Background

Balance problems in Parkinson’s Disease (PD) require appropriate evaluation. While the Mini-BESTest is commonly used to assess dynamic balance, some of its psychometric properties have not yet been addressed.

Research question

What is the responsiveness and the Minimal Clinically Important Difference (MCID) of the Mini-BESTest in patients with PD?

Methods

One-hundred forty-eight patients with PD underwent a treatment specific for balance skills (1-h session, three times/week for four weeks). All patients were initially evaluated with the Mini-BESTest and Activities-Specific Balance Confidence scale 5-levels (ABC-5L). Post-treatment, patients were assessed with the Mini-BESTest, ABC-5L and Global Rating of Change (GRC, both patient- and physiotherapist-rated). Responsiveness to treatment and MCID were calculated with distribution and anchor-based methods: effect size, area under the curve (AUC) of receiver operating characteristics (ROC), and correlations between evaluations (change in score of Mini-BESTest, ABC-5L, GRC). Eleven a priori hypotheses were formulated for testing responsiveness.

Results

The effect size of treatment measured with the Mini-BESTest was 0.44, revealing moderate responsiveness. AUCs were 0.75, 0.82 and 0.59 for the patient-rated GRC, physiotherapist-rated GRC and ABC-5L, respectively. There was a moderate correlation between changes in the Mini-BESTest and patient-rated (r_s = 0.42) or physiotherapist-rated (r_s = 0.62) GRC scores. Conversely, a low correlation (r_s = 0.17) was found between changes in the Mini-BESTest and ABC-5L. Consequently, 72.7% of hypotheses were met. The Mini-BESTest MCID was between 3.4 and 4.0 when calculated with distribution and anchor-based methods, respectively.

Significance

The Mini-BESTest showed moderate responsiveness for detecting treatment-related improvement in dynamic balance. A 4.0-point MCID value is useful to identify clinical effects of balance rehabilitation in a single patient with PD. Values ranging from 3.4 and 4.0 are recommended for interpretation of results at a group level.

中文翻译：

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Mini-BESTest对帕金森氏病患者的反应性和最小的临床重要差异。

背景

帕金森氏病（PD）中的平衡问题需要适当的评估。虽然Mini-BESTest通常用于评估动态平衡，但其心理测度特性尚未得到解决。

研究问题

PD患者中Mini-BESTest的反应性和最小临床重要差异（MCID）是什么？

方法

一百四十八名PD患者接受了一项针对平衡技巧的治疗（1小时疗程，每周3次，共4周）。最初对所有患者进行了迷你最佳和活动特异性平衡置信度量表5级（ABC-5L）评估。治疗后，对患者进行了Mini-BESTest，ABC-5L和总体变化评分（GRC，分别由患者和物理治疗师评估）进行评估。使用分布和基于锚的方法计算对治疗和MCID的反应性：效果大小，接收者操作特征（ROC）的曲线下面积（AUC）以及评估之间的相关性（Mini-BESTest得分的变化，ABC-5L， GRC）。制定了11个先验假设以测试响应能力。

结果

使用Mini-BESTest测得的治疗效果大小为0.44，表明反应中等。患者评估的GRC，物理治疗师评估的GRC和ABC-5L的AUC分别为0.75、0.82和0.59。Mini-BESTest和患者评分（r _s = 0.42）或物理治疗师评分（r _s = 0.62）GRC评分的变化之间存在中等相关性。相反，在Mini-BESTest和ABC-5L的变化之间发现较低的相关性（r _s = 0.17）。因此，满足了72.7％的假设。当分别使用分布和基于锚的方法进行计算时，Mini-BESTest MCID分别在3.4和4.0之间。

意义

Mini-BESTest显示出适中的响应能力，可检测与治疗相关的动态平衡改善。4.0点MCID值可用于确定单例PD患者平衡康复的临床效果。建议使用3.4和4.0之间的值来解释组级别的结果。