Variability of the modified Balance Error Scoring System at baseline using objective and subjective balance measures

Amaal J Starling, Danielle F Leong, Jamie M Bogle, Bert B Vargas, Amaal J Starling, Danielle F Leong, Jamie M Bogle, Bert B Vargas

Abstract

Aim: To investigate preseason modified Balance Error Scoring System (mBESS) performance in a collegiate football cohort; to compare scores to an objective mobile balance measurement tool.

Materials & methods: Eighty-two athletes completed simultaneous balance testing using mBESS and the King-Devick Balance Test, an objective balance measurement tool. Errors on mBESS and objective measurements in the double-leg, single-leg (SS) and tandem stances were compared.

Results: Mean mBESS error score was 7.23 ± 4.65. The SS accounted for 74% of errors and 21% of athletes demonstrated the maximum error score. There was no significant correlation between mBESS score and objective balance score.

Conclusion: The high variability and large number of errors in the SS raises concerns over the utility of the SS in identifying suspected concussion.

Keywords: athlete; baseline; concussion evaluation; modified Balance Error Scoring System; postural control; sports concussion; standing balance.

Conflict of interest statement

Financial & competing interests disclosure D Leong is employed by King–Devick Test as the Director of Research. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.

Figures

Figure 1. . The device is placed…
Figure 1.. The device is placed into a holder around the neck, the holder is adjusted to bring the device just below the neck and is then secured to the body with a chest strap.
Figure 2. . Screen shot of the…
Figure 2.. Screen shot of the balance test application.
Figure 3. . Distributions of King–Devick balance…
Figure 3.. Distributions of King–Devick balance test scores by stance.
The line within the box defines the median value. The range of the box corresponds to the interquartile range (25th and 75th percentile). Whiskers extending from the box plot represent the range of observations, excluding outliers. The small circles beyond the whiskers represent the outliers. Analysis demonstrated a significant effect of score by stance (F [2, 243] = 13.23, p
Figure 4. . Frequency of error scores…
Figure 4. . Frequency of error scores by stance.
Figure 4.. Frequency of error scores by stance.
Figure 5. . Box plots show the…
Figure 5. . Box plots show the distribution of modified balance error scoring system scores…
Figure 5.. Box plots show the distribution of modified balance error scoring system scores by stance and total modified balance error scoring system score.
The line within the box defines the median value. The range of the box corresponds to the interquartile range (25th and 75th percentile). Whiskers extending from the box plot represent the range of observations, excluding outliers. The small circles beyond the whiskers represent the outliers. Analysis demonstrated a significant effect of stance (F [2, 243] = 110.2, p
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Figure 4. . Frequency of error scores…
Figure 4.. Frequency of error scores by stance.
Figure 5. . Box plots show the…
Figure 5.. Box plots show the distribution of modified balance error scoring system scores by stance and total modified balance error scoring system score.
The line within the box defines the median value. The range of the box corresponds to the interquartile range (25th and 75th percentile). Whiskers extending from the box plot represent the range of observations, excluding outliers. The small circles beyond the whiskers represent the outliers. Analysis demonstrated a significant effect of stance (F [2, 243] = 110.2, p

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