Differential Item Functioning of the Mini-BESTest Balance Measure: A Rasch Analysis Study

Antonio Caronni (), Michela Picardi, Stefano Scarano, Peppino Tropea, Giulia Gilardone, Nadia Bolognini, Valentina Redaelli, Giuseppe Pintavalle, Evdoxia Aristidou, Paola Antoniotti and Massimo Corbo
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Antonio Caronni: IRCCS Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, 20149 Milano, Italy
Michela Picardi: Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milano, Italy
Stefano Scarano: IRCCS Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, 20149 Milano, Italy
Peppino Tropea: Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milano, Italy
Giulia Gilardone: Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milano, Italy
Nadia Bolognini: IRCCS Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, 20149 Milano, Italy
Valentina Redaelli: Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milano, Italy
Giuseppe Pintavalle: Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milano, Italy
Evdoxia Aristidou: Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milano, Italy
Paola Antoniotti: Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milano, Italy
Massimo Corbo: Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milano, Italy

IJERPH, 2023, vol. 20, issue 6, 1-22

Abstract: The Mini-Balance Evaluation Systems Test (Mini-BESTest), a 14-item scale, has high content validity for balance assessment. This study further examines the construct validity of the Mini-BESTest with an emphasis on its measurement invariance. The Mini-BESTest was administered to 292 neurological patients in two sessions (before and after rehabilitation) and evaluated with the Rasch analysis (Many-Facet Rating Scale Model: persons, items, sessions). Categories’ order and fit to the model were assessed. Next, maps, dimensionality, and differential item functioning (DIF) were examined for construct validity evaluation. DIF was inspected for several clinically important variables, including session, diagnosis, and assistive devices. Mini-BESTest items had ordered categories and fitted the Rasch model. The item map did not flag severe construct underrepresentation. The dimensionality analysis showed that another variable extraneous to balance affected the score of a few items. However, this multidimensionality had only a modest impact on measures. Session did not cause DIF. DIF for assistive devices affected six items and caused a severe measurement artefact. The measurement artefact caused by DIF for diagnosis was negligible. The Mini-BESTest returns interval measures with robust construct validity and measurement invariance. However, caution should be used when comparing Mini-BESTest measures obtained with and without assistive devices.

Keywords: balance assessment; psychometrics; Rasch analysis; neurological rehabilitation; neurological balance impairment; falls risk assessment (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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