Construct validity of the BESTest, mini-BESTest and briefBESTest in adults aged 50 years and older

- The BESTest, mini-BESTest and briefBESTest are performance-based balance tests.
- Research on their psychometric properties has focused on neurological populations.
- This study investigates the construct validity of the tests in adults over 50 years of age.
- The BESTest shows good convergent validity with other balance measures.
- The tests can discriminate between those at high versus low risk of falls.

BackgroundThe Balance Evaluation Systems Test (BESTest) and its two abbreviated versions (mini-BESTest and briefBESTest) are functional balance tools that have yet to be validated in middle aged and elderly people living in the community.ObjectiveDetermine the construct validity of the three BESTest versions by comparing them with commonly-used measures of balance, balance confidence and physical activity, and examining their ability to discriminate between groups with respect to falls and fall risk.MethodsThis was a secondary analysis of data from 79 adults (mean age 68.7 ± 10.57 years). Pearson correlation coefficients were used to examine the relationships between each BESTest measure and the Activities-Specific Balance Confidence (ABC) scale, the Physical Activity Scale for the Elderly (PASE), the Timed Up and Go (TUG) and the Single Leg Stance (SLS) test. Independent t-tests were used to examine differences in balance between fallers (≥1 fall in previous year) and non-fallers and individuals classified at low versus high fall risk using the Elderly Falls Screening Test (EFST).ResultsThe BESTest measures showed moderate associations with the ABC scale and TUG (r = 0.62-0.67 and −0.60 to −0.68 respectively), fair associations (r = 0.33-0.40) with the PASE and moderate to high associations (r = 0.67-0.77) with the SLS. Fallers showed a trend (p = 0.054) for lower scores on the original BESTest, and people at high risk for falls had significantly lower scores on all BESTest versions.ConclusionsThese findings support the construct validity of the BESTest, mini-BESTest and briefBESTest in adults over 50 years old.