Person with MS balancing, BESTest concept.

MS & Balance: Can This Simple Test Predict Your Fall Risk?

Lena Kashyap in Health & Wellness December 2025 • 4 min read.

"Discover how the Balance Evaluation Systems Test (BESTest) can accurately assess and improve balance in individuals with multiple sclerosis."

Multiple sclerosis (MS) can bring many challenges, and balance problems are a big one. Falls aren't just inconvenient; they can lead to serious injuries and a lower quality of life. The usual balance tests designed for older adults often miss the specific issues that people with MS face.

That's where the Balance Evaluation Systems Test (BESTest) comes in. This test is designed to pinpoint exactly which body systems are contributing to balance problems, helping therapists create more effective treatment plans. But how reliable and accurate is it for people with MS? Research has been digging into this, and the findings are promising.

This article explores how the BESTest can be used to assess balance in individuals with MS, comparing its effectiveness to other common balance tests and highlighting its potential to reduce fall risk. We'll break down the research, explain what it means for you, and show you how this test could make a real difference in managing your balance.

BESTest: A Better Way to Assess Balance in MS?

Person with MS balancing, BESTest concept.

The BESTest isn't just another balance test. It's designed to look at six different areas of postural control, giving a much more detailed picture of a person's balance abilities. These areas include:

The BESTest's detailed approach means it can catch subtle balance issues that other tests might miss, especially in people with MS. By identifying specific weaknesses, therapists can create targeted exercises and strategies to improve balance and reduce the risk of falls.

Biomechanical Constraints: Ankle strength and range of motion.
Limits of Stability: How far you can lean without losing balance.
Sensory Orientation: Using vision and body awareness to stay balanced.
Anticipatory Postural Responses: Preparing for movements.
Reactive Postural Responses: Recovering from unexpected disturbances.
Gait: How you walk and maintain balance while moving.

A recent study published in the International Journal of MS Care investigated the BESTest's reliability and validity in people with MS. The researchers found that the BESTest had excellent test-retest reliability, meaning it gives consistent results over time. It also correlated well with another common balance test, the Berg Balance Scale (BBS), but offered more specific insights.

Taking Control of Your Balance With the BESTest

The BESTest offers a promising tool for assessing and addressing balance issues in individuals with MS. Its detailed approach and proven reliability make it a valuable addition to the therapist's toolkit.

If you're concerned about your balance, talk to your doctor or physical therapist about the BESTest. It could be the first step toward a more stable and confident you.

Remember, falls don't have to be an inevitable part of living with MS. With the right assessment and intervention, you can take control of your balance and live a fuller, more active life.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.7224/1537-2073.2016-118, Alternate LINK

Title: Test-Retest Reliability, Validity, And Minimal Detectable Change Of The Balance Evaluation Systems Test To Assess Balance In Persons With Multiple Sclerosis

Subject: Advanced and Specialized Nursing

Journal: International Journal of MS Care

Publisher: Consortium of Multiple Sclerosis Centers

Authors: Kathryn D. Mitchell, Han Chen, Sheri P. Silfies

Published: 2018-09-01

Everything You Need To Know

What does the Balance Evaluation Systems Test (BESTest) evaluate?

The Balance Evaluation Systems Test (BESTest) is a comprehensive assessment tool designed to evaluate different aspects of postural control. It pinpoints specific body systems contributing to balance problems. These areas include biomechanical constraints, limits of stability, sensory orientation, anticipatory postural responses, reactive postural responses, and gait. By identifying weaknesses in these areas, therapists can create targeted interventions to improve balance and reduce the risk of falls.

How does the Balance Evaluation Systems Test (BESTest) improve on other balance tests?

The Balance Evaluation Systems Test (BESTest) differs from other balance tests because it provides a more detailed analysis of balance abilities. Unlike general balance tests, the BESTest looks at six specific areas of postural control. This detailed approach allows it to catch subtle balance issues that other tests might miss, which is particularly useful for individuals with multiple sclerosis (MS). This comprehensive assessment leads to more targeted and effective treatment plans.

What specific areas of postural control are evaluated by the Balance Evaluation Systems Test (BESTest)?

The Balance Evaluation Systems Test (BESTest) assesses six key areas of postural control. These include: biomechanical constraints (ankle strength and range of motion), limits of stability (how far you can lean without losing balance), sensory orientation (using vision and body awareness), anticipatory postural responses (preparing for movements), reactive postural responses (recovering from unexpected disturbances), and gait (walking and maintaining balance while moving).

What does research say about the reliability of the Balance Evaluation Systems Test (BESTest)?

Research indicates that the Balance Evaluation Systems Test (BESTest) has excellent test-retest reliability, meaning it provides consistent results over time. A study in the *International Journal of MS Care* showed it correlates well with the Berg Balance Scale (BBS), a common balance test, but offers more specific insights into balance deficits. This makes it a reliable tool for therapists to assess and track balance changes in individuals with multiple sclerosis (MS).

How does using the Balance Evaluation Systems Test (BESTest) improve the treatment of balance issues?

Using the Balance Evaluation Systems Test (BESTest) allows therapists to identify specific areas of balance impairment, leading to more effective and personalized treatment plans. By understanding which body systems are contributing to balance problems, therapists can design targeted exercises and strategies to improve balance and reduce the risk of falls. This proactive approach helps individuals with multiple sclerosis (MS) maintain their independence and quality of life. While the Berg Balance Scale (BBS) is valuable, the BESTest offers a deeper diagnostic ability.