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Development of the sBESS, a Pragmatic Dual-Task Balance Test in Adolescents With Acute Concussion
Jacqueline van Ierssel1, Richard Webster2, Lamia Hayawi2
1Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Summary
A new dual-task balance test, "sharpened BESS" (sBESS), shows stronger association with objective balance measures in concussed adolescents than standard tests. Further research is needed to confirm its clinical utility for concussion management.
Area of Science:
- Sports Medicine
- Neurology
- Pediatric Health
Background:
- Concussion assessment in adolescents often relies on subjective measures.
- Existing balance tests may not accurately capture functional deficits after acute concussion.
Purpose of the Study:
- To develop and evaluate a clinically pragmatic dual-task balance test for improved identification of balance problems in acutely concussed adolescents.
- To compare the accuracy of a novel dual-task test against current standard balance assessments.
Main Methods:
- An observational cohort study was conducted in a pediatric emergency department.
- Adolescents aged 10-18 years with acute concussion (<48 hours) performed single and dual-task balance, cognitive, and vestibular-oculomotor tests.
- Center-of-pressure (COP) sway area on a force plate served as the gold-standard outcome measure.
Main Results:
- Dual-task gaze stabilization with tandem stance (sBESS) showed a stronger correlation with COP sway area (rs = 0.77) than the standard mBESS (max rs = 0.58).
- Cognitive dual-tasking was associated with fewer balance errors and reduced sway.
- Symptom change did not correlate with objective balance measures (sway area).
Conclusions:
- The "sharpened BESS" (sBESS) dual-task vestibular test demonstrates superior association with objective balance performance in concussed adolescents compared to the mBESS.
- Future diagnostic and prognostic accuracy studies are warranted to establish the clinical utility of sBESS for concussion diagnosis and return-to-sport decisions.
