Construct validity of the mini-bestest in individuals with chronic pain in specialized pain care

Presentatörer:
Sofia Wagner, PT, M.Sc., Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden.
Annika Bring, PT, Ph.D., Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden.
Pernilla Åsenlöf, PT, Ph.D., Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden.

Background: Balance assessment scales are important clinical tests to identify balance impairments. Chronic pain (> 3 months) is associated with impaired dynamic balance; however, very few balance assessment scales are psychometrically evaluated for the population.

Aim: To evaluate the construct validity and internal consistency of the Mini-BESTest for individuals with chronic pain in specialized pain care.

Methods: 180 individuals with chronic pain (> 3 months) were included. For construct validity, five alternative factor structures were evaluated using a confirmatory factor analysis. A priori hypotheses about convergent validity with the 10-meter walk test, and divergent validity with the Brief Pain Inventory (BPI): pain intensity, the Tampa Scale of Kinesiophobia-11 (TSK-11), and the Pain Catastrophizing Scale (PCS-SW) were tested. Internal consistency was evaluated for the best fitting model.

Results: A one-factor model with added covariance via the modification indices showed adequate fit. In line with our hypotheses, Mini-BESTest showed convergent validity (r_s = >.70) with the 10-meter walk test, and divergent validity (r_s = <.50) with BPI pain intensity, TSK-11, and PCS-SW. Internal consistency for the one-factor model was good (α = 0.92).

Conclusion: Our study supported the construct validity and internal consistency of the Mini-BESTest for measuring balance in individuals with chronic pain in specialized pain care. The one-factor model showed an adequate fit. In comparison, models with subscales did not reach convergence, or showed high correlations between subscales, implying that Mini-BESTest is measuring one construct in this sample. We, therefore, propose using the total score, instead of subscale scores, for individuals with chronic pain.