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Georgia Southern University

Influence of Testing Environment on Balance Error Scoring System Performance

Abstract

dc:description.abstract

Context: The Balance Error Scoring System (BESS) is a commonly utilized and recommended sideline assessment tool to evaluate post-concussion postural stability. Baseline BESS scores are typically recorded during preseason physical examinations in the athletic training room or nearby laboratory. However, post-concussion assessment typically takes place on the sideline during a sporting event. Objective: The purpose of this study was to evaluate the effect of a sideline environment on BESS performance. Setting: 37 NCAA Division 1 healthy, female student athletes (SA) and 32 healthy, female non-athlete healthy young adult (HYA) controls were assessed on BESS performance in three different environments: a controlled laboratory or baseline (BL), a basketball arena (BKB) and a football field (FB). The SA group performed the experimental trials during a live competition while the HYA group was tested with minimal distractions. Interventions: The BESS was administered using an Airex Pad and videotaped from the frontal and sagittal planes. Main Outcome Measures: Two 2 x 3 ANOVAs with repeated measures, one 2 x 6 ANOVA with repeated measures, and a frequency distribution were used to analyze the results. Results: A significant main effect was found for the two groups (p = .001) with the SA group scoring higher than the HYA group. Significance within the SA group was found between BL and FB (p = .047) environments and FB and BKB (p = .005) environments. Significance within the HYA group was noted between BL and BKB trials (p = .025). Significance was found between groups for the single leg firm (p = .032), single leg foam (p < .001), and tandem foam stances ( p < .001) with the SA group scoring significantly higher. Conclusions: A previous study reported no differences in total BESS score between a controlled environment and a baseball dugout, however our results suggest that a more distracting environment may impair BESS performance in female intercollegiate athletes. While this study is limited by testing athletes outside of their sport environment, the results of this study suggest that clinicians should consider the ambient environment when performing BESS during a postconcussion assessment.

Degree

thesis:*
Name thesis:degree_name
Master of Science in Kinesiology (M.S.)
Level thesis:degree_level
Thesis (open access)
Discipline thesis:degree_discipline
Department of Health and Kinesiology
Year dc:date.available
2011

Author and committee

dc:creator, dc:contributor.*
Author dc:creator
  • Rahn, Carrie
Contributors dc:contributor
  • Barry Joyner
  • Barry Munkasy
  • Thomas Buckley

Subjects

dc:subject × 5

Identifiers

dc:identifier.*
Repository record dc:identifier
https://digitalcommons.georgiasouthern.edu/etd/118
OAI identifier oai:identifier
oai:digitalcommons.georgiasouthern.edu:etd-1118

Chain of custody

source
Harvested from
Georgia Southern University
Base URL
digitalcommons.georgiasouthern.edu/do/oai/
Last updated
2026-07-24
Source record
OAI-PMH GetRecord
citation

Rahn, Carrie. Influence of Testing Environment on Balance Error Scoring System Performance. Thesis (open access) thesis, 2011. https://digitalcommons.georgiasouthern.edu/etd/118