[Editor's note: Both the letter to the editor by Franchignoni and Giordano and the response by Padgett and colleagues are commenting on the accepted but unedited author manuscript version of this article that was published ahead of print on June 7, 2012.]
We thank Franchignoni and Giordano for their insightful comments1 on our article.2 We would like to initially acknowledge that we agree our study represents preliminary findings. We did not intend for our preliminary study to answer our title question: “Is the BESTest at its best?” Rather, we sought to propose an alternative assessment that would allow the question to be formally tested by future larger-scale comparative studies. We also agree that the 2 analyses used to derive the Mini-BESTest and Brief-BESTest are complementary, with neither producing definitive evaluations alone. This point of view represents the very reason we hoped our analysis would add value to the goal of developing a feasible, reliable, and valid clinical balance assessment.
Following our study, at least 3 fundamental questions remain:
Which test version produces the most useful clinical tool for insights regarding sensitivity to change, as well as risk of falls, comorbidities, or decrement in community participation and quality of life?
How generalizable are such insights across populations with different clinical diagnoses?
Is there added value to including items that represent all of the BESTest's theoretical contexts of balance performance?
These questions will require summative evidence across multiple studies from independent research groups, but …
