scholarly journals Postural Control Deficits in Participants with Functional Ankle Instability as Measured by the Balance Error Scoring System

2006 ◽  
Vol 16 (3) ◽  
pp. 203-208 ◽  
Author(s):  
Carrie L. Docherty ◽  
Tamara C. Valovich McLeod ◽  
Sandra J. Shultz
2013 ◽  
Vol 22 (3) ◽  
pp. 224-228 ◽  
Author(s):  
Mason D. Smith ◽  
David R. Bell

Context:Anterior cruciate ligament (ACL) reconstruction is the standard of care for individuals with ACL rupture. Balance deficits have been observed in patients with ACL reconstruction (ACLR) using advanced posturography, which is the current gold standard. It is unclear if postural-control deficits exist when assessed by the Balance Error Scoring System (BESS), which is a clinical assessment of balance.Objective:The purpose of this study is to determine if postural-control deficits are present in individuals with ACLR as measured by the BESS.Participants:Thirty participants were included in this study. Fifteen had a history of unilateral ACLR and were compared with 15 matched controls.Interventions:The BESS consists of 3 stances (double-limb, single-limb, and tandem) on 2 surfaces (firm and foam). Participants begin in each stance with hands on their hips and eyes closed while trying to stand as still as possible for 20 s.Main Outcome Measures:Each participant performed 3 trials of each stance (18 total), and errors were assessed during each trial and summed to create a total score.Results:We observed a significant group × stance interaction (P = .004) and a significant main effect for stance (P < .001). Post hoc analysis revealed that the ACLR group had worse balance on the single-leg foam stance than did controls. Finally, the reconstructed group had more errors when total BESS score was examined (P = .02).Conclusions:Balance deficits exist in individuals with ACLR as measured by the BESS. Total BESS score was different between groups. The only condition that differed between groups was the single-leg stance on the unstable foam surface.


Author(s):  
Courtney J. DeFeo ◽  
Nathan Morelli ◽  
Matthew C. Hoch

Clinical Scenario: Postural control deficits are one of the most common impairments associated with sport-related concussion. The Modified Balance Error Scoring System (mBESS) is one of the current standard clinical measures for assessing these deficits; however, it is dependent upon observer-rated measurements. Advancements in inertial measurement units (IMUs) lend themselves to be a viable option in objectifying postural control assessments, such as the mBESS. Clinical Question: Are IMU-based measures of the mBESS more effective than observer-rated measures of the mBESS in identifying patients with sport-related concussion? Summary of Key Findings: Following a systematic search, three studies were included. One study compared observer-rated measures of the Balance Error Scoring System and mBESS to instrumented measures of both tests and determined that the instrumented mBESS had the highest diagnostic accuracy. The results of the second study determined that IMU-based measures were successful in both classifying group and identifying task errors. The final study found that using IMUs increased sensitivity of the mBESS, specifically the double-limb stance, to group classification. Clinical Bottom Line: Instrumentation of the mBESS using IMUs provides more objective and sensitive measures of postural control in patients with SRC. Strength of Recommendation: Due to the consistent, good-quality evidence used to answer this critically appraised topic, the grade of A is recommended by the Strength of Recommendation Taxonomy.


2008 ◽  
Vol 38 (12) ◽  
pp. 782-789 ◽  
Author(s):  
Marcos De Noronha ◽  
Kathryn M. Refshauge ◽  
Jack Crosbie ◽  
Sharon L. Kilbreath

2016 ◽  
Vol 25 (2) ◽  
pp. 133-136 ◽  
Author(s):  
Jaclyn B. Caccese ◽  
Thomas W. Kaminski

Context:The Balance Error Scoring System (BESS) is the current standard for assessing postural stability in concussed athletes on the sideline. However, research has questioned the objectivity and validity of the BESS, suggesting that while certain subcategories of the BESS have sufficient reliability to be used in evaluation of postural stability, the total score is not reliable, demonstrating limited interrater and intrarater reliability. Recently, a computerized BESS test was developed to automate scoring.Objective:To compare computerderived BESS scores with those taken from 3 trained human scorers.Design:Interrater reliability study.Setting:Athletic training room.Patients:NCAA Division I student athletes (53 male, 58 female; 19 ± 2 y, 168 ± 41 cm, 69 ± 4 kg).Interventions:Subjects were asked to perform the BESS while standing on the Tekscan (Boston, MA) MobileMat® BESS. The MobileMat BESS software displayed an error score at the end of each trial. Simultaneously, errors were recorded by 3 separate examiners. Errors were counted using the standard BESS scoring criteria.Main Outcome Measures:The number of BESS errors was computed for the 6 stances from the software and each of the 3 human scorers. Interclass correlation coefficients (ICCs) were used to compare errors for each stance scored by the MobileMat BESS software with each of 3 raters individually. The ICC values were converted to Fisher Z scores, averaged, and converted back into ICC values.Results:The double-leg, single-leg, and tandem-firm stances resulted in good agreement with human scorers (ICC = .999, .731, and .648). All foam stances resulted in fair agreement.Conclusions:Our results suggest that the MobileMat BESS is suitable for identifying BESS errors involving each of the 6 stances of the BESS protocol. Because the MobileMat BESS scores consistently and reliably, this system can be used with confidence by clinicians as an effective alternative to scoring the BESS.


CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S100-S101
Author(s):  
A. Robert ◽  
M. Moroz ◽  
D. Var ◽  
J. Correa ◽  
S. Delaney

Introduction: During a hockey game, athletes who are suspected of having sustained a concussion are removed from the game and evaluated. The modified balance error scoring system (MBESS) assessment, an essential part of the concussion evaluation, is performed in the dressing room, barefoot on a hard surface after equipment removal. While, players that pass the concussion assessment may re-dress and return to play, the equipment removal and re-dressing delays their return into the game. The objective of our study was to develop and evaluate a new in-skates balance error scoring system (SBESS) to reduce the delay in returning to the game. Methods: A prospective randomized single blinded study was conducted with 80 healthy university hockey players split into two groups. An at-rest group performed the SBESS assessment at rest on two separate occasions. A post-exercise group performed the test once at rest and once after exercise. The SBESS consisted of performing 4 different stances for 20 seconds each without equipment removal. The assessments were video recorded, and 3 independent reviewers scored the videos. For both the at-rest and post-exercise groups, the primary outcome measured was the number of balance errors. The secondary outcome was the number of falls. Statistics: For the primary outcome, both inter-rater and intra-rater reliability were calculated. The concordance between the SBESS and the currently used baseline pre-season balance score (MBESS) was also assessed. Results: The number of cumulative balance errors for all four stances varied between 4 and 7 for both groups without any significant exercise effect. No athletes fell. For inter-rater reliability, the intra-class correlation (ICC) was above 0.86, ranging from 0.86-0.92 for most stances except for the easiest stance, for which it was 0.66. For intra-rater reliability, the ICC ranged from 0.88 to 1 for all stances and raters. There was a lack of concordance between the SBESS and MBESS. Conclusion: The SBESS is a reliable balance test that can be safely performed in healthy athletes wearing their full equipment. The next step will be to evaluate the use of this test on concussed hockey athletes


2018 ◽  
Vol 10 (6) ◽  
pp. 270-276
Author(s):  
Hayley J. Root ◽  
Tamara C. Valovich McLeod ◽  
Eleanor Beltz ◽  
Julie Burland ◽  
Lindsay J. DiStefano

Concussion ◽  
2019 ◽  
Vol 4 (4) ◽  
pp. CNC66
Author(s):  
Travis White-Schwoch ◽  
Jennifer Krizman ◽  
Kristi McCracken ◽  
Jamie K Burgess ◽  
Elaine C Thompson ◽  
...  

Aim: Neurosensory tests have emerged as components of sport-related concussion management. Limited normative data are available in healthy, nonconcussed youth athletes. Patients & methods/results: In 2017 and 2018, we tested 108 youth tackle football players immediately before their seasons on the frequency-following response, Balance Error Scoring System, and King-Devick test. We compared results with published data in older and/or and nonathlete populations. Performance on all tests improved with age. Frequency-following response and Balance Error Scoring System results aligned with socioeconomic status. Performance was not correlated across neurosensory domains. Conclusion: Baseline neurosensory functions in seven 14-year-old male tackle football players are consistent with previously published data. Results reinforce the need for individual baselines or demographic-specific norms and the use of multiple neurosensory measures in sport-related concussion management.


Sign in / Sign up

Export Citation Format

Share Document