Cross-cultural adaption and validation of the German version of the Mini-BESTest in individuals after stroke: an observational study

Elena Cramer; Franziska Weber; Gilian Faro; Michael Klein; Dennis Willeke; Thomas Hering; Dörte Zietz

doi:10.1186/s42466-020-00078-w

Cross-cultural adaption and validation of the German version of the Mini-BESTest in individuals after stroke: an observational study

Neurol Res Pract. 2020 Oct 1:2:27. doi: 10.1186/s42466-020-00078-w. eCollection 2020.

Authors

Elena Cramer^#¹, Franziska Weber^#¹, Gilian Faro², Michael Klein², Dennis Willeke³, Thomas Hering⁴, Dörte Zietz¹

Affiliations

¹ Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Gesundheitscampus 6-8, 44801 Bochum, Germany.
² Rehabilitation Center for Neurology, Neurosurgery and Neuropaediatrics, VAMED Klinik Hattingen GmbH, Am Hagen 20, 45527 Hattingen, Germany.
³ Rehabilitation Center for Neurology and Orthopaedics, Johanniter-Klinik am Rombergpark, Am Rombergpark 42, 44225 Dortmund, Germany.
⁴ Department of Applied Human Sciences, Hochschule Magdeburg-Stendal (University of Applied Sciences), Osterburger Str. 25, 39576 Stendal, Germany.

^# Contributed equally.

Abstract

Background: Postural control is a very important function in everyday life. However, assessing postural control with commonly used measurement instruments (MIs) is limited due to deficits in their psychometric properties. The Mini-Balance Evaluation Systems Test (Mini-BESTest) is a comprehensive and multidimensional MI for assessing postural control in persons with limited balance function, such as individuals after stroke. Despite the increasing use of the Mini-BESTest worldwide, no German version is available.

Research question: Is the German version of the Mini-BESTest (GVMBT) comprehensible and valid for measuring postural control in individuals after stroke?

Methods: The Mini-BESTest was translated and cross-culturally adapted, following established guidelines. It was pilot-tested with ten participants. This observational measurement and validation study was conducted at one point and included 50 participants with subacute and chronic stroke (mean age: 64.58 ± 13.34 years/ 34 men/ 16 women). Convergent validity was investigated using 1) the Berg Balance Scale (BBS) and 2) the Timed "Up & Go" (TUG). The MIs were evaluated for normal distribution with the calculation of skewness, kurtosis and Q-Q-Plots. Spearman correlation coefficients and Bland Altman analysis were used to examine the relationship between the MIs. The internal consistency was assessed using Cronbach's alpha.

Results: Comprehension of the GVMBT was confirmed. The GVMBT correlated significantly with the BBS (r_s = 0.93) and the TUG (r_s = - 0.85). Bland Altman analysis revealed low absolute differences. The GVMBT demonstrated no significant floor or ceiling effects and showed excellent internal consistency (Cronbach's α = 0.90).

Significance: The GVMBT has excellent validity and internal consistency. Due to this and its specific subcategories, the GVMBT is recommended for the use in research and clinical practice. Further psychometric properties should be evaluated.

Keywords: Cross-cultural adaption; Measurement instrument; Mini-BESTest; Postural control; Stroke; Validity.