Diagnostic accuracy of the Mini-Balance Evaluation Systems Test (Mini-BESTest) in screening for fall risk among individuals with vestibular disorders

Information from the abstract

Vestibular disorders significantly impair postural stability and elevate fall risk, necessitating the use of validated assessment tools. While the Mini-Balance Evaluation Systems Test (Mini-BESTest) is a comprehensive measure of balance, diagnostic cut-off scores tailored to the vestibular population remain poorly defined. This study aimed to evaluate the diagnostic accuracy of the Mini-BESTest in identifying fall risk among individuals with vestibular disorders. Forty-two participants underwent assessment using the Mini-BESTest, 4-Meter Walk Test (4MWT), and Timed Up and Go (TUG) test. Fall risk was classified using a dual-criteria approach: (1) fall history and severity (e.g., injury, frequency, and frailty) and (2) physical performance benchmarks on the 4MWT and TUG. Participants were subsequently categorized into low or intermediate-to-high fall risk groups. Accuracy was determined via receiver operating characteristic (ROC) curve analysis. The results yielded an Area Under the Curve (AUC) of 0.69, indicating poor-to-modest discriminatory ability. At the optimal cut-off score of ≤ 23, the scale demonstrated high sensitivity (92.3%) and low specificity (44.8%), resulting in a positive likelihood ratio (LR+) of 1.67 and a negative likelihood ratio (LR-) of 0.17. Exploratory subscore analysis revealed that only the reactive postural control domain provided significant discriminatory trends under bootstrap analysis (95% CI: 0.516-0.823). These results suggest that while the comprehensive total score of Mini-BESTest remains the necessary standard for primary risk stratification due to the scale's validated unidimensional design, reactive postural control performance represents a key underlying physiological driver of instability in this population. Recognizing this specific domain impairment can better assist clinicians in tailoring targeted, individualized therapeutic interventions during vestibular rehabilitation.

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Related topics: Vestibular and auditory disorders · Balance, Gait, and Falls Prevention · Temporomandibular Joint Disorders