and validity of the Japanese version of the Mini-Balance Evaluation Systems Test (J-Mini-BESTest) in patients with subacute stroke. METHODS: Eighteen patients who had suffered a first hemiplegic stroke (mean age, 59.1 ± 27.0 years) and had been admitted to convalescent rehabilitation wards were enrolled. The J-Mini-BESTest, the Berg Balance Scale (BBS), and the functional reach test (FRT) were used to assess balance. Four physical therapists (PTs) observed and scored the J-Mini-BESTest while another PT conducted the test. The interrater reliability of the J-Mini-BESTest was assessed using intraclass correlation coefficients (ICC[2,1]) for the total and section scores, and kappa statistics for each item. Internal consistency of the five raters was assessed using Cronbach's alpha. Concurrent validity of the J-Mini-BESTest was assessed against the BBS and FRT using Spearman's correlation coefficients. RESULTS: The ICC[2,1] of the total and section scores were 0.90 (95% confidence interval: 0.81-0.95) and 0.63-0.85, respectively. Cronbach's alphas were 0.80-0.87. The kappa statistics were 0.47-1.00. The scores of the J-Mini-BESTest were significantly correlated with those of the BBS (rho=0.66, p=0.006) but not with those of the FRT (rho=-0.36, p=0.189). CONCLUSION: The J-Mini-BESTest showed excellent inter-rater reliability and internal consistency. Although the J-Mini-BESTest was not correlated with the FRT, it was significantly correlated with the BBS. The J-Mini-BESTest is a reliable and valid tool for evaluating dynamic balance in patients with subacute stroke.
