The Mini-Balance Evaluation Systems Test (Mini-BESTest) Demonstrates Higher Accuracy in Identifying Older Adult Participants With History of Falls Than Do the BESTest, Berg Balance Scale, or Timed Up and Go Test

J Geriatr Phys Ther. Apr-Jun 2016;39(2):64-70. doi: 10.1519/JPT.0000000000000050.


Background and purpose: Balance deficits a significant predictor of falls in older adults. The Balance Evaluation Systems Test (BESTest) and the Mini-Balance Evaluation Systems Test (Mini-BESTest) are tools that may predict the likelihood of a fall, but their capabilities and accuracies have not been adequately addressed. Therefore, this study aimed at examining the capabilities of the BESTest and Mini-BESTest for identifying older adult with history of falls and comparing the participants with history of falls identification accuracy of the BESTest, Mini-BESTest, Berg Balance Scale (BBS), and the Timed Up and Go Test (TUG) for identifying participants with a history of falls.

Methods: Two hundred healthy older adults with a mean age of 70 years were classified into participants with and without history of fall groups on the basis of their 12-month fall history. Their balance abilities were assessed using the BESTest, Mini-BESTest, BBS, and TUG. An analysis of the resulting receiver operating characteristic curves was performed to calculate the area under the curve (AUC), sensitivity, specificity, cutoff score, and posttest accuracy of each.

Results: The Mini-BESTest showed the highest AUC (0.84) compared with the BESTest (0.74), BBS (0.69), and TUG (0.35), suggesting that the Mini-BESTest had the highest accuracy in identifying older adult with history of falls. At the cutoff score of 16 (out of 28), the Mini-BESTest demonstrated a posttest accuracy of 85% with a sensitivity of 85% and specificity of 75%. The Mini-BESTest had the highest posttest accuracy, with the others having results of 76% (BESTest), 60% (BBS), and 65% (TUG).

Conclusion: The Mini-BESTest is the most accurate tool for identifying older adult with history of falls compared with the BESTest, BBS, and TUG.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / prevention & control*
  • Aged
  • Aged, 80 and over
  • Disability Evaluation*
  • Female
  • Geriatric Assessment / methods*
  • Humans
  • Male
  • Middle Aged
  • Physical Therapy Modalities*
  • Postural Balance*
  • Psychometrics
  • ROC Curve
  • Reproducibility of Results