Systematic Review of the Balance Error Scoring System

Bell, David R.; Guskiewicz, Kevin M.; Clark, Micheal A.; Padua, Darin A.

doi:10.1177/1941738111403122

Cited by 417 publications

(374 citation statements)

References 34 publications

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“…Of the methods we analyzed, ImPACT and BESS have been established as viable tests to assess postconcussion recovery. [23][24][25] However, our findings suggested that postconcussion, testing the DLEC stance on the WBB with analytic balance software may be an alternative to the BESS for assessing postural stability and may provide information to supplement the neurocognitive information provided by ImPACT. Furthermore, the WBB may be more sensitive than the BESS to postconcussion changes in balance.…”

Section: Discussionmentioning

confidence: 48%

Evaluation of Nintendo Wii Balance Board as a Tool for Measuring Postural Stability After Sport-Related Concussion

Merchant‐Borna¹,

Jones

Janigro³

et al. 2017

Journal of Athletic Training

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Context: Recent changes to postconcussion guidelines indicate that postural-stability assessment may augment traditional neurocognitive testing when making return-to-participation decisions. The Balance Error Scoring System (BESS) has been proposed as 1 measure of balance assessment. A new, freely available software program to accompany the Nintendo Wii Balance Board (WBB) system has recently been developed but has not been tested in concussed patients.Objective: To evaluate the feasibility of using the WBB to assess postural stability across 3 time points (baseline and postconcussion days 3 and 7) and to assess concurrent and convergent validity of the WBB with other traditional measures (BESS and Immediate Post-Concussion Assessment and Cognitive Test [ImPACT] battery) of assessing concussion recovery.Design: Cohort study. Setting: Athletic training room and collegiate sports arena. Patients or Other Participants: We collected preseason baseline data from 403 National Collegiate Athletic Association Division I and III student-athletes participating in contact sports and studied 19 participants (age ¼ 19.2 6 1.2 years, height ¼ 177.7 6 8.0 cm, mass ¼ 75.3 6 16.6 kg, time from baseline to day 3 postconcussion ¼ 27.1 6 36.6 weeks) who sustained concussions. Main Outcome Measure(s):We assessed balance using single-legged and double-legged stances for both the BESS and WBB, focusing on the double-legged, eyes-closed stance for the WBB, and used ImPACT to assess neurocognition at 3 time points. Descriptive statistics were used to characterize the sample. Mean differences and Spearman rank correlation coefficients were used to determine differences within and between metrics over the 3 time points. Individual-level changes over time were also assessed graphically.Results: The WBB demonstrated mean changes between baseline and day 3 postconcussion and between days 3 and 7 postconcussion. It was correlated with the BESS and ImPACT for several measures and identified 2 cases of abnormal balance postconcussion that would not have been identified via the BESS.Conclusions: When accompanied by the appropriate analytic software, the WBB may be an alternative for assessing postural stability in concussed student-athletes and may provide additional information to that obtained via the BESS and ImPACT. However, verification among independent samples is required.

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Section: Discussionmentioning

confidence: 48%

Evaluation of Nintendo Wii Balance Board as a Tool for Measuring Postural Stability After Sport-Related Concussion

Merchant‐Borna¹,

Jones

Janigro³

et al. 2017

Journal of Athletic Training

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“…35,36 The test consists of 3 stance conditions (double leg, single leg, tandem); each stance is performed with eyes closed on both normal firm flooring and a mediumdensity foam surface. Inability to maintain stance or eye opening is deemed an error and is recorded as a quantitative measurement of postural instability.…”

Section: Efficacy: Balance Assessmentmentioning

confidence: 99%

Benefits of Strict Rest After Acute Concussion: A Randomized Controlled Trial

et al. 2015

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OBJECTIVES: To determine if recommending strict rest improved concussion recovery and outcome after discharge from the pediatric emergency department (ED).METHODS: Patients aged 11 to 22 years presenting to a pediatric ED within 24 hours of concussion were recruited. Participants underwent neurocognitive, balance, and symptom assessment in the ED and were randomized to strict rest for 5 days versus usual care (1-2 days rest, followed by stepwise return to activity). Patients completed a diary used to record physical and mental activity level, calculate energy exertion, and record daily postconcussive symptoms. Neurocognitive and balance assessments were performed at 3 and 10 days postinjury. Sample size calculations were powered to detect clinically meaningful differences in postconcussive symptom, neurocognitive, and balance scores between treatment groups. Linear mixed modeling was used to detect contributions of group assignment to individual recovery trajectory.RESULTS: Ninety-nine patients were enrolled; 88 completed all study procedures (45 intervention, 43 control). Postdischarge, both groups reported a 20% decrease in energy exertion and physical activity levels. As expected, the intervention group reported less school and after-school attendance for days 2 to 5 postconcussion (3.8 vs 6.7 hours total, P , .05). There was no clinically significant difference in neurocognitive or balance outcomes. However, the intervention group reported more daily postconcussive symptoms (total symptom score over 10 days, 187.9 vs 131.9, P , .03) and slower symptom resolution.CONCLUSIONS: Recommending strict rest for adolescents immediately after concussion offered no added benefit over the usual care. Adolescents' symptom reporting was influenced by recommending strict rest. WHAT'S KNOWN ON THIS SUBJECT:Expert consensus recommends rest after concussion with stepwise return to activity. Animal and retrospective human data suggest that early mental and physical activity may worsen outcome. There are no pediatric studies testing the efficacy of recommending strict rest after concussion. WHAT THIS STUDY ADDS:Recommending strict rest postinjury did not improve outcome and may have contributed to increased symptom reporting. Usual care (rest for 1-2 days with stepwise return to activity) is currently the best discharge strategy for pediatric mild traumatic brain injury/concussion. Dr Thomas developed the study concept and design, obtained funding, supervised the study, acquired data, analyzed and interpreted data, and drafted and revised the manuscript; Dr Apps assisted with study concept and design, supervised the study, provided technical support, analyzed and interpreted data, and critically revised the manuscript; Dr Hoffmann assisted with study design, analyzed data, provided statistical expertise, and critically revised the manuscript; Dr McCrea assisted with study design, analyzed and interpreted data, provided technical support, and critically revised the manuscript; Dr Hammeke assisted with study concept and ...

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“…The scoring system BESS (balance error scoring system), is a test commonly used by clinical investigators [1][2][3]. However, there is an increase of studies that couple the BESS system, as a measure of results beyond the scope of its original purpose [3] introducing the field of sport.…”

mentioning

confidence: 99%

“…However, there is an increase of studies that couple the BESS system, as a measure of results beyond the scope of its original purpose [3] introducing the field of sport. Originally this test was created to evaluate postural control [2], postural instability after a concussion [1,4] or after an uncle injury [5].…”

mentioning

confidence: 99%

Validation of BESS (Balance Errors Scoring System) Test in Physical Education

Espinosa-Méndez¹,

San-Martin-Rodríguez²,

Buendia-Lozada³

et al. 2017

JSS

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Abstract:The scoring system BESS (balance errors scoring system), is a test commonly used by clinical investigators, however there is an increase of studies that couple the BESS system, as a measure of results beyond the scope of its original purpose introducing the field of sport, and in our case, as a possible assessment tool balance in physical education. In this paper, the application of BESS Test two different age groups, 5th-grade and 4 semester of high school, college Ypsilanti Puebla was conducted in order to validate it, using the Software ptets to analyze. It conducted a non-random selection of 26 elementary and 26 high school students, 13 men and 13 women in each case. The results were compared in 6 different positions, including 3 on a flat surface and the other 3 on an implement with an unstable surface, each position must be maintained for 20 seconds. It was obtained as a result; the BESS Test is valid for children 5th-grade, not valid for high school students study.

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Systematic Review of the Balance Error Scoring System

Cited by 417 publications

References 34 publications

Evaluation of Nintendo Wii Balance Board as a Tool for Measuring Postural Stability After Sport-Related Concussion

Evaluation of Nintendo Wii Balance Board as a Tool for Measuring Postural Stability After Sport-Related Concussion

Benefits of Strict Rest After Acute Concussion: A Randomized Controlled Trial

Validation of BESS (Balance Errors Scoring System) Test in Physical Education

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