- I put the DVD into my computer and it doesn't work. What should I do?
The BESTest DVD doesn't play on a standard TV set/DVD player but is an interactive program that runs on any Mac or PC computer that has a DVDrom drive.
- 1st, check that your computer has a DVD drive - most computers do but some older computers do not.
- 2nd, follow the instruction sheet that came with the DVD to start the program. You can download a new sheet here: BESTest Start-Up Instructions (right click and "save as").
If the software starts and the videos don't work or playback is jumpy:
- 1st, Check that you have the latest version of Quicktime installed on your computer. This comes with all Macs but sometimes PC owners will need to download the free quicktime installer through the Quicktime website here: Quicktime.
- 2nd, make sure your computer has minimum system requirements to run the DVD:
- For Windows: your computer should have at least 512 MB RAM, a 2.0Ghz Pentium 4 or higher processor and a minimum of 64MB of Video RAM.
- For Macs: your computer should have at least 128 MB RAM, a 1.25GHz G4 or higher processor and a minimum of 64MB of Video RAM.
If you still have trouble after trying these steps please email tech support: techsupport@bestest.us
- How do you score the stability in gait section when they have to use an assistive device?
Always score one point less if a patient uses a device or needs assistance from the examiner. For example, if the patient score's a 3 in Gait- Level Surface, but needs a cane, the final score would be 2.
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- How do you score the stability in gait section when they have limited ability to do head movements secondary to limited cervical Range of Motion?
What matters most is that they turn their head within their range of motion while walking and that doing so does not create instability. If patient has very limited Range of Motion, allow combined head and trunk movement. If patient has a significant Range of Motion while sitting, but refuses to use full range while walking, subtract 1 point from their score.
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- How high should the foot be in Task 4 (Hip/Trunk Lateral Strength)?
The important part is that the leg is straight at the knee, the foot is lifted to the side (abducted along the coronal plane), that the trunk is kept vertical, and to evaluate the force on your hands the patient uses to keep trunk vertical. Height of foot isn't as important but should be substantial. The video samples of perfect scores all have the foot about 6"- 18" high.
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- What is the differences between "push and release" test and "compensatory stepping" part of BESTest?
Is the "push and release" being considered for UPDRS?
Sorry for the confusion between our previous paper's presentation of the Push and Release test (Jacobs, et al, 2006) and the use of the Push and Release technique to test compensatory stepping in the BESTest. The previous version of the test in Jacobs was designed for neurologists as a substitute for the Pull test in the UPDRS so it has 5 levels (0 to 4). In contrast, the version of the Push and Release in the BESTest has 4 levels (0 to 3) so it is consistent with all of the other items in the BESTest. The procedure for eliciting the compensatory step is the same but the scoring is different.
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- Does an assistive device include orthoses (e.g. in patients with drop-foot)?
Yes.
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- How do you define "touch assist"?
When the patient or therapist uses their sense of touch to help the patient complete a task. For instance, back of the leg touching the chair is providing assist as would touching a person nearby or a wall, even for a split second.
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- Does assistance include both personal assistance and help from an assistive device in all the items?
Either type of support would reduce the score.
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- We presumed that the BESTest included the "Timed Up & Go" test and items from the DGI, although the instructions and the scoring is different. Is this correct or are the tests modifications of the above and thus have different instructions?
The tests have been modified so the instructions are sometimes different.
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- If the therapist thinks it is too hazardous to let the patient do the task, would the score then be (0)?
Yes, definitely (for example won’t or cant safely go to floor with the therapist). If a patient cannot safely complete any task, that score is automatically (0)
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- Base Of Support: What is the score if a patient has one painful foot and one foot with deformities?
Both feet are affected so the score is (1).
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- Ankle Strength & Range: It appears that you are assessing muscle strength and ROM. Is range of motion because of factors other than muscle strength taken into account?
Any reason for loss of range would affect the score, not only strength.
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- Alternate Stair Touching: How do you define "excessive trunk motion"? Could it be considered as "upper body motion including the arms"?
Yes, any body motion or arm motion that is more than normal.
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- Compensatory Stepping Correction- Forward: What do you mean by "falling spontaneously"?
When asked to stand still without support, would fall if not assisted.
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- Incline - Eyes Closed: For score of (1) Why is it not 10-29s? What about a patient who stands for 25s?
Yes, it should be changed to 10-29 seconds!!
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- Gait - Level Surface: What do you mean by "lateral trunk motion" and "inconsistent step path"?
Signs of imbalance during gait include excessive lateral trunk motion and veering of steering left and right when trying to walk straight ahead: ataxia.
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- Walk With Head Turns - Horizontal: "Perform head turns with reduced speed" - do you mean the head turns at a reduced speed or that the patient performs head turns with reduced gait speed?
Gait speed slows down.
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- Do patients who have a cervical restriction and are unable to turn their head score as high as those who have no restrictions?
Allow patients with restricted neck movement to turn at the trunk and score as if they have no restrictions.
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- Step Over Obstacles: What is the implication of level (0), "cannot step over shoe boxes AND slows down with imbalance or cannot perform with assistance"?
If a patient cannot step over the shoe boxes with or without assistance score as (0).
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- Timed "Get Up & Go" With Dual Task: What is the 10% referring to in level (2)?
The percentages refer to a change in gait speed compared to gait without a dual task. This is a comparison of the gait speed from the previous task (Timed "Get up and Go").
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