title: The utility of the balance error scoring system for mild brain injury assessments in children and adolescents.
abstract: The Balance Error Scoring System (BESS) is widely recognized as an acceptable assessment of postural control for adult patients following a mild traumatic brain injury (mTBI) or concussion. However, the measurement properties of the BESS as a post-mTBI assessment test for younger patients are not well understood. The purpose of this study was to evaluate the utility of the BESS as a post-mTBI assessment test for children and adolescents aged 8 to 18 years through 2 investigations: (1) a retrospective medical records review of the relationship among age, BESS scores, and other common post-mTBI assessment tests; and (2) a prospective study comparing BESS scores for a cohort of children with a recent mTBI and BESS scores for a cohort of matched healthy peers. Age was found to be significantly correlated with several of the BESS measures and the total BESS score (P < 0.05). Significant differences were observed between the injured and healthy cohorts for 3 of the BESS measures and the total BESS score. However, the observed differences were not likely to be clinically meaningful. Cumulatively, evidence from the literature and the results of these studies indicate that the BESS may be limited for producing accurate assessments of younger athletes' post-mTBI postural control abilities. Future research recommendations include testing of modified versions of the BESS or other alternatives for post-mTBI postural control assessments with younger individuals.
authors.affiliation: Assistant Professor, Divisions of Sports Medicine and Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. Catherine.quatman@cchmc.org.
authors.forename: Catherine
authors.initials: C
authors.lastname: Quatman-Yates
authors.forename: Jason
authors.initials: J
authors.lastname: Hugentobler
authors.forename: Robin
authors.initials: R
authors.lastname: Ammon
authors.forename: Najima
authors.initials: N
authors.lastname: Mwase
authors.forename: Brad
authors.initials: B
authors.lastname: Kurowski
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Myer
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001924:Brain Concussion / Q000175:diagnosis*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D004856:Postural Balance; D011187:Posture; D011446:Prospective Studies; D015203:Reproducibility of Results; D012189:Retrospective Studies; D057566:Self Report