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Title: Recovery of balance function among individuals with total knee arthroplasty : comparison of responsiveness among four balance tests
Authors: Chan, ACM 
Ouyang, XH 
Jehu, DAM 
Chung, RCK 
Pang, MYC 
Issue Date: Jan-2018
Source: Gait and posture, Jan. 2018, v. 59, p. 267-271
Abstract: Background and aim: Balance deficits are common after total knee arthroplasty (TKA); however the responsiveness of commonly used balance measurement tools has not been well defined. The objective of this prospective study was to compare the internal and external responsiveness of four measurement tools in assessing recovery of balance function following TKA.
Methods: A total of 134 individuals with TKA (95 women; age: 66.3 +/- 6.6 years) completed the Balance Evaluation Systems Test (BESTest), Mini-BESTest, Brief-BESTest, and Berg Balance Scale (BBS) at 2, 4, 8, 12, and 24 weeks post-TKA. The Functional Gait Assessment (FGA) served as the anchor measure, and was also measured across these time points. Internal responsiveness was indicated by the standardized response mean (SRM), while external responsiveness was reflected by the degree of association of the changes of balance scores with those of FGA.
Results: The SRM ranged from 0.60-1.14 for the BESTest, 0.40-0.94 for the Mini-BESTest, 0.27-0.91 for the Brief-BESTest, and 0.19-0.70 for the BBS, over time. The change in BESTest and Mini-BESTest scores predicted the change in the FGA scores across all time periods, except for the Mini-BESTest between weeks 12-24, accounting for 13-27%, and 12-24% of the variance, respectively. The Brief-BESTest scores only predicted FGA scores between the weeks 2-4 (R-2 = 20%). The changes in BBS scores were not associated with the FGA.
Conclusion: The BESTest is the most responsive in measuring recovery of balance among individuals with TKA. The Mini-BESTest is a reasonable option during time constraints.
Keywords: Balance
Total knee arthroplasty
Publisher: Elsevier
Journal: Gait and posture 
ISSN: 0966-6362
EISSN: 1879-2219
DOI: 10.1016/j.gaitpost.2017.10.020
Rights: © 2017 Published by Elsevier B.V.
© 2017. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
The following publication Chan, A. C., Ouyang, X. H., Jehu, D. A., Chung, R. C., & Pang, M. Y. (2018). Recovery of balance function among individuals with total knee arthroplasty: comparison of responsiveness among four balance tests. Gait & posture, 59, 267-271 is available at
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