Novice versus experienced rater reliability of the Mini Balance Evaluation Systems Test (Mini-BESTest) in patients with acquired brain injury (ABI)
Objectives: The purpose of this study was to examine novice versus experienced rater’s inter-rater and test retest reliability when scoring the Mini-BESTest in patients with acquired brain injury (ABI); and to provide clinically relevant information regarding the reliability and clinical feasibility of using the Mini-BESTest in a population with ABI.
Background: Individuals who sustain an ABI often have many functional deficits including impaired balance. Currently there is no gold standard for assessing balance in individuals with ABI. Many balance measures have been shown to have ceiling effects and inconsistent reliability results when measured by novice physical therapists verses experienced physical therapists.
Methods and Measures: Participants were selected using convenience sampling meeting specific inclusion and exclusion criteria. Each was video recorded while completing the Mini-BESTest, administered by one test-administrator who was not a rater. Inter-rater reliability was tested using four raters (two novice, two experienced), whom simultaneously and independently observed and rated performance from the same angle. All raters were blinded to others’ scores. Test retest reliability was tested using three raters (two novice, one experienced), whom independently viewed video recording in random order approximately four weeks later. All raters were blinded to each other’s scores and their own scores.
Results: There was a significant intra-class correlation coefficient (p < .001) demonstrating excellent inter-rater reliability and a significant Pearson's correlation (p < .001) demonstrating high test retest reliability among all raters. Novice raters demonstrated slightly higher test retest reliability (r=.953) than the experienced raters (r=.933).
Conclusion: Both novice and experienced raters demonstrated excellent inter-rater and test retest reliability when rating individuals with ABI using the Mini- BESTest. The Mini-BESTest is a reliable tool, which uses multiple constructs to assess balance deficits in 4 specific constructs. It can be used by both novice and experienced physical therapists to guide interventions for the impaired systems. Increased time to administer and modifications to verbal instructions may be appropriate for use in the ABI population. Follow-up studies are necessary to determine the extent and validity of instruction modifications.