Cross-cultural adaption and validation of the German version of the Mini-BESTest in individuals after stroke: An observational study

Abstract

Background: Postural control is a very important function in everyday life. However, assessing postural control with commonly used measurement instruments (MIs) is limited due to deficits in their psychometric properties. The Mini-Balance Evaluation Systems Test (Mini-BESTest) is a comprehensive and multidimensional MI for assessing postural control in persons with limited balance function, such as individuals after stroke. Despite the increasing use of the Mini-BESTest worldwide, no German version is available. Research question: Is the German version of the Mini-BESTest (GVMBT) comprehensible and valid for measuring postural control in individuals after stroke? Methods: The Mini-BESTest was translated and cross-culturally adapted, following established guidelines. It was pilot-tested with ten participants. This observational measurement and validation study was conducted at one point and included 50 participants with subacute and chronic stroke (mean age: 64.58 ± 13.34 years/ 34 men/ 16 women). Convergent validity was investigated using 1) the Berg Balance Scale (BBS) and 2) the Timed "Up & Go"(TUG). The MIs were evaluated for normal distribution with the calculation of skewness, kurtosis and Q-Q-Plots. Spearman correlation coefficients and Bland Altman analysis were used to examine the relationship between the MIs. The internal consistency was assessed using Cronbach's alpha. Results: Comprehension of the GVMBT was confirmed. The GVMBT correlated significantly with the BBS (rs = 0.93) and the TUG (rs = - 0.85). Bland Altman analysis revealed low absolute differences. The GVMBT demonstrated no significant floor or ceiling effects and showed excellent internal consistency (Cronbach's α = 0.90). Significance: The GVMBT has excellent validity and internal consistency. Due to this and its specific subcategories, the GVMBT is recommended for the use in research and clinical practice. Further psychometric properties should be evaluated.