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

Author

Listed:
  • 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
    Department of Biomedical Sciences for Health, Università Degli Studi di Milano, 20133 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
    Department of Psychology and NeuroMI, University of Milano-Bicocca, 20126 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)

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.

Suggested Citation

  • Antonio Caronni & Michela Picardi & Stefano Scarano & Peppino Tropea & Giulia Gilardone & Nadia Bolognini & Valentina Redaelli & Giuseppe Pintavalle & Evdoxia Aristidou & Paola Antoniotti & Massimo Co, 2023. "Differential Item Functioning of the Mini-BESTest Balance Measure: A Rasch Analysis Study," IJERPH, MDPI, vol. 20(6), pages 1-22, March.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:6:p:5166-:d:1097836
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    References listed on IDEAS

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    1. Meenakshi Nayar & Roxana Vanderstay & Richard J Siegert & Lynne Turner-Stokes, 2016. "The UK Functional Assessment Measure (UK FIM+FAM): Psychometric Evaluation in Patients Undergoing Specialist Rehabilitation following a Stroke from the National UK Clinical Dataset," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-15, January.
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