{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T16:02:39Z","timestamp":1793462559760,"version":"4.5.0"},"reference-count":41,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T00:00:00Z","timestamp":1654473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Research Center in Back, Neck, Other Joint Pain and Human Performance"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Type 2 diabetic peripheral neuropathy is known to cause balance limitations in static, dynamic, and functional activity. The Mini-BESTest, a shortened version of BESTest, was evolved to identify balance disorders within a short duration. No prior studies have yet been conducted to assess the usefulness of Mini-BESTest in the diagnosis of type 2 diabetic peripheral neuropathy. The current study aimed to examine the reliability and discriminant validity by comparing the Mini-BESTest scores between type 2 diabetic patients with peripheral neuropathy, divided into two 2 groups based on reporting scores of &lt;4 and \u22654 in the MNSI questionnaire, respectively. Therefore, a cross-sectional study design was conducted including 44 type 2 diabetic patients (4 males and 40 females; aged 56.61 \u00b1 7.7 years old). Diabetic peripheral neuropathy was diagnosed by physical assessment using the Michigan Neuropathy Screening Instrument (MNSI). Inter-rater (two physiotherapists) and Intra-rater (7\u201310 days) reliability of the Mini-BESTest were explored with intraclass correlation coefficients (ICC2,1) and (ICC3,1). The Mini-BESTest presented an excellent inter-rater reliability (ICC2,1= 0.95, 95% CI = 0.91\u20130.97, SEM = 0.61) and an excellent intra-rater reliability (ICC3,1 = 0.93, 95% CI = 0.87\u20130.96, SEM = 0.66), with confirmation by a good agreement presented by the Bland\u2013Altman plots. The internal consistency measured with the overall Cronbach\u2019s alpha showed an acceptable agreement (0.73). The MDC was 2.16. In addition, the Mini-BESTest scores in the type 2 diabetic neuropathy patients reporting MNSI questionnaire scores &lt;4 was found to be significantly higher when compared with those reporting scores \u22654. The Mini-BESTest can be used as a highly reliable and valid clinical application in the population with type 2 diabetic peripheral neuropathy.<\/jats:p>","DOI":"10.3390\/ijerph19116944","type":"journal-article","created":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T10:08:24Z","timestamp":1654510104000},"page":"6944","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Reliability and Validity of Mini-Balance Evaluation System Test in Type 2 Diabetic Patients with Peripheral Neuropathy"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7690-2930","authenticated-orcid":false,"given":"Sitt Nyein","family":"Phyu","sequence":"first","affiliation":[{"name":"Faculty of Graduate School, Khon Kean University, Khon Kaen 40002, Thailand"},{"name":"Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kean University, Khon Kaen 40002, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Punnee","family":"Peungsuwan","sequence":"additional","affiliation":[{"name":"Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kean University, Khon Kaen 40002, Thailand"},{"name":"School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rungthip","family":"Puntumetakul","sequence":"additional","affiliation":[{"name":"Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kean University, Khon Kaen 40002, Thailand"},{"name":"School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2109-0394","authenticated-orcid":false,"given":"Uraiwan","family":"Chatchawan","sequence":"additional","affiliation":[{"name":"Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kean University, Khon Kaen 40002, Thailand"},{"name":"School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"107843","DOI":"10.1016\/j.diabres.2019.107843","article-title":"Global and Regional Diabetes Prevalence Estimates for 2019 and Projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th Edition","volume":"157","author":"Saeedi","year":"2019","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1038\/nrendo.2011.183","article-title":"The Worldwide Epidemiology of Type 2 Diabetes Mellitus\u2014Present and Future Perspectives","volume":"8","author":"Chen","year":"2012","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1002\/dmrr.2239","article-title":"Advances in the Epidemiology, Pathogenesis and Management of Diabetic Peripheral Neuropathy","volume":"28","author":"Tesfaye","year":"2012","journal-title":"Diabetes\/Metab. Res. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1111\/nhs.12618","article-title":"Prevalence of Peripheral Neuropathy and Its Impact on Activities of Daily Living in People with Type 2 Diabetes Mellitus","volume":"21","author":"Win","year":"2019","journal-title":"Nurs. Health Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.14802\/jmd.16062","article-title":"Functional Neuroanatomy for Posture and Gait Control","volume":"10","author":"Takakusaki","year":"2017","journal-title":"J. Mov. Disord."},{"key":"ref_6","unstructured":"Centers for Disease Control and Prevention (2020, November 14). Prevention National Diabetes Fact Sheet: National Estimates and General Information on Diabetes and Prediabetes in the United States. Available online: http:\/\/www.caldiabetes.org\/content_display.cfm?FontSize=normal&contentID=562&CategoriesID=31."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.2337\/diacare.27.7.1591","article-title":"Prevalence of Lower-Extremity Disease in the US Adult Population \u2265 40 Years of Age with and without Diabetes: 1999\u20132000 National Health and Nutrition Examination Survey","volume":"27","author":"Gregg","year":"2004","journal-title":"Diabetes Care"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.pmrj.2013.11.007","article-title":"Comparison of Balance Ability Between Patients with Type 2 Diabetes and With and Without Peripheral Neuropathy","volume":"6","author":"Lim","year":"2014","journal-title":"PM R"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Timar, B., Timar, R., Gai\u021b\u0103, L., Oancea, C., Levai, C., and Lungeanu, D. (2016). The Impact of Diabetic Neuropathy on Balance and on the Risk of Falls in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0154654"},{"key":"ref_10","first-page":"1002","article-title":"Balance Training in Diabetic Peripheral Neuropathy: A Narrative Review","volume":"2","author":"Ahmad","year":"2017","journal-title":"JSM Diabetol. Manag."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Roman de Mettelinge, T., Cambier, D., Calders, P., Van Den Noortgate, N., and Delbaere, K. (2013). Understanding the Relationship between Type 2 Diabetes Mellitus and Falls in Older Adults: A Prospective Cohort Study. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0067055"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1046\/j.1532-5415.2002.50503.x","article-title":"Factors Associated with Falls in Older Patients with Diffuse Polyneuropathy","volume":"50","author":"Richardson","year":"2002","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.2337\/diacare.25.10.1749","article-title":"Older Women with Diabetes Have a Higher Risk of Falls: A Prospective Study","volume":"25","author":"Schwartz","year":"2002","journal-title":"Diabetes Care"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.jdiacomp.2005.06.004","article-title":"Falls as a Complication of Diabetes Mellitus in Older People","volume":"20","author":"Tilling","year":"2006","journal-title":"J. Diabetes Complicat."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.2522\/ptj.20120070","article-title":"Diagnostic Accuracy of Fall Risk Assessment Tools in People with Diabetic Peripheral Neuropathy","volume":"92","author":"Jernigan","year":"2012","journal-title":"Phys. Ther."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"484","DOI":"10.2522\/ptj.20080071","article-title":"The Balance Evaluation Systems Test (BESTest) to Differentiate Balance Deficits","volume":"89","author":"Horak","year":"2009","journal-title":"Phys. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.gaitpost.2017.08.022","article-title":"Clinical Measures of Balance in People with Type Two Diabetes: A Systematic Literature Review","volume":"58","author":"Dixon","year":"2017","journal-title":"Gait Posture"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"323","DOI":"10.2340\/16501977-0537","article-title":"Using Psychometric Techniques to Improve the Balance Evaluation Systems Test: The Mini-BESTest","volume":"42","author":"Franchignoni","year":"2010","journal-title":"J. Rehabil. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.apmr.2014.06.021","article-title":"Using the Systems Framework for Postural Control to Analyze the Components of Balance Evaluated in Standardized Balance Measures: A Scoping Review","volume":"96","author":"Sibley","year":"2015","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_20","doi-asserted-by":"crossref","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":"ref_21","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1519\/JPT.0000000000000109","article-title":"Validity and Relative Ability of 4 Balance Tests to Identify Fall Status of Older Adults with Type 2 Diabetes","volume":"40","author":"Marques","year":"2017","journal-title":"J. Geriatr. Phys. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1111\/j.1464-5491.2012.03644.x","article-title":"Use of the Michigan Neuropathy Screening Instrument as a Measure of Distal Symmetrical Peripheral Neuropathy in Type 1 Diabetes: Results from the Diabetes Control and Complications Trial\/Epidemiology of Diabetes Interventions and Complications","volume":"29","author":"Herman","year":"2012","journal-title":"Diabet. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"68","DOI":"10.12659\/MSMBR.894163","article-title":"Effects of Thai Foot Massage on Balance Performance in Diabetic Patients with Peripheral Neuropathy: A Randomized Parallel-Controlled Trial","volume":"21","author":"Chatchawan","year":"2015","journal-title":"Med. Sci. Monit. Basic Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1097\/NPT.0b013e31821a620c","article-title":"Utility of the Mini-BESTest, BESTest, and BESTest Sections for Balance Assessments in Individuals with Parkinson Disease","volume":"35","author":"Leddy","year":"2011","journal-title":"J. Neurol. Phys. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"571","DOI":"10.2522\/ptj.2013.93.4.571","article-title":"On the Mini-BESTest: Scoring and the Reporting of Total Scores","volume":"93","author":"King","year":"2013","journal-title":"Phys. Ther."},{"key":"ref_26","unstructured":"Nunnally, J.C. (1978). Psychometric Theory, McGraw. [2nd ed.]."},{"key":"ref_27","unstructured":"Nurosis, M. (1993). Statistical Data Analysis, SPSS Inc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"217","DOI":"10.2165\/00007256-199826040-00002","article-title":"Statistical Methods for Assessing Measurement Error (Reliability) in Variables Relevant to Sports Medicine","volume":"26","author":"Atkinson","year":"1998","journal-title":"Sports Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1093\/bja\/aem214","article-title":"Using the Bland\u2013Altman Method to Measure Agreement with Repeated Measures","volume":"99","author":"Myles","year":"2007","journal-title":"Br. J. Anaesth."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"158","DOI":"10.2522\/ptj.20120171","article-title":"Comparison of Reliability, Validity, and Responsiveness of the Mini-BESTest and Berg Balance Scale in Patients With Balance Disorders","volume":"93","author":"Godi","year":"2013","journal-title":"Phys. Ther."},{"key":"ref_31","unstructured":"Portney, L.G., and Watkins, M.P. (2009). Foundations of Clinical Research: Applications to Practice, Pearson & Prentice Hall."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.2522\/ptj.20140486","article-title":"Assessing Balance Function in Patients with Total Knee Arthroplasty","volume":"95","author":"Chan","year":"2015","journal-title":"Phys. Ther."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1080\/09593985.2018.1441931","article-title":"Reliability, Validity and Minimal Detectable Change of the Mini-BESTest in Greek Participants with Chronic Stroke","volume":"35","author":"Lampropoulou","year":"2019","journal-title":"Physiother. Theory Pract."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.2522\/ptj.20120454","article-title":"Psychometric Properties of the Mini-Balance Evaluation Systems Test (Mini-BESTest) in Community-Dwelling Individuals with Chronic Stroke","volume":"93","author":"Tsang","year":"2013","journal-title":"Phys. Ther."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"20180015","DOI":"10.2490\/prm.20180015","article-title":"Reliability and Validity of the Japanese Version of the Mini-Balance Evaluation Systems Test in Patients with Subacute Stroke","volume":"3","author":"Oyama","year":"2018","journal-title":"Prog. Rehabil. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"E45","DOI":"10.1519\/JPT.0000000000000215","article-title":"Reliability, Validity, and Ability to Identity Fall Status of the Berg Balance Scale, Balance Evaluation Systems Test (BESTest), Mini-BESTest, and Brief-BESTest in Older Adults Who Live in Nursing Home","volume":"42","author":"Viveiro","year":"2019","journal-title":"J. Geriatr. Phys. Ther."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"L\u00f6fgren, N., Lenholm, E., Conradsson, D., St\u00e5hle, A., and Franz\u00e9n, E. (2014). The Mini-BESTest\u2014A Clinically Reproducible Tool for Balance Evaluations in Mild to Moderate Parkinson\u2019s Disease?. BMC Neurol., 14.","DOI":"10.1186\/s12883-014-0235-7"},{"key":"ref_38","first-page":"1","article-title":"Intra-and Inter-Rater Reliability of the Mini-Balance Evaluation Systems Test in Individuals with Stroke","volume":"2","author":"Dahl","year":"2013","journal-title":"Int. J. Phys. Med. Rehabil."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2166","DOI":"10.1016\/j.apmr.2016.07.011","article-title":"Reliability, Validity, and Ability to Identify Fall Status of the Balance Evaluation Systems Test, Mini\u2013Balance Evaluation Systems Test, and Brief\u2013Balance Evaluation Systems Test in Older People Living in the Community","volume":"97","author":"Marques","year":"2016","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.2522\/ptj.20130558","article-title":"Reliability and Validity of the Balance Evaluation Systems Test (BESTest) in People with Subacute Stroke","volume":"94","author":"Chinsongkram","year":"2014","journal-title":"Phys. Ther."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1097\/MRR.0000000000000153","article-title":"The Mini-BESTest: A Review of Psychometric Properties","volume":"39","author":"Bravini","year":"2016","journal-title":"Int. J. Rehabil. Res."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/11\/6944\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:25:03Z","timestamp":1760138703000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/11\/6944"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,6]]},"references-count":41,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["ijerph19116944"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19116944","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,6]]}}}