Improvement in balance from diagnosis to return-to-play initiation following a sport-related concussion: BESS scores vs center-of-pressure measures

Sophia Ulman, Ashley L. Erdman, Alex Loewen, Hannah M. Worrall, Kirsten Tulchin-Francis, Jacob C Jones, Jane S. Chung, Henry B Ellis, C. Munro Cullum, Shane M. Miller

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: Accurate assessment of balance recovery throughout treatment of a sport-related concussion is imperative. This study examined differences in balance from diagnosis to return-to-play initiation in adolescent patients post-concussion. Second, this study investigated the extent to which the Balance Error Scoring System (BESS) correlated with center-of-pressure (COP) measures. Methods: Forty participants performed the BESS while standing on a force platform such that COP data were obtained simultaneously. Spatial and velocity COP-based measures were computed for the double-stance conditions. Results: BESS scores and COP-based measures indicated improved balance performance between visits. Specifically, 62.5/65.0% of participants exhibited improved firm/foam BESS final scores, respectively, and 56.4–71.8% exhibited improved COP-based measures. However, once normative ranges were referenced to identify maintained performance, the percentage of participants who substantially improved differed from initial findings (BESS: 2.5/7.5%, COP: 48.7–69.2%). Additionally, positive correlations between balance measures were primarily found at diagnosis (r=0.33–0.53), while only three correlations were maintained at return-to-play initiation (r=0.34–0.39). Conclusions: BESS scores successfully identified poor balance performance at diagnosis when symptoms were most pronounced, but failed to accurately depict performance once balance impairment, indicated by COP-based measures, became less apparent. Further work is needed to implement more advanced balance assessments into clinical environments.

Original languageEnglish (US)
JournalBrain injury
DOIs
StateAccepted/In press - 2022

Keywords

  • Adolescent
  • balance assessment
  • recovery
  • sport-related concussion

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Developmental and Educational Psychology
  • Clinical Neurology

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