Measurement Characteristics and Clinical Utility of the Mini BESTest in Individuals With Parkinson Disease

      Individuals with Parkinson disease (PD) develop impairments in balance and gait that can lead to postural instability and falls. Studies indicate that 60% of individuals with PD fall in a 12-month period.1 These falls are associated with increased risk of hip fractures, nursing home admissions, and reduced survival rates.2,3 The Mini Balance Evaluation Systems Test (Mini BESTest), a shortened version of the BESTest, was developed to assess elements of postural control thought to underlie postural instability.4,5 14-item Mini BESTest can be administered in 10 to 15 minutes, and addresses 4 of the 6 constructs included in the BESTest: anticipatory control, reactive postural control, sensory orientation, and dynamic gait. The Mini BESTest exhibits excellent reliability and validity across stages of PD, can discriminate between fallers and non-fallers, and is responsive to change with rehabilitation interventions.5
      This Rehabilitation Measures Database summary provides a review of the psychometric properties of the Mini BESTest in community-dwelling older adults and individuals living with PD. A full review of the Mini BESTest as well as reviews of more than 100 other instruments can be found at Please address correspondence to [email protected] .
      • 1.
        Wood B, Bilclough J, Bowron A, Walker R. Incidence and prediction of falls in Parkinson’s disease: a prospective multidisciplinary study. J Neurol Neurosurg Psychiatry 2002;72:721-725.
      • 2.
        Johnell O, Melton L, Atkinson E, O'Fallon W, Kurland L. Fracture risk in patients with parkinsonism: a population-based study in Olmsted County, Minnesota. Age Ageing 1992;21:32-38.
      • 3.
        King LA, Priest K, Salarian A, Pierce D, Horak F. Comparing the Mini-BESTest with the Berg Balance Scale to evaluate balance disorders in Parkinson’s disease. Parkinsons Dis 2012;2012:375419.
      • 4.
        Duncan RP, Leddy AL, Cavanaugh JT, et al. Comparative utility of the BESTest, mini-BESTest, and brief-BESTest for predicting falls in individuals with Parkinson disease: a cohort study. Phys Ther 2013;93:542-550.
      • 5.
        Leddy AL, Crowner BE, Earhart GM. Utility of the Mini-BESTest, BESTest, and BESTest sections for balance assessments in individuals with Parkinson disease. J Neurol Phys Ther 2011;35:90-97.
      • 6.
        Duncan RP, Earhart GM. Four square step test performance in people with Parkinson disease. J Neurol Phys Ther 2013;37:2-8.
      • 7.
        Duncan RP, Leddy AL, Earhart GM. Five times sit-to-stand test performance in Parkinson’s disease. Arch Phys Med Rehabil 2011;92:1431-1436.
      • 8.
        Bergstrom M, Lenholm E, Franzen E. Translation and validation of the Swedish version of the mini-BESTest in subjects with Parkinson’s disease or stroke: a pilot study. Physiother Theory Pract 2012;28:509-514.
      • 9.
        McNeely ME, Duncan RP, Earhart GM. Medication improves balance and complex gait performance in Parkinson disease. Gait Posture 2012;36:144-148.
      This instrument summary is designed to facilitate the selection of outcome measures by trained clinicians. The information contained in this summary represents a sample of the peer-reviewed research available at the time of this summary’s publication. The information contained in this summary does not constitute an endorsement of this instrument for clinical practice. The views expressed are those of the summary authors and do not represent those of authors’ employers, instrument owner(s), the Archives of Physical Medicine and Rehabilitation, the Rehabilitation Measures Database, the United States Department of Education, or the Retirement Research Foundation. The information contained in this summary has not been reviewed externally.
      The Rehabilitation Measures Database and Instrument Summary Tear-sheets are funded by the National Institute on Disability and Rehabilitation Research, United States Department of Education through the Rehabilitation Research and Training Center on Improving Measurement of Medical Rehabilitation Outcomes (H133B090024) and the Retirement Research Foundation (2011-027).