Systematic review of the balance error scoring system

Area of Science:

• Biomechanics
• Neurology
• Sports Medicine

Background:

• The Balance Error Scoring System (BESS) is a widely adopted tool for balance evaluation in research and clinical settings.
• Increasingly, the BESS is utilized as an outcome measure beyond its initial intended applications.

Purpose of the Study:

• To systematically review the existing literature on the reliability and validity of the BESS.
• To provide an objective assessment of the BESS's performance as a balance assessment tool.

Main Methods:

• A comprehensive literature search was conducted on PubMed and CINHAL databases.
• Studies published between January 1999 and December 2010 were included if they established BESS reliability or validity.
• English-language research articles utilizing the BESS as an outcome measure were selected.

Main Results:

• BESS reliability for total scores and individual stances varied from poor to good, contingent on the type of reliability assessed.
• Criterion-related validity was demonstrated with force plate measures, with better agreement for more challenging stances.
• The BESS effectively identifies balance deficits in conditions like concussion and fatigue but may be less sensitive to subtle changes.

Conclusions:

• The BESS demonstrates moderate to good reliability for assessing static balance, though some studies report lower reliability.
• The BESS correlates with other balance measurement devices and is capable of detecting deficits in individuals with concussion and fatigue.
• Factors such as age, ankle instability, bracing, and training influence BESS scores, indicating its responsiveness to various conditions.