Responsiveness and Minimal Important Change of the Mini- and Brief-Balance Evaluation Systems Tests in People with Incomplete Cervical Spinal Cord Injury: A Prospective Cohort Study

Background/Objectives: Responsiveness and minimal important change (MIC) are key metrics that vary across conditions and should be determined for specific populations. However, these metrics have not yet been established for the Mini-Balance Evaluation Systems Test (Mini-BESTest) and Brief-BESTest i...

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Main Authors: Yusuke Morooka, Yosuke Kunisawa, Shigeru Obayashi, Yasuyuki Takakura
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Neurology International
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Online Access:https://www.mdpi.com/2035-8377/17/3/43
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author Yusuke Morooka
Yosuke Kunisawa
Shigeru Obayashi
Yasuyuki Takakura
author_facet Yusuke Morooka
Yosuke Kunisawa
Shigeru Obayashi
Yasuyuki Takakura
author_sort Yusuke Morooka
collection DOAJ
description Background/Objectives: Responsiveness and minimal important change (MIC) are key metrics that vary across conditions and should be determined for specific populations. However, these metrics have not yet been established for the Mini-Balance Evaluation Systems Test (Mini-BESTest) and Brief-BESTest in people with subacute traumatic incomplete cervical spinal cord injury (iCSCI). In this study, we aimed to determine the responsiveness and MIC of the Mini-BESTest and Brief-BESTest in people with subacute iCSCI. Methods: This study included people with iCSCI who could maintain the standing position for 30 s without assistance within 7 days of injury at the university hospital’s advanced critical care center. Responsiveness was assessed by correlating Mini-BESTest and Brief-BESTest change scores with the Berg Balance Scale (BBS). MIC values were determined using the global rating of change scale as an anchor, employing receiver operating characteristic curve methods (MIC<sub>ROC</sub>) and predictive modeling methods adjusted for the proportion of improved participants (MIC<sub>adjusted</sub>). Results: Fifty people with iCSCI were included in the analysis. Changes in BBS scores were moderately positively correlated with changes in Mini-BESTest and Brief-BESTest scores. MIC<sub>adjusted</sub> values were 3.7 for the Mini-BESTest and 2.2 for the Brief-BESTest. The MIC<sub>ROC</sub>, based on an improvement rate of 64%, was deemed less appropriate for interpreting meaningful changes due to the high proportion of improved participants. Conclusions: MIC<sub>adjusted</sub> benchmarks can help clinicians measure significant improvements in dynamic balance, design effective interventions, and evaluate rehabilitation outcomes in people with iCSCI.
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spelling doaj-art-b6a04b695c8a44508be6d0cb83f3b3892025-08-20T01:48:53ZengMDPI AGNeurology International2035-83772025-03-011734310.3390/neurolint17030043Responsiveness and Minimal Important Change of the Mini- and Brief-Balance Evaluation Systems Tests in People with Incomplete Cervical Spinal Cord Injury: A Prospective Cohort StudyYusuke Morooka0Yosuke Kunisawa1Shigeru Obayashi2Yasuyuki Takakura3Department of Physical Therapy, Faculty of Health and Medical Care, Saitama Medical University, 981, Kawakado, Iruma-gun 350-0496, Saitama, JapanDepartment of Physical Therapy, Faculty of Health and Medical Care, Saitama Medical University, 981, Kawakado, Iruma-gun 350-0496, Saitama, JapanDepartment of Rehabilitation Medicine, Saitama Medical Center, Saitama Medical University, 1981, Kamoda, Kawagoe 350-8550, Saitama, JapanDepartment of Physical Therapy, Faculty of Health and Medical Care, Saitama Medical University, 981, Kawakado, Iruma-gun 350-0496, Saitama, JapanBackground/Objectives: Responsiveness and minimal important change (MIC) are key metrics that vary across conditions and should be determined for specific populations. However, these metrics have not yet been established for the Mini-Balance Evaluation Systems Test (Mini-BESTest) and Brief-BESTest in people with subacute traumatic incomplete cervical spinal cord injury (iCSCI). In this study, we aimed to determine the responsiveness and MIC of the Mini-BESTest and Brief-BESTest in people with subacute iCSCI. Methods: This study included people with iCSCI who could maintain the standing position for 30 s without assistance within 7 days of injury at the university hospital’s advanced critical care center. Responsiveness was assessed by correlating Mini-BESTest and Brief-BESTest change scores with the Berg Balance Scale (BBS). MIC values were determined using the global rating of change scale as an anchor, employing receiver operating characteristic curve methods (MIC<sub>ROC</sub>) and predictive modeling methods adjusted for the proportion of improved participants (MIC<sub>adjusted</sub>). Results: Fifty people with iCSCI were included in the analysis. Changes in BBS scores were moderately positively correlated with changes in Mini-BESTest and Brief-BESTest scores. MIC<sub>adjusted</sub> values were 3.7 for the Mini-BESTest and 2.2 for the Brief-BESTest. The MIC<sub>ROC</sub>, based on an improvement rate of 64%, was deemed less appropriate for interpreting meaningful changes due to the high proportion of improved participants. Conclusions: MIC<sub>adjusted</sub> benchmarks can help clinicians measure significant improvements in dynamic balance, design effective interventions, and evaluate rehabilitation outcomes in people with iCSCI.https://www.mdpi.com/2035-8377/17/3/43spinal cord injuryminimal important changepostural balance
spellingShingle Yusuke Morooka
Yosuke Kunisawa
Shigeru Obayashi
Yasuyuki Takakura
Responsiveness and Minimal Important Change of the Mini- and Brief-Balance Evaluation Systems Tests in People with Incomplete Cervical Spinal Cord Injury: A Prospective Cohort Study
Neurology International
spinal cord injury
minimal important change
postural balance
title Responsiveness and Minimal Important Change of the Mini- and Brief-Balance Evaluation Systems Tests in People with Incomplete Cervical Spinal Cord Injury: A Prospective Cohort Study
title_full Responsiveness and Minimal Important Change of the Mini- and Brief-Balance Evaluation Systems Tests in People with Incomplete Cervical Spinal Cord Injury: A Prospective Cohort Study
title_fullStr Responsiveness and Minimal Important Change of the Mini- and Brief-Balance Evaluation Systems Tests in People with Incomplete Cervical Spinal Cord Injury: A Prospective Cohort Study
title_full_unstemmed Responsiveness and Minimal Important Change of the Mini- and Brief-Balance Evaluation Systems Tests in People with Incomplete Cervical Spinal Cord Injury: A Prospective Cohort Study
title_short Responsiveness and Minimal Important Change of the Mini- and Brief-Balance Evaluation Systems Tests in People with Incomplete Cervical Spinal Cord Injury: A Prospective Cohort Study
title_sort responsiveness and minimal important change of the mini and brief balance evaluation systems tests in people with incomplete cervical spinal cord injury a prospective cohort study
topic spinal cord injury
minimal important change
postural balance
url https://www.mdpi.com/2035-8377/17/3/43
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AT shigeruobayashi responsivenessandminimalimportantchangeoftheminiandbriefbalanceevaluationsystemstestsinpeoplewithincompletecervicalspinalcordinjuryaprospectivecohortstudy
AT yasuyukitakakura responsivenessandminimalimportantchangeoftheminiandbriefbalanceevaluationsystemstestsinpeoplewithincompletecervicalspinalcordinjuryaprospectivecohortstudy