Work

Comparison of the structural validity of three Balance Evaluation Systems Test in older adults with femoral or vertebral fracture

Year: 2020

Type: article

Abstract: The Balance Evaluation Systems Test (BESTest), a clinical balance measure, categorizes balance into 6 factors.The aim of this study was to determine which short versions of the BESTest, Mini-BESTest, and Brief-BESTest, were most appropriate for assessing balance impairments in older adults with femoral or vertebral fracture.Subjects were older adults (age ≥65 years), who could walk with out physical assistance.The models' fitting was evaluated for four BESTest models (BESTest, one-factor Mini-BESTest, four-factor Mini-BESTest, and Brief-BESTest).The four-factor Mini-BESTest model was the only model that had a good fit and reflected the balance ability in older adults with femoral or vertebral fracture.We suggest that the using the four-factor Mini-BESTest model and seeing dynamic balance as composed of four factors may help therapists in making clinical decisions.Objective: To clarify and compare the structural validity of 3 Balance Evaluation Systems Tests (BESTest, Mini-BESTest, and Brief-BESTest) in older adults with femoral or vertebral fractures.Design: Cross-sectional study.Subjects: Ninety-four older adults (age ≥65 years) with femoral or vertebral fractures, who could walk without physical assistance.Methods: Four BESTest models (BESTest, one-factor Mini-BESTest, four-factor Mini-BESTest, and Brief-BESTest) were examined using confirmatory factor analysis, and the models' goodness-of-fit was assessed.Unidimensionality of the best-fitting model was confirmed by Rasch principal component analysis on the residuals.Results: Confirmatory factor analysis showed that the four-factor Mini-BESTest model (comparative fit index = 0.952; Tucker-Lewis index = 0.937; root-mean square error of approximation = 0.060; standardized root-mean-square residual = 0.062) has a better structure than other models.The principal component analysis of standardized residuals showed that the variance attributable to Rasch factor was good, with eigenvalues < 2, confirming the factor's unidimensionality.Conclusion: The four-factor Mini-BESTest model shows good structural validity in older adults with femoral or vertebral fracture.Evaluating dynamic balance by focusing on 4 components (anticipatory postural adjustments, postural responses, sensory orientation, and stability in gait) may help therapists in making clinical decisions.

Source: Journal of Rehabilitation Medicine

DOI: 10.2340/16501977-2709