Mini Balance Evaluation Systems Test(mini-BESTest)

Administration.

14 items including sit-to-stand, rise to toes, stand on one leg, compensatory stepping (forward, backward, lateral), stance on firm and foam surfaces, incline stance eyes closed, gait, gait with head turns, pivot turn, stepping over obstacles, TUG with dual task. Equipment: foam pad, incline, step, stopwatch. Time: 10–15 minutes. Assistive device permitted and scored.

Scoring.

0 = severe, 1 = moderate, 2 = normal per item criteria.

MDC and MCID, stroke-specific.

• Chronic stroke MDC ≈ 3 points (Tsang 2013).
• Early subacute stroke pooled MCID = 3.8 (95% CI 2.9–5.0; Yamamoto Y et al. *Phys Ther*. 2024;104:pzae017).
• Outpatient stroke MCID estimates ~4 points have been reported in earlier work.

Cut-points.

≤17/28 has been associated with falls in mixed neurologic populations; stroke-specific cut-points vary by setting.

What it measures.

Dynamic balance across four subsystems: anticipatory postural adjustments, reactive postural control, sensory orientation, dynamic gait. 14 items scored 0–2, total 0–28.

History.

Derived from the BESTest via Rasch analysis (Franchignoni F, Horak F, Godi M, Nardone A, Giordano A. *J Rehabil Med*. 2010;42:323–331). Stroke validity established in Tsang CSL, Liao LR, Chung RCK, Pang MYC. *Phys Ther*. 2013;93:1102–1115; comparison with Berg in Godi M et al. *Phys Ther*. 2013;93:158–167.

When to use.

Higher-functioning patients where Berg ceilings out; community-dwelling stroke; falls clinic; multi-system dysfunction.

When not to use.

Non-ambulatory patients (many items require gait or stance challenges). Acute, medically unstable patients.