Reliability and concurrent validity of instrumented balance error scoring system using a portable force plate system

Area of Science:

• Biomechanics
• Sports Medicine
• Neurology

Background:

• The Balance Error Scoring System (BESS) is widely used for balance assessment in young individuals.
• Force plate technology offers higher precision for balance measures.
• The validity and reliability of instrumented BESS compared to the original clinical scoring remain unclear.

Purpose of the Study:

• To evaluate the concurrent validity and reliability of an instrumented BESS using a portable force plate system.
• To compare the performance metrics of the original BESS with its instrumented version.

Main Methods:

• Thirty-six adolescents (mean age 15.9 years) performed the BESS on a portable force plate.
• Test-retest reliability was assessed after one week with 26 participants.
• Concurrent validity was determined by correlating original and instrumented BESS scores; reliability was assessed using Intraclass Correlation Coefficient (ICC3,1).

Main Results:

• A moderate correlation (rs = 0.54, p = 0.001) was found between original and instrumented BESS total scores, indicating concurrent validity.
• Reliability scores varied across conditions for both versions (ICC3,1 = 0.13-0.71).
• The total test score reliability was identical for both instrumented and clinical BESS (ICC3,1 = 0.74).

Conclusions:

• Instrumenting the BESS with force plates demonstrates concurrent validity but does not enhance its reliability.
• Further investigation is required to validate the instrumented BESS against laboratory-grade equipment.
• Future studies should explore if the instrumented BESS can address the ceiling effect observed in the clinical version.