The mini-bestest can predict parkinsonian recurrent fallers : a 6-month prospective study

Abstract

Objectives: To examine whether the Mini-Balance Evaluation Systems Test (Mini-BESTest) independently predicts recurrent falls in people with Parkinson’s disease. Design: The study used a longitudinal cohort design. Subjects: A total of 110 patients with Parkinson’s disease completed the study and were included in the final analysis. Most of the patients had moderate disease severity. Methods: All subjects were measured to establish a baseline. The tests used were Unified Parkinson’s Disease Rating Scale (MDS-UPDRS III), Freezing of Gait Questionnaire, Five-Time-Sit-To-Stand Test, and Mini-BESTest. All patients were followed by telephone interview for 6 months to register the incidence of monthly falls. Results: Twenty-four patients (21.2%) reported more than one fall and were classified as recurrent fallers. Results of the multivariate logistic regression showed that, after adjusting for fall history and MDS-UPDRS III score, the Mini-BESTest score remained a significant predictor of recurrent falls. We further established that a cut-off Mini-BESTest score of 19 had the best sensitivity (79%) for predicting future falls in patients with Parkinson’s disease. Conclusion: The results indicate that those with a Mini-BESTest score < 19 at baseline had a significantly higher risk of sustaining recurrent falls in the next 6 months. These findings highlight the importance of evaluating dynamic balance ability during fall risk assessment in patients with Parkinson’s disease.