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Inter-Rater Reliability of the Balance Evaluation Systems Test

1 May 2004


Background and Purpose. Currently, no functional balance measures provide information regarding the different components of balance, to assist the clinician in the direction of their physical therapy intervention. The BESTest was designed to provide clinicians with such information. The BESTest consists of five categories testing different components of balance: 1) stability limits/verticality, 2) transitions/anticipatory, 3) reactive, 4) sensory orientation, 5) stability and gait. The purpose of this study was to examine the inter~rater reliability of the BESTest.

Subjects. The subjects were eleven adult community members, including five with vestibular loss, three with Parkinson's disease, and three healthy control subjects. Their ages ranged from 50-80 years old. Raters: Six physical therapists, with four to nineteen years of experience and three physical therapy students participated in the study as "scoring therapists."

Methods: The scoring therapists were asked to concurrently score the performance of 11 subjects on the items of the BESTest.

Results. The BESTest overall demonstrated good inter-rater reliability (ICC = .90). Inter-rater reliability varied among the five sections, with Section five (ICC=.54) demonstrating the lowest and Section three (ICC=.93) the highest.

Discussion and Conclusion. The BESTest has demonstrated appropriate reliability for a clinical functional tool. Further studies examining intra-rater reliability and validity are necessary.


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