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Balance Error Scoring System (BESS)
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Core: Sport-Related Concussion (SRC) Acute (time of injury until 72 hours)
Supplemental: Sport-Related Concussion (SRC) Subacute (after 72 hours to 3 months) and Persistent/Chronic (3 months and greater post concussion), and Traumatic Brain Injury (TBI)
Short Description of Instrument
In the Balance Error Scoring System (BESS), three stances all held with eyes closed—double-leg stance with hands on hips and feet together, single-leg stance using the non-dominant foot and a heel-toe stance with the non-dominant foot in the rear—are held for 20 seconds each on a firm surface. The number of balance errors is recorded for each trial. Balance errors include moving the hands off the iliac crests, opening the eyes, step stumble or fall, abduction or flexion of the hip beyond 30°, lifting the forefoot or heel off the testing surface, and remaining out of the proper testing position for greater than 5 seconds.
The BESS is calculated by adding on error point for each error during the three 20-second tests. A maximum of 10 errors can be counted for any single condition. If the individual is unable to maintain the testing procedure for a minimum of 5 seconds, from start, the highest possible score of 10 is assigned for that testing condition.
A standard testing protocol is administered and the test can be completed in under 10 minutes.
The test may be administered to children or adults and in military or civilian populations.
The BESS is inexpensive, easy to administer, and has been used extensively to assess athletes' balance on the playing field after injury.
Age Range: 13 to 40
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Document last updated July 2019
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