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Affiliation
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A. Marques, PT, MSc, PhD, Lab 3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro, Agras do Crasto-Campus Universitário de Santiago, Edifício 30, 3810-193 Aveiro, Portugal, and Institute for Research in Biomedicine, University of Aveiro, Aveiro, Portugal. |
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Abstract
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BACKGROUND: The Berg Balance Scale (BBS), Balance Evaluation Systems Test (BESTest), Mini-BESTest and the Brief-BESTest are useful to assess balance, however their psychometric properties have not been tested in patients with chronic obstructive pulmonary disease (COPD).
OBJECTIVE: This study aimed to compare the validity, reliability and ability to identify fall status of the BBS, BESTest, Mini-BESTest and the Brief-BESTest in patients with COPD.
DESIGN: A cross-sectional study was conducted.
METHODS: Forty-six patients (24 males; 75.9±7.1years) were included. Participants were asked to report their falls during the previous 12 months and to fill in the Activity-specific Balance Confidence (ABC) Scale. The BBS and the BESTest were administered. Mini-BESTest and Brief-BESTest scores were computed based on the BESTest performance. Validity was assessed by correlating balance tests with each other and with the ABC Scale. Interrater reliability (2 raters), intrarater reliability (48-72 hours) and minimal detectable changes (MDCs) were established. Receiver operating characteristics assessed the ability of each balance test to differentiate between patients with and without a history of falls.
RESULTS: Balance test scores were significantly correlated with each other (spearman's correlation [rho]=0.73-0.90) and with the ABC Scale (rho=0.53-0.75). Balance tests presented high interrater (Intraclass Correlation Coefficients[ICCs]=0.85-0.97) and intrarater reliability (ICCs=0.52-0.88), and acceptable MDCs (MDCs=3.3-6.3 points). Although all balance tests were able to identify fall status (area under the curve [AUC]=0.74-0.84), the BBS (sensitivity=73%, specificity=77%) and the Brief-BESTest (sensitivity=81%, specificity=73%) had the higher ability. LIMITATIONS: Findings are generalizable mainly to older patients with moderate COPD.
CONCLUSIONS: The four balance tests are valid, reliable and valuable to identify fall status in patients with COPD. The Brief-BESTest presented slightly higher interrater reliability and ability to differentiate patients' falls status.
© 2016 American Physical Therapy Association.
Language: en |