PT  - JOURNAL ARTICLE
AU  - Duncan, Ryan P.
AU  - Leddy, Abigail L.
AU  - Cavanaugh, James T.
AU  - Dibble, Leland E.
AU  - Ellis, Terry D.
AU  - Ford, Matthew P.
AU  - Foreman, K. Bo
AU  - Earhart, Gammon M.
TI  - Comparative Utility of the BESTest, Mini-BESTest, and Brief-BESTest for Predicting Falls in Individuals With Parkinson Disease: A Cohort Study
AID  - 10.demo/ptj.20120302
DP  - 2013 Apr 01
TA  - Demo Journal of Physical Therapy
PG  - 542--550
VI  - 93
IP  - 4
4099  - http://demo.highwire.org/content/93/4/542.short
4100  - http://demo.highwire.org/content/93/4/542.full
AB  - Background The newly developed Brief–Balance Evaluation System Test (Brief-BESTest) may be useful for measuring balance and predicting falls in individuals with Parkinson disease (PD).Objectives The purposes of this study were: (1) to describe the balance performance of those with PD using the Brief-BESTest, (2) to determine the relationships among the scores derived from the 3 versions of the BESTest (ie, full BESTest, Mini-BESTest, and Brief-BESTest), and (3) to compare the accuracy of the Brief-BESTest with that of the Mini-BESTest and BESTest in identifying recurrent fallers among people with PD.Design This was a prospective cohort study.Methods Eighty participants with PD completed a baseline balance assessment. All participants reported a fall history during the previous 6 months. Fall history was again collected 6 months (n=51) and 12 months (n=40) later.Results At baseline, participants had varying levels of balance impairment, and Brief-BESTest scores were significantly correlated with Mini-BESTest (r=.94, P<.001) and BESTest (r=.95, P<.001) scores. Six-month retrospective fall prediction accuracy of the Brief-BESTest was moderately high (area under the curve [AUC]=0.82, sensitivity=0.76, and specificity=0.84). Prospective fall prediction accuracy over 6 months was similarly accurate (AUC=0.88, sensitivity=0.71, and specificity=0.87), but was less sensitive over 12 months (AUC=0.76, sensitivity=0.53, and specificity=0.93).Limitations The sample included primarily individuals with mild to moderate PD. Also, there was a moderate dropout rate at 6 and 12 months.Conclusions All versions of the BESTest were reasonably accurate in identifying future recurrent fallers, especially during the 6 months following assessment. Clinicians can reasonably rely on the Brief-BESTest for predicting falls, particularly when time and equipment constraints are of concern.