Reproducibility of the Kids Balance Evaluation Systems Test (Kids-BESTest) and the Kids-Mini-BESTest for children with cerebral palsy

Publication date: Available online 9 January 2019

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Rosalee Dewar, Andrew P. Claus, Kylie Tucker, Robert S. Ware, Leanne M. Johnston

Abstract

Objective

To evaluate the reproducibility, including reliability and agreement, of the Kids Balance Evaluation Systems Test (Kids-BESTest) and short-form Kids-Mini-BESTest for measuring postural control in school-aged children with cerebral palsy.

Design

Psychometric study of intra-rater, inter-rater and test-retest reliability and agreement;

Setting

Clinical laboratory and home.

Participants

Convenience sample of 18 children aged 8 to 17 years with ambulant cerebral palsy (Gross Motor Function Classification System I-II) with spastic or ataxic motor type.

Intervention

Not applicable.

Main Outcome measures

Postural control was assessed using the Kids-BESTest and the short-form Kids-Mini-BESTest. An experienced physiotherapist assessed all children in real-time and the testing session was videoed. The same physiotherapist viewed and scored the video twice, at least two weeks apart, to assess intra-rater reproducibility. Another experienced physiotherapist scored the same video to determine inter-rater reproducibility. Thirteen children returned for a repeat assessment with the first physiotherapist within 6 weeks and their test-retest performance was rated in real time and with video.

Results

Excellent reliability was observed for both the Kids-BESTest (ICC 0.96 to 0.99) and Kids-Mini-BESTest (ICC 0.79 to 0.98). The Smallest Detectable Change was good to excellent for all Kids-BESTest agreement analyses (5% to 9%), but poor to good for Kids-Mini-BESTest analyses (9% to 16%).

Conclusion

The Kids-BESTest shows an excellent ability to discriminate postural control abilities of school-aged children with cerebral palsy and it has a low Smallest Detectable Change, suitable for use as a pre-post intervention outcome measure. Although the Kids-Mini-BESTest is 5-10 min shorter to administer, it has poorer reproducibility and focuses only on falls-related balance, which excludes two domains of postural control.

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