Validation of the Japanese Version of the Balance Evaluation Systems Test (BESTest)

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<0.01). 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 0.56-0.94 versus J-BESTest 0.94, 95% confidence interval 0.84.1.0, p<0.05). 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.