Assessing Balance Function in Patients With Total Knee Arthroplasty. Issue 10 (1st October 2015)

• Record Type: Journal Article
• Authors: Chan, Andy C.M.; Pang, Marco Y.C.
• Is Part Of: Physical therapy. Volume 95:Issue 10(2015)
• Page Start: 1397
• Page End: 1407
• Publication Date: 2015-10-01
• Subjects: Physical therapy -- Periodicals; Physical therapy; Physical Therapy Modalities; Rehabilitation; Physical and Rehabilitation Medicine; Periodicals; 615.8205
• DOI: 10.2522/ptj.20140486
• Languages: English
• ISSNs: 0031-9023

Abstract

Abstract : Background: The Balance Evaluation Systems Test (BESTest) is a relatively new balance assessment tool. Recently, the Mini-BESTest and the Brief-BESTest, which are shortened versions of the BESTest, were developed. Objective: The purpose of this study was to estimate interrater and intrarater-interoccasion reliability, internal consistency, concurrent and convergent validity, and floor and ceiling effects of the 3 BESTests and other related measures, namely, the Berg Balance Scale (BBS), Functional Gait Assessment (FGA), and Activities-specific Balance Confidence (ABC) Scale, among patients with total knee arthroplasty (TKA). Design: This was an observational measurement study. Methods: To establish interrater reliability, the 3 BESTests were administered by 3 independent raters to 25 participants with TKA. Intrarater-interoccasion reliability was evaluated in 46 participants with TKA (including the 25 individuals who participated in the interrater reliability experiments) by repeating the 3 BESTests, BBS, and FGA within 1 week by the same rater. Internal consistency of each test also was assessed with Cronbach alpha. Validity was assessed in another 46 patients with TKA by correlating the 3 BESTests with BBS, FGA, and ABC. The floor and ceiling effects also were examined. Results: The 3 BESTests demonstrated excellent interrater reliability (intraclass correlation coefficient [ICC] [2, 1]=.96–.99), intrarater-interoccasion reliability (ICC [2, 1]=.92–.96), and internal consistency (Cronbach alpha=.96–.98). These values were comparable to those for the BBS and FGA. The 3 BESTests also showed moderate-to-strong correlations with the BBS, FGA, and ABC ( r =.35–.81), thus demonstrating good concurrent and convergent validity. No significant floor and ceiling effects were observed, except for the BBS. Limitations: The results are generalizable only to patients with TKA due to end-stage knee osteoarthritis. Conclusions: The 3 BESTests have good reliability and validity for evaluating balance in people with TKA. The Brief-BESTest is the least time-consuming and may be more useful clinically.