Balance Assessments Using Smartphone Sensor Systems and a Clinician-Led Modified BESS Test in Soccer Athletes with...

Area of Science:

• Sports Medicine
• Biomechanics
• Digital Health

Background:

• The Balance Error Scoring System (BESS) is a standard but limited tool for assessing static postural balance.
• Its reliance on visual observation leads to low inter-rater reliability and missed diagnoses, especially in athletes.
• Smartphone motion sensors offer a potential solution for quantitative, objective balance assessment.

Purpose of the Study:

• To evaluate the discriminative validity of a novel smartphone-based system for remote balance measurement.
• To compare smartphone balance quantification with the modified BESS test in soccer athletes.
• To identify differences in balance between athletes with and without hip pain.

Main Methods:

• An exploratory cross-sectional study involving 64 Australian soccer athletes (18-40 years).
• Balance tests (single and tandem stance) were scored using the modified BESS and quantified via a smartphone device.
• Statistical analyses included Exploratory Factor Analysis (EFA), Clustered Receiver Operating Characteristic (ROC) with Area Under the Curve (AUC), and Linear Mixed-Effects ANCOVA.

Main Results:

• EFA indicated distinct factors for smartphone measurements and modified BESS scores.
• Smartphone sway measurements (anterior-posterior, mediolateral) during single-leg stance showed acceptable to excellent accuracy (AUC = 0.72-0.80) in differentiating hip pain groups.
• Athletes with hip pain exhibited significantly less single-leg balance variability and magnitude compared to those without hip pain (p < 0.05).

Conclusions:

• Smartphone technology effectively discriminates between individuals with and without hip pain during static balance tasks.
• Integrating smartphone balance assessment with the modified BESS can optimize clinical evaluations.
• Further research is needed to explore smartphone use for dynamic balance assessment.