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Evidence to Eliminate Double-Leg Conditions From the Modified Balance Error Scoring System and Balance Error Scoring

Melissa A Fraser1, Michael Kuo, Anne Marie Boeckmann

  • 1Department of Health and Human Performance, Texas State University, San Marcos, Texas.

Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine
|March 22, 2022
PubMed
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The Balance Error Scoring System (BESS) and its revised version (BESS-R) showed statistically significant differences in healthy athletes, but these were not clinically meaningful. Revised BESS versions may offer a more practical balance assessment for athletes.

Area of Science:

  • Sports Medicine
  • Neurology
  • Biomechanics

Background:

  • Concussion assessment in athletes relies on balance testing.
  • The Balance Error Scoring System (BESS) is a common tool, but its variations and clinical utility require further investigation.

Purpose of the Study:

  • To compare the Balance Error Scoring System (BESS), modified BESS (mBESS), and their revised versions (BESS-R, mBESS-R) which exclude double-leg stances.
  • To assess these balance tests in healthy and concussed collegiate athletes.

Main Methods:

  • A retrospective, repeated-measures cohort study design was employed.
  • Data were collected from 622 healthy collegiate athletes at baseline and 41 post-concussion.
  • Four BESS variations (BESS, mBESS, BESS-R, mBESS-R) and six BESS conditions were analyzed.

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Main Results:

  • A statistically significant difference was found between the BESS and BESS-R at baseline for the entire sample.
  • No other significant differences were observed between the BESS variations at baseline.
  • The greatest mean difference between any test versions was less than one error.

Conclusions:

  • While statistically significant, the differences between BESS and BESS-R are not clinically meaningful.
  • Current BESS variations may lack the specificity to detect subtle balance deficits.
  • Removing double-leg stances in revised BESS versions could offer a more practical clinical assessment tool for athletes.