Balance Evaluation Systems Test BESTest

Transcription

1 Jpn J Rehabil Med 2014 ; : Balance Evaluation Systems Test BESTest 1, 2 3, 4, Validation of the Japanese Version of the Balance Evaluation Systems Test BESTest Eri OTAKA, 1, 2 Yohei OTAKA, 3, 4, 5 Mitsuo MORITA, 3 Akimasa YOKOYAMA, 4 Takaharu KONDO, 2 Meigen LIU 5 Abstract Objective : The Balance Evaluation Systems Test BESTest is a new balance assessment set based on systems theory. The purpose was to examine the validity of the Japanese version of the BESTest J-BESTest that we translated. Methods : The J-BESTest was produced using a translation and back translation method referenced from a guideline proposed by Guillemin et al. We tested 20 patients with balance dysfunction due to various diseases and 5 healthy persons with the J-BESTest, the Berg Balance Scale BBS, the Falls Efficacy Scale-International FES-I and the Activities-specific Balance Confidence Scale ABC Scale. We assessed the concurrent validity of the J-BESTest by comparing it with the other measures using Spearman s correlation method. Furthermore, we compared the ability of the J-BESTest to discriminate balance dysfunction with that of the BBS using receiver operating characteristic ROC analyses. Results : The J-BESTest was highly correlated with BBS r 0.84, p 0.01, FES-I r 0.61, p 0.01 and ABC Scale r 0.63, p The distribution of the BBS score was more skewed compared with the J-BESTest and had a ceiling effect 6 participants had perfect scores with BBS versus none with the J-BESTest. The area under the ROC curve AUC of the J-BESTest was significantly larger than that of BBS BBS 0.75, 95 confidence interval versus J-BESTest 0.94, 95 confidence interval , p Conclusion : The J-BESTest was suggested as a clinically useful tool, with good concurrent validity and better sensitivity and specificity than BBS, to identify people with mild balance dysfunction. Jpn J Rehabil Med. Balance Evaluation Systems Test BESTest BESTest BESTest Berg Balance Scale BBS FES-I Activities-specific Balance Confidence Scale ABC Scale Spearman BBS BESTest ROC Department of Rehabilitation Medicine, Eisei Hospital National Hospital Organization East Saitama National Hospital Keiyu Orthopaedic Hospital Tokyo Bay Rehabilitation Hospital Department of Rehabilitation Medicine, Keio University School of Medicine eyokohama93@gmail.com Jpn J Rehabil Med VOL. 51 NO

2 Balance Evaluation Systems Test BESTest BESTest BESTest Berg Balance Scale BBS FES-I Activities-specific Balance Confidence Scale ABC Scale Spearman BBS BESTest ROC BESTest BBS r 0.84 FES-I r 0.61 ABC Scale r 0.63 p 0.01 BBS BESTest ROC AUC p 0.05 BESTest BBS Key words : postural controlbalance control clinical assessment validation study 1 Functional Reach Test 2 Berg Balance Scale 3 4 Balance Evaluation Systems Test BESTest BESTest BESTest Guillemin 6 Fay B. Horak BESTest 1 Balance Disorder Lab, Oregon Health & Science University BESTest m Jpn J Rehabil Med VOL. 51 NO

3 BESTest n 20 n Functional ambulation category m a MSA-c g-nail b YAM a 6 b wall-occiput test YAM young adult mean. UMIN UMIN ID BESTest BESTest DVD Functional Ambulation Category m BESTest Berg Balance Scale BBS BBS 4 Falls Efficacy Scale-International FES-I Falls Efficacy Scale Activities-specific Balance Confidence Scale ABC Scale FES BESTest ABC Scale 16 5 BESTest BBS FES-I ABC Scale Jpn J Rehabil Med VOL. 51 NO

4 Spearman ROC receiver operating characteristic BBS BESTest Delong Youden index 1 R version BESTest 16 BESTest BBS FES-I ABC Scale BESTest BBS r 0.84 p 0.01 FES-I r 0.61 p 0.01 ABC Scale r 0.63 p 0.01 BBS BESTest BBS BESTest BBS BESTest skewness BBS 0.81BESTest 0.14 BBS BESTest BBS BESTest ROC BBS BESTest ROC Area under the curve AUC BESTest p 0.05 BBS BESTest BESTest BESTest a BBS r 0.84 p 0.01 b FES-I r 0.61 p 0.01 c ABC Scale r 0.63 p 0.01 r Spearman 568 Jpn J Rehabil Med VOL. 51 NO

5 BESTest BBS BESTest a BBS b BESTest BBS skewness BBS 0.81 BESTest BESTest 17 Mini-BESTest BESTest 18 5 BESTest BBS BESTest ROC a BBS b BESTest ROC 1 ROC AUC BBS BESTest BESTest BBS BBS 19 BESTest Jpn J Rehabil Med VOL. 51 NO

6 ROC BESTest BESTest 40 BESTest Mini-BESTest 20 BESTest Oregon Health & Science Fay Horak Laurie King 1 Shumway-Cook A, Woollacott MH : 3,, 2009 ; pp Duncan PW, Weiner DK, Chandler J, Studenski S : Functional reach : a new clinical measure of balance. J Gerontol 1990 ; : M Berg KO, Wood-Dauphinee SL, Williams JI, Maki B : Measuring balance in the elderly : validation of an instrument. Can J Public Health 1992 ; Suppl 2 : S Persad CC, Cook S, Giordani B : Assessing falls in the elderly : should we use simple screening tests or a comprehensive fall risk evaluation? Eur J Phys Rehabil Med 2010 ; : Horak FB, Wrisley DM, Frank J : The balance evaluation systems test BESTest to differentiate balance deficits. Phys Ther 2009 ; : Guillemin F, Bombardier C, Beaton D : Cross-cultural adaptation of health-related quality of life measures : literature review and proposed guidelines. J Clin Epidemiol 1993 ; : Auais MA, Eilayyan O, Mayo NE : Extended exercise rehabilitation after hip fracture improves patients physical function : a systematic review and meta-analysis. Phys Ther 2012 ; : Pahwa R, Koller WC : Gait disorders in Parkinsonism and Other Movement Disorders. in Gait Disorders of Aging : falls and therapeutic strategies ed by Masdeu JC, Sudarsky L, Wolfson L. Lippincott-Raven Publishers, Philadelphia, 1997 ; pp Missaoui B, Rakotovao E, Bendaya S, Mane M, Pichon B, Faucher M, Thoumie P : Posture and gait abilities in patients with myotonic dystrophy Steinert disease. Evaluation on the short-term of a rehabilitation program. Ann Phys Rehabil Med 2010 ; : de Groot MH, van der Jagt-Willems HC, van Campen JP, Lems WF, Lamoth CJ. Testing postural control among various osteoporotic patient groups : a literature review. Geriatr Gerontol Int 2012 ; : de Oliveira CB, de Medeiros IR, Frota NA, Greters ME and Conforto AB : Balance control in hemiparetic stroke patients : main tools for evaluation. J Rehabil Res Dev 2008 ; : Holden MK, Gill KM, Magliozzi MR, NathanJ, Piehl- Baker L : Clinical gait assessment in the neurologically impaired : reliability and meaningfulness. Phys Ther 1984 ; : Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C : Development and initial validation of the Falls Efficacy Scale-International FES-I. Age Ageing 2005 ; : ,,,, : the Falls Efficacy Scale-International ; : Powell LE, Myers AM : The activities-specific balance confidence ABC scale. J Gerontol A Biol Sci Med Sci 1995 ; A : M BESTest Balance Evaluation Systems Test. Available from URL : http: files BESTest_Jpn.pdf Maia AC, Rodrigues-de-Paula F, Magalhães LC, Teixeira RL : Cross-cultural adaptation and analysis of the psychometric properties of the Balance Evaluation Systems Test and MiniBESTest in the elderly and individuals with Parkinson s disease : application of the Rasch model. Braz J Phys Ther 2013 ; : Bergström M, Lenholm E, Franzén E : Translation and validation of the Swedish version of the mini-bestest in subjects with Parkinson s disease or stroke : a pilot study. Physiother Theory Pract 2012 ; : Pardasaney PK, Latham NK, Jette AM, Wagenaar RC, Ni P, Slavin MD, Bean JF : Sensitivity to change and responsiveness of four balance measures for communitydwelling older adults. Phys Ther 2012 ; : Franchignoni F, Horak FB, Godi M, Nardone A, Giordano A : Using psychometric techniques to improve the balance evaluation systems test : the Mini-BESTest. J Rehabil Med 2010 ; : Jpn J Rehabil Med VOL. 51 NO

7 BESTest CoM 3 CoM 2 CoM 1 CoM 0 CoM Balance Evaluation-Systems Test BESTest 7 cm 3 32 cm cm cm 0 8 cm cm cm cm cm Jpn J Rehabil Med VOL. 51 NO

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9 BESTest 19 CTSIB A B C B D m m m 0 6m TIMED GET UP & GOGet Up & Go TIMED GET UP & GO Jpn J Rehabil Med VOL. 51 NO