Tradução e adaptação para o português - Brasil do balance evaluation systems test e do minibestest e análise de suas propriedades psicométricas em idosos e indivíduos com doença de Parkinson

Abstract

Background: Postural control (CP) involves several underlying systems: visual, vestibular, somatosensory, nervous system, biomechanical and cognitive. In the elderly, balance disorders may occur due to multiple disabilities, such as multi-sensory loss, weakness, orthopedic and cognitive constraints. With the progression of Parkinson's disease (PD), postural instability appears. Assessment tools of the balance currently used are directed to the identification of subjects with deficits and prediction of the risk of falls, pointing individuals who could benefit from interventions, but this assessments do not help in the decision of how to treat the dysfunction. To overcome the lack of instruments to assess specifically the underlying systems of balance, was developed the Balance Evaluation Systems Test (BESTest), designed to help identify the underlying systems that may be the responsible for the poor functional balance, and then guide clinical intervention. There is also a short version of this test, the MiniBESTest. Objectives: Make a cultural adaptation of the BESTest and MiniBESTest for Brazilian Portuguese and to assess its psychometric properties in elderly and individuals with PD. Methods: Tests were translated and adapted in accordance with standardized instructions and was subjected to test-retest reliability analysis in ten elderly and ten individuals with PD. The psychometric properties were evaluated using Rasch analysis in 35 subjects and 35 subjects with PD. Results: The reliability coefficient of calibration of the items ranged from 0.97 to 0.98, indicating stability of measurements. And ranged from 0.91 to 0.95 for subjects, indicating that the measures can be reproduced in subsequent applications. In the BESTest, the participants were divided into six skill levels and items in 7.5 degrees of difficulty. In MiniBESTest, individuals were separated on 4.5 skill levels and items in nine levels of difficulty. Only two items BESTest did not fit to model expectations. This way, the set of items that constitute the test proved to be suitable for evaluating a unidimensional construct, so the test showed construct validity. For MiniBESTest, the items showed appropriate statistics. The PD patients showed worse balance than the elders, who had lower test scores. Among individuals with PD, those classified in the early stages of the disease (Hoehn and Yahr stages - HY = 1 to 2.5) had better balance than those with more severe PD (HY = 3 and 4). Conclusion: The BESTest and MiniBESTest shown to be reliable and valid tools for assessing the elderly and subjects DP, but is necessary study its use in other populations.