Use of the mini-BESTest to measure balance in people with multiple sclerosis

Balance impairments are common in Multiple Sclerosis (MS). The Berg Balance Scale (BBS) is widely used measure of balance in People with MS (PwMS), however it may not capture all domains of balance. The novel Mini-BESTest (MBT) assesses additional balance domains but relatively little research has been carried out investigating its use in PwMS. Therefore, we aimed to investigate the inter-rater reliability of the MBT and also to compare it to the BBS, as a measure of balance post treatment, in ambulatory PwMS. Fifty-two PwMS receiving out-patient physiotherapy were included. All mobilised independently with or without an aid and gave demographic details, prior to completion of the MBT with two different raters. Participants then completed the BBS and five other secondary measures before and after 8 weeks of routine physiotherapy. For the inter-rater reliability analysis of the MBT, the intra class correlation coefficient was high, the standard error of the measure was less than 10% of the scale, and the Minimal Detectable Change (MDC) was 7. Reasons for a higher MDC in this study compared to other studies may be the difference in populations investigated, sample sizes used, means reported or the difference in experience or number of raters used, for the MBT Using pre and post treatment data for the BBS and MBT, the MBT demonstrated less ceiling effects, larger effect sizes, higher standard response mean values and higher correlation coefficients for each secondary measure after treatment. These data suggests there is a strong agreement between two raters for the MBT and also provides preliminary evidence that the MBT may be a better measurement for detecting balance change in ambulatory PwMS, compared to the BBS.