Background: The Berg Balance Scale (BBS) has several constraints-ceiling effect, low responsiveness, and uncertain predictability of falls-in neurological populations. The Mini-BESTest, which has not yet been validated in spinal cord injury (SCI) populations, has shown no ceiling effect, slightly better responsiveness, and could in some neurological populations predict falls.
Objective: Validate and compare psychometric performances of the BBS and Mini-BESTest in individuals with chronic SCI.
Design: Cross-sectional validation study.
Methods: Forty-six individuals able to walk 10 meters (85% American Spinal Injury Association Impairment Scale grade D) with mean age of 55±17 years and median 7 years (range: 1-41) postinjury were included. Floor/ceiling effects were inspected; internal consistency, construct validity, and receiver operating characteristics were analyzed.
Results: The Mini-BESTest had no ceiling effect; 28% of participants achieved the maximum score on the BBS. Both scales showed excellent internal consistency (α > .93). Strong correlations between both scales (r s = 0.90, P < .001) and between both scales and Timed Up and Go (r s > .70), Spinal Cord Independence Measure-mobility items (r s > .80), and 10-Meter Walk Test (r s > .80) support high construct validity. Both scales could differentiate community walkers without walking aids from participants using aids (AUC > .86) and individuals with low/high concerns about falling (AUC > 0.79) but not recurrent (>2 falls/year) and infrequent fallers (AUC < 0.55). The BBS and Mini-BESTest separated 2 and more than 3 different levels of balance control, respectively.
Limitations: Small sample.
Conclusions: Both the BBS and Mini-BESTest were found to be valid scales for assessing balance control in individuals with chronic SCI. The Mini-BESTest may be preferable for this group primarily due to the lack of a ceiling effect.
© 2017 American Physical Therapy Association