title: The reliability of the modified Balance Error Scoring System.
abstract: OBJECTIVE
  Study 1 investigated the intraclass reliability and percent variance associated with each component within the traditional Balance Error Scoring System (BESS) protocol. Study 2 investigated the reliability of subsequent modifications of the BESS.
  
  
  METHODS
  Prospective cross-sectional examination of the traditional and modified BESS protocols.
  
  
  METHODS
  Schools participating in Georgia High School Athletics Association.
  
  
  METHODS
  The modified BESS consisted of 2 surfaces (firm and foam) and 2 stances (single-leg and tandem-leg stance) repeated for a total of three 20-second trials.
  
  
  METHODS
  Participants consisted of 2 independent samples of high school athletes aged 13 to 19 years.
  
  
  METHODS
  Percent variance for each condition of the BESS was obtained using GENOVA 3.1. An intraclass reliability coefficient and repeated measures analysis of variance were calculated using SPSS 13.0.
  
  
  RESULTS
  Study 1 obtained an intraclass correlation coefficient (r = 0.60) with stance accounting for 55% of the total variance. Removing the double-leg stance increased the intraclass correlation coefficient (r = 0.71). Study 2 found a statistically significant difference between trials 1 and 2 (F(1.65,286) = 4.890, P = 0.013) and intraclass reliability coefficient of r = 0.88 for 3 trials of 4 conditions.
  
  
  CONCLUSIONS
  The variance associated with the double-leg stance was very small, and when removed, the intraclass reliability coefficient of the BESS increased. Removal of the double-leg stance and addition of 3 trials of 4 conditions provided an easily administered, cost-effective, time-efficient tool that provides reliable objective information for clinicians to base clinical decisions upon.
authors.affiliation: School of Allied Medical Professions, The Ohio State University, Columbus, Ohio 43221, USA. tamerah.hunt@osumc.edu
authors.forename: Tamerah N
authors.initials: TN
authors.lastname: Hunt
authors.forename: Michael S
authors.initials: MS
authors.lastname: Ferrara
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bornstein
authors.forename: Ted A
authors.initials: TA
authors.lastname: Baumgartner
mesh_terms: D000293:Adolescent; D001924:Brain Concussion / Q000175:diagnosis*; D004185:Disability Evaluation; D006801:Humans; D008297:Male; D010808:Physical Examination / Q000379:methods*; D004856:Postural Balance; D015203:Reproducibility of Results; D055815:Young Adult