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The reliability of the modified Balance Error Scoring System
Tamerah N Hunt1, Michael S Ferrara, Robert A Bornstein
1School of Allied Medical Professions, The Ohio State University, Columbus, Ohio 43221, USA. tamerah.hunt@osumc.edu
Objective:
Study 1 investigated the intraclass reliability and percent variance associated with each component within the traditional Balance Error Scoring System (BESS) protocol. Study 2 investigated the reliability of subsequent modifications of the BESS.
Design:
Prospective cross-sectional examination of the traditional and modified BESS protocols.
Setting:
Schools participating in Georgia High School Athletics Association.
Intervention:
The modified BESS consisted of 2 surfaces (firm and foam) and 2 stances (single-leg and tandem-leg stance) repeated for a total of three 20-second trials.
Participants:
Participants consisted of 2 independent samples of high school athletes aged 13 to 19 years.
Main Outcome Measures:
Percent variance for each condition of the BESS was obtained using GENOVA 3.1. An intraclass reliability coefficient and repeated measures analysis of variance were calculated using SPSS 13.0.
Results:
Study 1 obtained an intraclass correlation coefficient (r = 0.60) with stance accounting for 55% of the total variance. Removing the double-leg stance increased the intraclass correlation coefficient (r = 0.71). Study 2 found a statistically significant difference between trials 1 and 2 (F(1.65,286) = 4.890, P = 0.013) and intraclass reliability coefficient of r = 0.88 for 3 trials of 4 conditions.
Conclusions:
The variance associated with the double-leg stance was very small, and when removed, the intraclass reliability coefficient of the BESS increased. Removal of the double-leg stance and addition of 3 trials of 4 conditions provided an easily administered, cost-effective, time-efficient tool that provides reliable objective information for clinicians to base clinical decisions upon.
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