1. How do I know what are the cut-off values for normal versus abnormal balance control from the Mini-BESTest scores?
The cut-off values for normal versus mildly-, moderately-, or severely-affected balance control will depend on your patient diagnosis as well how the levels are defined (fall risk, %tile of normal range, age, etc.). New research is constantly being published on cut-off values so it is best to look at the literature since new studies come out frequently. One quick option is to check the Rehabilitation Measures database from the Shirley Ryan Ability Lab, because they regularly add new evidence for the BESTest and Mini-BESTest clinemetrics.
2. How do I know if my patient’s balance is getting significantly better or worse based on scores from the BESTest or Mini-BESTest?
You may be interested in what is the minimal detectable change (MDC) in the test scores, based on statistical measures of group mean differences due to intervention, divided by variability of the mean scores. Alternatively, you may be interested in the Clinically Significant Difference (CSD) in the test scores, that is, how much does a score need to change for a clinician and/or a patient to notice a change. Both of these values can often be found by doing a literature search or you can also check the Shirley Ryan Ability Lab mentioned above (Mini-BESTest, BESTest).
3. Can I use the BESTest or Mini-BESTest for my research, clinical practice, or educational endeavors?
The tests, themselves, are no longer under copyright control, so you are free (and encouraged) to use the balance tests for either your research or for your clinical practice. You are welcome to add the tests to your REDCap database or your hospital’s electronic medical records. You can also use the tests in education, either as part of your academic responsibilities or for private, for profit courses. However, if you want to publish figures from the original publications (such as for reviews or textbooks), please contact the journal publishers for permission.
4. Has the BESTest or Mini-BESTest been adapted for use in children?
Although several researchers have modified the BESTest and the Mini-BESTest for school-aged children, all of the test clinemetrics have not yet been determined (see References). It is important to remember that sensory and motor control of balance are not mature until about age 7 years old and the tests require voluntary attention and ability to follow directions.
Reproducibility of the Balance Evaluation Systems Test (BESTest) and the Mini-BESTest in school-aged children. Dewar R, Claus AP, Tucker K, Ware R, Johnston LM. Gait Posture. 2017 Jun;55:68-74.
Reproducibility of the Kids-BESTest and the Kids-Mini-BESTest for Children With Cerebral Palsy. Dewar R, Claus AP, Tucker K, Ware RS, Johnston LM. Arch Phys Med Rehabil. 2019 Apr;100(4):695-702.
Balance impairment in individuals with Wolfram syndrome. Pickett KA, Duncan RP, Paciorkowski AR, Permutt MA, Marshall B, Hershey T, Earhart GM; Washington University Wolfram Study Group. Gait Posture. 2012 Jul;36(3):619-24.