Measurement properties of Brief-BESTest scores from children, adolescents, and youth with visual impairments

Disabil Rehabil. 2024 Oct;46(20):4797-4806. doi: 10.1080/09638288.2023.2288935. Epub 2023 Dec 1.

Abstract

Purpose: This study aimed to vet the measurement properties of Brief-BESTest scores in children, adolescents, and youth with visual impairment and blindness (YVI). Methods: A cross-sectional sample of YVI (N = 101) completed the Brief-BESTest, a modified version of the Y-Balance Test, the 360-degree turn test, bipedal quiet stance, and Activity-Specific Balance Confidence Scales. Thirty-seven YVI completed test-retest of the Brief-BESTest using a one-year interval. Using classical test theory, various forms of total and item-level Brief-BESTest score reliability and validity were investigated in YVI. Results: All inter-rater reliability coefficients were ≥ .80. When considering the eight items of the Brief-BESTest, 27 of the 28 possible correlations were statistically significant (p<.05). Various internal consistency and item difficulty results were strong. When taking total Brief-BESTest scores and their association with the complementary balance tasks/metrics into account, 11 of 13 associations were statistically significant (p<.05) providing strong convergent validity evidence. Being multimorbid and degree of vision significantly predicted total Brief-BESTest scores (p<.001) suggesting construct (i.e. known groups) validity. Numerous test-retest results (e.g. coefficients, limits of agreement) following the one-year interval were indicative of score stability. Conclusion: Practitioners and researchers should have confidence in, and consider adopting, the Brief-BESTest to examine multidimensional balance in YVI.

Keywords: Blind; assessment; balance; low vision; postural control; psychometric.

Plain language summary

Rehabilitation, motor, and health professionals should view the Brief-BESTest as the preeminent clinical balance assessment for children, adolescents, and youth with visual impairment and blindness (YVI).Brief-BESTest scores may be used to investigate multidimensional balance, provide ‘systems-based’ balance profiles, and inform targeted balance interventions in YVI.Practitioners and researchers may now investigate Brief-BESTest scores alongside pertinent health- or movement-relevant outcomes of interest (e.g., gait, mobility, falls).

MeSH terms

  • Adolescent
  • Blindness / rehabilitation
  • Child
  • Cross-Sectional Studies
  • Disability Evaluation*
  • Female
  • Humans
  • Male
  • Postural Balance* / physiology
  • Psychometrics
  • Reproducibility of Results
  • Vision Disorders* / diagnosis
  • Young Adult