{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:11:51Z","timestamp":1788826311460,"version":"build-2803163510"},"reference-count":73,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:00:00Z","timestamp":1733961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ricerca Corrente Funding Scheme of the Ministry of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>People with neurological conditions (PwNC) frequently fall, mainly due to balance impairments. Among the scales assessing balance, the Balance Evaluation System Test (BESTest) is one of the most comprehensive in evaluating all components of postural control. This study aimed to systematically review and summarize the measurement properties of the BESTest in PwNC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Embase, MEDLINE, ScienceDirect, Scopus, and PEDro were searched up to December 2023. Studies assessing at least 1 BESTest measurement property in PwNC were included. Methodological quality of studies was assessed with the COSMIN Risk of Bias checklist. Overall rating and level of evidence for each property were given according to COSMIN criteria. Where possible, meta-analysis was performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Thirty-six studies (1749 PwNC) were included. The BESTest demonstrated a high quality of evidence supporting good reliability (intraclass correlation coefficients\u2009=\u20090.96\u20130.98 for total score, and 0.70\u20130.98 for subsections), internal consistency, and measurement error. High quality levels of responsiveness, and content and construct validity were also found. However, evidence for structural validity was insufficient to be sure the BESTest actually tests several, or 1, balance constructs. Criterion validity cannot be evaluated. While translated into different languages, cross-cultural validity has never been assessed in PwNC. Evidence to support use of the BESTest for specific neurological conditions is limited to Parkinson disease and stroke, due to the small sample sizes and number of studies in other populations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This systematic review provided high quality evidence supporting the reliability, content and construct validity, and responsiveness of the BESTest to intervention, being able to detect balance changes and to differentiate heterogeneous PwNC based on fall history, falling risk, and physical performance. However, low-quality evidence was found when considering each neurological condition alone. To comprehensively understand the BESTest measurement properties, future studies are needed with larger samples for each neurological condition, especially assessing cross-cultural and structural validity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Impact<\/jats:title>\n                  <jats:p>Assessing balance is crucial for fall risk prevention. The BESTest has been demonstrated to be a reliable, responsive, and valid scale usable in clinical setting for assessing balance in PwNC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Lay Summary<\/jats:title>\n                  <jats:p>Assessing balance is crucial for fall risk prevention. The BESTest has been demonstrated to be a reliable, responsive, and valid scale usable in clinical setting for assessing balance in PwNC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ptj\/pzae178","type":"journal-article","created":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T12:11:05Z","timestamp":1734005465000},"source":"Crossref","is-referenced-by-count":6,"title":["Measurement Properties of the BESTest Scale in People With Neurological Conditions: A Systematic Review With Meta-Analysis"],"prefix":"10.1093","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5948-2428","authenticated-orcid":false,"given":"Ilaria","family":"Arcolin","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabiitation of Veruno Institute, Istituti Clinici Scientifici Maugeri IRCCS , Gattico-Veruno 28013,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8910-2649","authenticated-orcid":false,"given":"Marica","family":"Giardini","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabiitation of Veruno Institute, Istituti Clinici Scientifici Maugeri IRCCS , Gattico-Veruno 28013,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2615-7781","authenticated-orcid":false,"given":"Federica","family":"Tagliabue","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabiitation of Veruno Institute, Istituti Clinici Scientifici Maugeri IRCCS , Gattico-Veruno 28013,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9893-1804","authenticated-orcid":false,"given":"Valeria","family":"Belluscio","sequence":"additional","affiliation":[{"name":"Department of Human Movement and Sport Science, University of Rome \u201cForo Italico\u201d , Rome 00135,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7704-5459","authenticated-orcid":false,"given":"Fay","family":"Horak","sequence":"additional","affiliation":[{"name":"Department of Neurology, Oregon Health and Science University , Portland, OR 97239,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8501-6524","authenticated-orcid":false,"given":"Marco","family":"Godi","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabiitation of Veruno Institute, Istituti Clinici Scientifici Maugeri IRCCS , Gattico-Veruno 28013,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,12,12]]},"reference":[{"issue":"1","key":"2025032508471291600_ref1","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1007\/s00415-004-0276-8","article-title":"Falls in frequent neurological diseases prevalence, risk factors and aetiology","volume":"251","author":"Stolze","year":"2004","journal-title":"J Neurol"},{"key":"2025032508471291600_ref2","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1056\/NEJMcp1903252","article-title":"Prevention of falls in community-dwelling older adults","volume":"382","author":"Ganz","year":"2023","journal-title":"N Engl J Med"},{"issue":"2","key":"2025032508471291600_ref3","doi-asserted-by":"publisher","first-page":"ii7","DOI":"10.1093\/ageing\/afl077","article-title":"Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls?","volume":"35","author":"Horak","year":"2006","journal-title":"Age Ageing"},{"key":"2025032508471291600_ref4","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1136\/jnnp.2005.068742","article-title":"Multiple balance tests improve the assessment of postural stability in subjects with Parkinson\u2019s disease","volume":"77","author":"Jacobs","year":"2006","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"2","key":"2025032508471291600_ref5","doi-asserted-by":"publisher","first-page":"484","DOI":"10.2522\/ptj.20080071","article-title":"The relevance of clinical balance assessment tools to differentiate balance deficits","volume":"89","author":"Mancini","year":"2010","journal-title":"Eur J Phys Rehabil Med"},{"issue":"3","key":"2025032508471291600_ref6","doi-asserted-by":"publisher","first-page":"233","DOI":"10.2522\/ptj.20080131","article-title":"Factors that influence the clinical decision making of physical therapists in choosing a balance assessment approach","volume":"89","author":"Mcginnis","year":"2009","journal-title":"Res Rep"},{"key":"2025032508471291600_ref7","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1177\/0269215509335018","article-title":"How to measure balance in clinical practice. 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