Comparing Computer-Derived and Human-Observed Scores for the Balance Error Scoring System

2016 ◽  
Vol 25 (2) ◽  
pp. 133-136 ◽  
Author(s):  
Jaclyn B. Caccese ◽  
Thomas W. Kaminski
Keyword(s):  
Athletic Training ◽  
Outcome Measures ◽  
Scoring System ◽  
Postural Stability ◽  
Correlation Coefficients ◽  
Current Standard ◽  
Interclass Correlation ◽  
Z Scores ◽  
Balance Error Scoring System ◽  
Balance Error

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.

Cleveland Clinic Postural Stability Index Norms for the Balance Error Scoring System

2018 ◽  
Vol 50 (10) ◽  
pp. 1998-2006 ◽  
Author(s):  
SUSAN M. LINDER ◽  
SARAH J. OZINGA ◽  
MANDY MILLER KOOP ◽  
TANUJIT DEY ◽  
RICHARD FIGLER ◽  
...  
Keyword(s):  
Scoring System ◽  
Postural Stability ◽  
Cleveland Clinic ◽  
Stability Index ◽  
Balance Error Scoring System ◽  
Balance Error

Negative Effects on Postural Control After Anterior Cruciate Ligament Reconstruction as Measured by the Balance Error Scoring System

2013 ◽  
Vol 22 (3) ◽  
pp. 224-228 ◽  
Author(s):  
Mason D. Smith ◽  
David R. Bell
Keyword(s):  
Anterior Cruciate Ligament ◽  
Postural Control ◽  
Acl Reconstruction ◽  
Outcome Measures ◽  
Scoring System ◽  
Cruciate Ligament ◽  
Balance Deficits ◽  
Balance Error Scoring System ◽  
Anterior Cruciate ◽  
Balance Error

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.

Quantitative assessment of postural stability using accelerometer and gyroscopic data during balance error scoring system

2013 ◽  
Vol 47 (5) ◽  
pp. e1.35-e1
Author(s):  
Jay L Alberts ◽  
Joshua R Hirsch ◽  
Richard Figler ◽  
Andrew N Russman ◽  
Robert Gray ◽  
...  
Keyword(s):  
Scoring System ◽  
Postural Stability ◽  
Quantitative Assessment ◽  
Balance Error Scoring System ◽  
Balance Error

Poster 35 Evaluation of Correlation Between the Modified Balance Error Scoring System and the Sensory Organization Test as Measures of Postural Stability

PM&R ◽  
2011 ◽  
Vol 3 ◽  
pp. S188-S188
Author(s):  
Elena J. Jelsing ◽  
Jonathan Finnoff ◽  
John H. Hollman ◽  
Desiree J. Lanzino ◽  
Cara Prideaux ◽  
...  
Keyword(s):  
Scoring System ◽  
Postural Stability ◽  
Sensory Organization Test ◽  
Sensory Organization ◽  
Balance Error Scoring System ◽  
Balance Error

The Comparison Between Instrumented and Observer-Rated Measures of the Modified Balance Error Scoring System: A Critically Appraised Topic

2021 ◽  
pp. 1-6
Author(s):  
Courtney J. DeFeo ◽  
Nathan Morelli ◽  
Matthew C. Hoch
Keyword(s):  
Postural Control ◽  
Scoring System ◽  
Current Standard ◽  
Bottom Line ◽  
System A ◽  
Final Study ◽  
Increased Sensitivity ◽  
Balance Error Scoring System ◽  
Clinical Measures ◽  
Balance Error

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.

Concussion History and Time Since Concussion Do not Influence Static and Dynamic Balance in Collegiate Athletes

2017 ◽  
Vol 26 (6) ◽  
pp. 518-523 ◽  
Author(s):  
Eric D. Merritt ◽  
Cathleen N. Brown ◽  
Robin M. Queen ◽  
Kathy J. Simpson ◽  
Julianne D. Schmidt
Keyword(s):  
Outcome Measures ◽  
Scoring System ◽  
Dynamic Balance ◽  
Collegiate Athletes ◽  
Balance Performance ◽  
Balance Test ◽  
History Of ◽  
Balance Deficits ◽  
Balance Error Scoring System ◽  
Balance Error

Context:Dynamic balance deficits exist following a concussion, sometimes years after injury. However, clinicians lack practical tools for assessing dynamic balance.Objectives:To determine if there are significant differences in static and dynamic balance performance between individuals with and without a history of concussion.Design:Cross sectional.Setting:Clinical research laboratory.Patients or Other Participants:45 collegiate student-athletes with a history of concussion (23 males, 22 females; age = 20.0 ± 1.4 y; height = 175.8 ± 11.6 cm; mass = 76.4 ± 19.2 kg) and 45 matched controls with no history of concussion (23 males, 22 females; age = 20.0 ± 1.3 y; height = 178.8 ± 13.2 cm; mass = 75.7 ± 18.2 kg).Interventions:Participants completed a static (Balance Error Scoring System) and dynamic (Y Balance Test-Lower Quarter) balance assessment.Main Outcome Measures:A composite score was calculated from the mean normalized Y Balance Test-Lower Quarter reach distances. Firm, foam, and overall errors were counted during the Balance Error Scoring System by a single reliable rater. One-way ANOVAs were used to compare balance performance between groups. Pearson’s correlations were performed to determine the relationship between the time since the most recent concussion and balance performance. A Bonferonni adjusted a priori α < 0.025 was used for all analyses.Results:Static and dynamic balance performance did not significantly differ between groups. No significant correlation was found between the time since the most recent concussion and balance performance.Conclusions:Collegiate athletes with a history of concussion do not present with static or dynamic balance deficits when measured using clinical assessments. More research is needed to determine whether the Y Balance Test-Lower Quarter is sensitive to acute balance deficits following concussion.

scholarly journals P124: A new in-skates balance error scoring system for the sideline assessment of concussion in hockey players

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S100-S101
Author(s):  
A. Robert ◽  
M. Moroz ◽  
D. Var ◽  
J. Correa ◽  
S. Delaney
Keyword(s):  
Scoring System ◽  
Primary Outcome ◽  
Return To Play ◽  
Secondary Outcome ◽  
Balance Test ◽  
Rater Reliability ◽  
Post Exercise ◽  
Hockey Players ◽  
Balance Error Scoring System ◽  
Balance Error

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

The Relationship Between Physical Literacy Measures of Balance and the Balance Error Scoring System in Youth Sports Participants

2018 ◽  
Vol 10 (6) ◽  
pp. 270-276
Author(s):  
Hayley J. Root ◽  
Tamara C. Valovich McLeod ◽  
Eleanor Beltz ◽  
Julie Burland ◽  
Lindsay J. DiStefano
Keyword(s):  
Scoring System ◽  
Youth Sports ◽  
Physical Literacy ◽  
Balance Error Scoring System ◽  
The Relationship ◽  
Balance Error

scholarly journals Baseline profiles of auditory, vestibular, and visual functions in youth tackle football players

Concussion ◽  
2019 ◽  
Vol 4 (4) ◽  
pp. CNC66
Author(s):  
Travis White-Schwoch ◽  
Jennifer Krizman ◽  
Kristi McCracken ◽  
Jamie K Burgess ◽  
Elaine C Thompson ◽  
...  
Keyword(s):  
Scoring System ◽  
Normative Data ◽  
Football Players ◽  
Published Data ◽  
Frequency Following Response ◽  
Youth Athletes ◽  
Concussion Management ◽  
Tackle Football ◽  
Balance Error Scoring System ◽  
Balance Error

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.

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