title: Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment.
abstract: This study evaluated the utility of the Balance Error Scoring System (BESS) and the Sensory Organization Test (SOT) as tools for the screening and monitoring of Service members (SMs) with mild traumatic brain injury (mTBI) in a deployed setting during the acute and subacute phases of recovery. Patient records (N = 699) were reviewed for a cohort of SMs who sustained a blast-related mTBI while deployed to Afghanistan and were treated at the Concussion Restoration Care Center (CRCC) at Camp Leatherneck. On initial intake into the CRCC, participants completed two assessments of postural control, the BESS, and SOT. SMs with mTBI performed significantly worse on the BESS and SOT when compared with comparative samples. When the SOT data were further examined using sensory ratios, the results indicated that postural instability was primarily a result of vestibular and visual integration dysfunction (r > 0.62). The main finding of this study was that the sensitivity of the SOT composite score (50-58%) during the acute phase was higher than previous sensitivities found in the sports medicine literature for impact-related trauma.
authors.affiliation: 1 Navy Experimental Diving Unit, Panama City Beach, Florida.
authors.forename: F Jay
authors.initials: FJ
authors.lastname: Haran
authors.affiliation: 2 The Geneva Foundation , Tacoma, Washington.
authors.forename: Jill C
authors.initials: JC
authors.lastname: Slaboda
authors.affiliation: 3 Department of Neurology, Oregon Health & Science University , Portland, Oregon.
authors.forename: Laurie A
authors.initials: LA
authors.lastname: King
authors.affiliation: 4 Department of Physical Therapy, Temple University , Philadelphia, Pennsylvania.
authors.forename: W Geoff
authors.initials: WG
authors.lastname: Wright
authors.affiliation: 5 Department of Occupational Therapy, Tufts University , Medford, Massachusett.
authors.forename: Daniel
authors.initials: D
authors.lastname: Houlihan
authors.affiliation: 6 Neurotrauma Department, Naval Medical Research Center ,Silver Spring, Maryland.
authors.forename: Jacob N
authors.initials: JN
authors.lastname: Norris
mesh_terms: D000328:Adult; D001753:Blast Injuries / Q000150:complications / Q000175:diagnosis*; D001924:Brain Concussion / Q000175:diagnosis* / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008889:Military Personnel; D009460:Neurologic Examination / Q000379:methods*; D004856:Postural Balance; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000175:diagnosis / Q000209:etiology*; D012680:Sensitivity and Specificity
keywords: BESS; SOT; mTBI; military