A comparison of the ceiling effect between Berg Balance Scale and Mini-BESTest in a group of balance trained community-dwelling older adults

Introduction The aim of the study was to examine the ceiling effect of Berg Balance Scale (BBS) and Mini-BESTest (MBT) and to determine the most difficult items of the two scales in a group of functionally fit older adults. Methods The total of 26 community-dwelling older adults were enrolled to the study. Their functional status and agility were evaluated with the 10-meter walk test and Four-Square Step Test, respectively, followed by the BBS and MBT. The descriptive statistics were used for data analysis. Results The participants’ functional status and agility were higher than the reported normative values for the age group. The results of BBS indicated a very high ceiling effect; as many as 73.1% of participants obtained the highest score. When tested by MBT, only 3.8% reached the highest score of the scale. The ceiling effect difference between BBS and MBT was statistically significant (<i>p</i> < 0.001). The most difficult item was 360° turning for BBS and Timed Up and Go test with a cognitive task for MBT. Conclusions The MBT presents a significantly smaller ceiling effect and is therefore more suitable for assessing balance even for balance trained older adults. The most difficult items of the two scales, i.e. 360° turning and Timed Up and Go test with a cognitive task, may be used as a short screening tool.