Evidence map›Paper›PMID 39665367›Full record

SynthesisPhysical therapy2025

Measurement Properties of the BESTest Scale in People With Neurological Conditions: A Systematic Review With Meta-Analysis.

Ilaria Arcolin, Marica Giardini, Federica Tagliabue, Valeria Belluscio, Fay Horak, Marco Godi

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Physical therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ilaria ArcolinDepartment of Physical Medicine and Rehabiitation of Veruno Institute, Istituti Clinici Scientifici Maugeri IRCCS, Gattico-Veruno 28013, Italy.ORCID 0000-0001-5948-2428
Marica GiardiniDepartment of Physical Medicine and Rehabiitation of Veruno Institute, Istituti Clinici Scientifici Maugeri IRCCS, Gattico-Veruno 28013, Italy.ORCID 0000-0002-8910-2649
Federica TagliabueDepartment of Physical Medicine and Rehabiitation of Veruno Institute, Istituti Clinici Scientifici Maugeri IRCCS, Gattico-Veruno 28013, Italy.ORCID 0009-0001-2615-7781
Valeria BelluscioDepartment of Human Movement and Sport Science, University of Rome "Foro Italico", Rome 00135, Italy.ORCID 0000-0001-9893-1804
Fay HorakDepartment of Neurology, Oregon Health and Science University, Portland, OR 97239, United States.ORCID 0000-0001-7704-5459
Marco GodiDepartment of Physical Medicine and Rehabiitation of Veruno Institute, Istituti Clinici Scientifici Maugeri IRCCS, Gattico-Veruno 28013, Italy.ORCID 0000-0002-8501-6524

Funding

Ricerca Corrente Funding Scheme of the Ministry of Health
6 · The paper itself

Abstract

objectivePeople with neurological conditions (PwNC) frequently fall, mainly due to balance impairments. Among the scales assessing balance, the Balance Evaluation System Test (BESTest) is one of the most comprehensive in evaluating all components of postural control. This study aimed to systematically review and summarize the measurement properties of the BESTest in PwNC.

methodsEmbase, MEDLINE, ScienceDirect, Scopus, and PEDro were searched up to December 2023. Studies assessing at least 1 BESTest measurement property in PwNC were included. Methodological quality of studies was assessed with the COSMIN Risk of Bias checklist. Overall rating and level of evidence for each property were given according to COSMIN criteria. Where possible, meta-analysis was performed.

resultsThirty-six studies (1749 PwNC) were included. The BESTest demonstrated a high quality of evidence supporting good reliability (intraclass correlation coefficients = 0.96-0.98 for total score, and 0.70-0.98 for subsections), internal consistency, and measurement error. High quality levels of responsiveness, and content and construct validity were also found. However, evidence for structural validity was insufficient to be sure the BESTest actually tests several, or 1, balance constructs. Criterion validity cannot be evaluated. While translated into different languages, cross-cultural validity has never been assessed in PwNC. Evidence to support use of the BESTest for specific neurological conditions is limited to Parkinson disease and stroke, due to the small sample sizes and number of studies in other populations.

conclusionThis systematic review provided high quality evidence supporting the reliability, content and construct validity, and responsiveness of the BESTest to intervention, being able to detect balance changes and to differentiate heterogeneous PwNC based on fall history, falling risk, and physical performance. However, low-quality evidence was found when considering each neurological condition alone. To comprehensively understand the BESTest measurement properties, future studies are needed with larger samples for each neurological condition, especially assessing cross-cultural and structural validity. IMPACT: Assessing balance is crucial for fall risk prevention. The BESTest has been demonstrated to be a reliable, responsive, and valid scale usable in clinical setting for assessing balance in PwNC. LAY SUMMARY: Assessing balance is crucial for fall risk prevention. The BESTest has been demonstrated to be a reliable, responsive, and valid scale usable in clinical setting for assessing balance in PwNC.

Indexed as

Disability EvaluationNervous System DiseasesPostural BalanceAccidental FallsHumansReproducibility of ResultsBalanceBESTestCOSMINMeasurementsPsychometricsRehabilitation

Identifiers

PMID39665367
PMCPMC11890282

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.