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The Frail’BESTest. An Adaptation of the “Balance Evaluation System Test” for Frail Older Adults. Description, Internal Consistency and Inter-Rater Reliability

Authors Kubicki A, Brika M, Coquisart L, Basile G, Laroche D, Mourey F

Received 26 January 2020

Accepted for publication 9 April 2020

Published 30 July 2020 Volume 2020:15 Pages 1249—1262


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Richard Walker

A Kubicki,1,2 M Brika,2 L Coquisart,3 G Basile,3 D Laroche,1,4 F Mourey1

1INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR Des Sciences Du Sport, Dijon F-21000, France; 2Institut De Formation Des Métiers De La Santé, Hôpital Nord Franche-Comté, 2 Rue Du Docteur Flamand, Montbéliard 25200, France; 3Centre Hospitalier Durécu-Lavoisier, Darnetal 76160, France; 4INSERM CIC 1432, Plateforme d’Investigation Technologique, University Hospital of Dijon, Dijon 21000, France

Correspondence: A Kubicki
INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, BP 27877, Campus Universitaire, Dijon 21078, France
Tel +33 684379141

Introduction: The Balance Evaluation System Test (BESTest) and the Mini-BESTest were developed to assess the complementary systems that contribute to balance function. These tests include functional tasks involving several high-level exercises to assess the balance function, which may be even more difficult in case of frailty. The Frail’BESTest has been developed to make it possible to include frail older adults in systemic assessment. In this first paper, the objective is to present the Frail’BESTest and to describe the usefulness and complementarity of each system and to test the inter-rater reliability of the score measurements in two health centers.
Methods: In the first center, 192 frail and non-frail older patients were enrolled to test I) the contribution of each system, II) internal consistency, and III) the threshold and ceiling effects. The scores of 32 patients from center 1 and 32 patients recruited in another center (center 2) were used to measure the inter-rater reliability of the measurements by means of Kendall’s tau coefficients.
Results: The internal consistency was moderate to good for five systems and limited for “biomechanical constraints”. The distribution of the Frail’BESTest was more centered than that of the Tinetti and Mini-Motor tests. The Kendall’s tau showed strong concordance in center 1 for all systems and only for 4 on 6 systems in center 2.
Discussion: Completing a systemic evaluation, the therapist may prioritize the patient’s needs identifying the most challenging systems. This paper presents the Frail’BESTest and confirms the psychometric properties at a first step level.

Keywords: frailty, geriatric assessment, systemic evaluation, motor evaluation, psychometric properties

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