Inter- and intra-rater reliability of brief BESTest in balance evaluation of patients with stroke: brief report

Background: Impaired balance is one of the most common symptoms that occur after stroke. There are several tests for evaluating balance in neurological disorders. Brief-balance evaluation systems test (Brief-BESTest) is the short version of BESTest that assess the systems contributing to postural control. The purpose of this study was to investigate the inter- and intra-rater reliability of the Persian version of Brief-BESTest for balance evaluation in patients with stroke. Methods: Patients with stroke recruited from the Tehran University of Medical Sciences Physiotherapy Clinics in Tehran participated in this cross-sectional study. Patients were included in the study with first ever stroke, able to follow instructions, able to walk without aid, and willingness to participate in the study. The study was conducted from August to December 2016. Two physiotherapists independently scored the videotaped performance of patients on Persian Brief-BESTest in one session for inter-rater reliability. The first physiotherapist recorded the patients' performance on Persian Brief-BESTest after 1 week for intra-rater reliability. The physiotherapists were blinded to each other's scores. Intraclass correlation coefficient (ICC) was used to assess the reliability. SPSS statistical software, version 18 (IBM, Armonk, NY, USA) was used for all analyses. Results: Thirty patients with stroke (10 males, 20 females, mean age 57.3±13.5 years, duration 40.7±47.3 months) participated in this study. The ICC values for inter-rater reliability and intra-rater reliability of total scores were 0.98 (95% CI: (0.95-0.99)) and 0.99 (95% CI: (0.98-0.99)), respectively. The ICC values for inter- and intra-rater reliability of each item score were 0.72-1.0, and 0.87-1.0 respectively. Conclusion: The Persian version of Brief-BESTest has high inter- and intra-rater reliability for evaluation of balance in patients with stroke. Therefore, it is recommended for use by clinicians in the clinic and for research purposes in the clinical trials.