Psychometric properties of the Mini-Balance Evaluation Systems Test (Mini-BESTest) among multiple populations: a COSMIN systematic review and meta-analysis

To synthesize evidence regarding psychometric properties of the Mini-Balance Evaluation Systems Test (Mini-BESTest) in assessing postural control. Six databases were searched until October 15th, 2024. Two authors independently assessed the methodological quality and results of studies using the COSMIN checklist and Terweés criteria. The overall quality of the evidence was provided using the modified GRADE approach. Ninety-one studies were included. The Mini-BESTest showed very good quality and sufficient structural validity (CFI: 0.91-0.99; TLI: 0.888-0.97; RMSEA: 0.05-0.45), internal consistency (α: 0.73-0.97), criterion validity (BESTest r: 0.65-0.95), convergent validity (e.g., Brief-BESTest r: 0.85-0.94; rs: 0.73-0.92; Berg Balance scale r: 0.58-0.85) and know-groups validity (AUC: 0.712-0.97; cutoffs: 9.0-22/28). However, the scale showed doubtful quality as well as sufficient and indeterminate reliability (inter-rater ICC: 0.56-0.998; r: 0.98; intra-rater ICC: 0.74-0.964) and measurement error (SEM: 0.45-3.03; MDC95: 1.23-8.40), respectively. Adequate quality and sufficient rating were found in most studies for responsiveness. The quality of evidence was moderate to low for structural validity and criterion validity, high to low for internal consistency, convergent validity, and high to very low for reliability, measurement error, know-groups validity, and responsiveness. Moderate to high quality evidence was found for support structural validity, internal consistency, reliability, measurement error, criterion validity, hypothesis testing, and responsiveness of the Mini-BESTest only in some study populations.