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Mini-Balance Evaluation Systems Test (Mini-BESTest)

Please visit this website for more information about the instrument: Mini-BESTest

NeuroRehab Supplemental - Highly Recommended
Recommendations for Use: Indicated for studies requiring a measure of balance.
Exploratory: Spinal Cord Injury (SCI)
Short Description of Instrument
The Mini-Balance Evaluation Systems Test (Mini-BESTest) is a 14-item scale that focuses on dynamic balance. The 14-items belong to four of the six sections found in the original BESTest: "section III 'Anticipatory Postural Adjustments' (sit to stand, rise to toes, stand on one leg); section IV 'Postural Responses' (stepping in four different directions); section V 'Sensory Orientation' (stance - eyes open; foam surface - eyes closed; incline - eyes closed); and section VI 'Balance during Gait' (gait during change speed, head turns, pivot turns, obstacles; timed 'Get Up and Go' with dual task)." (Franchignoni et al., 2010)
The MiniBESTest has a maximum score of 28 points. Each of the 14 items are scored from 0-2: "0" indicates the lowest level of function and "2" the highest level of function. If a subject must use an assistive device for an item, that item is scored one category lower. If a subject requires physical assistance to perform an item a "0" score is given for that item.
Strengths/Weaknesses: The MiniBESTest has "shown no ceiling effect, slightly better responsiveness, and could in some neurological populations predict falls." (JØrgensen et al., 2017) The Mini-BESTest has not yet been validated in spinal cord injury (SCI) populations (JØrgensen et al., 2017).
NeuroRehab Specific: This test is newer than the Functional Gait Assessment or Berg Balance Scale (BBS) and has less of a ceiling effect than the BBS so may be better for higher functioning individuals.  The downside of the MiniBESTest is the need for an incline and a block of foam, but the test has good reliability and validity and is used increasingly across populations.
Key references:
Franchignoni F, Horak F, Godi M, Nardone A, Giordano A. Using psychometric techniques to improve the Balance Evaluation Systems Test: the mini-BESTest. J Rehabil Med. 2010;42(4):323-331.
Franchignoni F, Godi M, Guglielmetti S, Nardone A, Giordano A. Enhancing the usefulness of the Mini-BESTest for measuring dynamic balance: a Rasch validation study. Eur J Phys Rehabil Med. 2015;51(4):429-437.
Additional references:
Di Carlo S, Bravini E, Vercelli S, Massazza G, Ferriero G. The Mini-BESTest: a review of psychometric properties. Int J Rehabil Res. 2016;39(2):97-105.
Godi M, Franchignoni F, Caligari M, Giordano A, Turcato AM, Nardone A. Comparison of reliability, validity, and responsiveness of the mini-BESTest and Berg Balance Scale in patients with balance disorders. Phys Ther 2013;93:158-167.
JØrgensen V, Opheim A, Halvarsson A, FranzÉn E, Roaldsen KS. Comparison of the Berg Balance Scale and the Mini-BESTest for Assessing Balance in Ambulatory People With Spinal Cord Injury: Validation Study. Phys Ther. 2017;97(6):677-687.
SCI-related reference:
Arora T, Oates A, Lynd K, Musselman KE. Current state of balance assessment during transferring, sitting, standing and walking activities for the spinal cord injured population: A systematic review. J Spinal Cord Med. 2020;43(1):10-23.
Document last updated January 2022