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A Normative Dataset of the Balance Error Scoring System in Children Aged Between 5 and 14
Colby Hansen1, Dan Cushman, Nicholas Anderson
1*Division of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, Utah;†Division of Epidemiology, University of Utah, Salt Lake City, Utah;‡College of Pharmacy, Roseman University, South Jordan, Utah;Departments of §Electrical & Computer Engineering; and¶Orthopaedics, University of Utah, Salt Lake City, Utah.
Objective:
Pediatric head injuries occur commonly and are being reported in increasing numbers. Balance testing is a key component in the evaluation of suspected concussion, and the balance error scoring system (BESS) is likely the most well-known and widely used measure. To date, normative BESS scores for adults have been reported but not for children.
Design:
Normative data for BESS scores and modified BESS scores were created in a cohort of healthy children. Potential variables were analyzed as predictors of BESS performance.
Setting:
Local elementary and junior high schools.
Participants:
A total of 373 healthy children between the ages of 5 and 14.
Interventions:
The BESS was performed on all children.
Assessment Of Risk Factors:
Gender, body mass index percentile, previous concussions, athletic participation, age, and the parental opinion of child's balance ability were examined as factors associated with the BESS score.
Main Outcome Measures:
BESS scores.
Results:
Normative data are reported, stratified by age groups of 5 to 7 years, 8 to 10 years, and 11 to 14 years of age, for both BESS and modified BESS. Median BESS scores are 23 for children aged 5 to 7, 18 for children aged 8 to 10, and 16 for children aged 11 to 14. Median modified BESS scores are 8 for children age 5 to 7, 5 for children age 8 to 10, and 4 for children age 11 to 14. Increasing age and positive parental opinion regarding their child's balance ability were independently correlated with decreasing BESS scores (P < 0.01).
Conclusions:
The normative data on BESS scores for healthy children reported here provide age-stratified reference values for suspected balance alterations.
