On the Mini-BESTest: Scoring and the Reporting of Total Scores

The Mini-BESTest1 was published in 2010 to introduce a shorter version of the Balance Evaluation Systems Test (BESTest). The Mini-BESTest has gained in popularity both as a clinical tool and as a research outcome measure of dynamic balance control. The test is freely downloadable and can be found at the BESTest website (www.BESTest.us) ( Appendix). It has come to our attention both through our own studies and through published manuscripts that there is a discrepancy in how people are scoring and reporting total scores. Part of this problem originates from the fact that the scoring instructions are inconsistent between the published version1 and that which is posted online. For example, a literature search of the past year and half resulted in 9 articles, most of which present the total Mini-BESTest score to be out of a maximum of 32 points.2–10 This is incorrect. The Mini-BESTest has 14 items, scored from 0–2, so the maximum score is 28. Two items (single-limb stance and lateral compensatory stepping) are being inappropriately counted into the total score because only the worst score between the sides should be counted in the total. Table I from the original article1 states, “Only the worst performance in items ‘stand on one leg' and ‘lateral stepping' have to be taken into account for the score. Moreover, the performance in Cognitive Get Up and Go must be compared with that in the baseline item.” Another common inconsistency is in determining a normal performance (score 2) versus an impaired performance (score 1) on the Cognitive Dual Task Get Up and Go. In the original paper, the authors stated, “Score dual task as affecting walking if speed slows >10% from TUG and/or new signs of imbalance.”1(p331) These discrepancies are an important point if we are aiming to streamline outcome measures across studies and report important cutoff scores and minimally important change in the tests we use. Below is a summary of clarification for the common errors in scoring, as well as the corrected version of the Mini-BESTest. Clarifications on Scoring and Total Scoring: The Mini-BESTest should be scored out of 28 points to include 14 items that are scored from 0 to 2. For Item 3 (single-leg stance) and Item 6 (compensatory lateral stepping), when compiling total score, use only the worse score. For Item 14, if a person's gait slows greater than 10% between the TUG with and without a dual task, the score should be decreased by a point. Mini-BESTest: Balance Evaluation Systems Test.