Instrumenting the Balance Error Scoring System for Use With Patients Reporting Persistent Balance Problems After Mild Traumatic Brain Injury

King, Laurie A.; Horak, Fay B.; Mancini, Martina; Pierce, Donald S.; Priest, Kelsey C.; Chesnutt, J. C.; Sullivan, Patrick M.; Chapman, Julie

doi:10.1016/j.apmr.2013.10.015

Cited by 130 publications

(121 citation statements)

References 30 publications

(31 reference statements)

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“…41 In an effort to improve concussion detection with the mBESS, King et al 24 added instrumentation in the form of an inertial sensor (accelerometer and gyroscope). The instrumented mBESS was found to be significantly better at detecting concussion (AUC = 0.81, 95% CI 0.64-0.990) than the noninstrumented mBESS (AUC = 0.64, 95% CI 0.42-0.86).…”

Section: Detecting Concussionmentioning

confidence: 99%

The Sport Concussion Assessment Tool: a systematic review

Yengo‐Kahn

Hale

Zalneraitis

et al. 2016

FOC

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OBJECTIVE Over the last 2 decades, sport-related concussion (SRC) has garnered significant attention. Even with increased awareness and athlete education, sideline recognition and real-time diagnosis remain crucial. The need for an objective and standardized assessment of concussion led to the eventual development of the Sport Concussion Assessment Tool (SCAT) during the Second International Conference on Concussion in Sport in 2004, which is now in its third iteration (SCAT3). In an effort to update our understanding of the most well-known sideline concussion assessment, the authors conducted a systematic review of the SCAT and the evidence supporting its use to date. METHODS English-language titles and abstracts published between 1995 and October 2015 were searched systematically across 4 electronic databases and a review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines adapted for the review of a heterogeneous collection of study designs. Peer-reviewed journal articles were included if they reported quantitative data on any iteration of the SCAT, Standardized Assessment of Concussion (SAC), or modified Balance Error Scoring System (mBESS) data at baseline or following concussion in an exclusively athlete population with any portion older than 13 years of age. Studies that included nonathletes, only children less than 13 years old, exclusively BESS data, exclusively symptom scale data, or a non–SCAT-related assessment were excluded. RESULTS The database search process yielded 549 abstracts, and 105 full-text articles were reviewed with 36 meeting criteria for inclusion. Nineteen studies were associated with the SAC, 1 was associated with the mBESS exclusively, and 16 studies were associated with a full iteration of the SCAT. The majority of these studies (56%) were prospective cohort studies. Male football players were the most common athletes studied. An analysis of the studies focused on baseline differences associated with age, sex, concussion history, and the ability to detect an SRC. CONCLUSIONS Looking toward the upcoming Concussion in Sport Group meeting in fall 2016, one may expect further revision to the SCAT3. However, based on this systematic review, the authors propose further, in-depth study of an already comprehensive concussion test, with acute, diagnostic, as well as long-term use.

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Section: Detecting Concussionmentioning

confidence: 99%

The Sport Concussion Assessment Tool: a systematic review

Yengo‐Kahn

Hale

Zalneraitis

et al. 2016

FOC

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“…The Multiple Errands Test (MET; Shallice & Burgess, 1991) is an example of a multitask assessment of executive functioning based on five demands of multitasking: (1) performing multiple but discrete tasks that vary in priority, complexity, and length; (2) managing interleaving and dovetailing tasks; (3) performing tasks without feedback; (4) dealing with interruptions, reprioritization, and rule changes; and (5) self-initiating task changes within the activity (Burgess, 2000). The many versions of the MET involve completing at least 10 unrelated tasks while complying with a series of rules in either a shopping mall or hospital lobby setting (Alderman, Burgess, Knight, & Henman, 2003;CuberosUrbano et al, 2013;Dawson et al, 2009;Morrison et al, 2013). Although the MET appears to assess "the central aspects of executive functioning in everyday life" (Frisch et al, 2012, p. 257), it has yet to be widely adopted in clinical practice because of site-specific validation requirements, time-intensive administration, and a lack of standardized scoring manuals specific to each site (Radomski & Morrison, 2014).…”

Section: Objectivesmentioning

confidence: 99%

The Assessment of Military Multitasking Performance: Validation of a Dual-Task and Multitask Protocol

Weightman¹

2014

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“…Early work investigating the use of IMUs in balance assessment has shown that a static balance assessment, instrumented with an IMU mounted on the lumbar spine, was not as effective as the traditional subjectively scored assessment in identifying balance deficits post-concussion (Furman et al, 2013). More recently, King et al (2014) demonstrated improved levels of sensitivity and specificity from the instrumented balance error scoring system (BESS). It is likely that the conflicting results are due to the different quantified variables selected in the two studies.…”

Section: Introductionmentioning

confidence: 99%

“…Such systems address some of the aforementioned limitations of traditional motion capture, as they allow for inexpensive, accessible quantification of human movement, in an unconstrained environment (Giggins et al, 2013). These IMU systems have been used in the objective quantification of a range of activities, from static balance tasks (King et al, 2014, Alberts et al, 2015, Furman et al, 2013, to dynamic tasks such as the squat and single leg squat , walking (Zijlstra andHof, 2003, Yang et al, 2013) and running (Lee et al, 2010). Early work investigating the use of IMUs in balance assessment has shown that a static balance assessment, instrumented with an IMU mounted on the lumbar spine, was not as effective as the traditional subjectively scored assessment in identifying balance deficits post-concussion (Furman et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…It is likely that the conflicting results are due to the different quantified variables selected in the two studies. King et al (2014) utilised root mean squared acceleration, whereas Furman et al (2013) used sway path length, which may not be capable of detecting subtle changes in balance, when measured using a lumbar mounted IMU. While these initial studies have demonstrated the ability of IMUs to detect differences in static balance between groups, there is a paucity of evidence surrounding their ability to classify dynamic balance performance during tasks such as the YBT.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Objective Classification of Dynamic Balance Using a Single Wearable Sensor

O’Reilly¹,

Dolan²,

Reid³

et al. 2016

Proceedings of the 4th International Congress on Sport Sciences Research and Technology Support

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Abstract:The Y Balance Test (YBT) is one of the most commonly used dynamic balance assessments in clinical and research settings. This study sought to investigate the ability of a single lumbar inertial measurement unit (IMU) to discriminate between the three YBT reach directions, and between pre and post-fatigue balance performance during the YBT. Fifteen subjects (age: 23±4, weight: 67.5±8, height: 175±8, BMI: 22±2) were fitted with a lumbar IMU. Three YBTs were performed on the dominant leg at 0, 10 and 20 minutes. A modified Wingate fatiguing intervention was conducted to introduce a balance deficit. This was followed immediately by three post-fatigue YBTs. Features were extracted from the IMU, and used to train and evaluate the random-forest classifiers. Reach direction classification achieved an accuracy of 97.80%, sensitivity of 97.86±0.89% and specificity of 98.90±0.56%. "Normal" and "abnormal" balance performance, as influenced by fatigue, was classified with an accuracy of 61.90%-71.43%, sensitivity of 61.90%-69.04% and specificity of 61.90%-78.57% depending on which reach direction was chosen. These results demonstrate that a single lumbar IMU is capable of accurately distinguishing between the different YBT reach directions and can classify between pre and post-fatigue balance with moderate levels of accuracy.

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Instrumenting the Balance Error Scoring System for Use With Patients Reporting Persistent Balance Problems After Mild Traumatic Brain Injury

Cited by 130 publications

References 30 publications

The Sport Concussion Assessment Tool: a systematic review

The Sport Concussion Assessment Tool: a systematic review

The Assessment of Military Multitasking Performance: Validation of a Dual-Task and Multitask Protocol

Objective Classification of Dynamic Balance Using a Single Wearable Sensor

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