Purpose: The Balance Error Scoring System provides a portable, cost-effective, and objective method of assessing static postural stability. In the absence of expensive, sophisticated postural stability assessment tools, the BESS can be used to assess the effects of mild head injury on static postural stability. Information obtained from this clinical balance tool can be used to assist clinicians in making return to play / return to activity decisions following mild head injury. The BESS can be performed in nearly any environment and takes approximately 10 minutes to conduct.
Scoring: Each of the 20 second trials is scored by counting the errors, or deviations from the proper stance, accumulated by the subject. The examiner begins counting errors only after the patient has assumed the proper testing position.
An error is credited to the patient when any of the following occur:
- Moving the hands off the iliac crests
- Opening the eyes
- Step, stumble or fall
- Abduction or flexion of the hip beyond 30o
- Lifting the forefoot or heel off the testing surface
- Remaining out of the proper testing position for greater than 5 seconds.
The maximum total number of errors for any single condition is 10. If the patient commits multiple errors simultaneously, only one error is recorded. For example, if a patient steps or stumbles, opens their eyes and removes their hands from their hips simultaneously, then they are credited with only one error. Patients that are unable to maintain the testing procedure for a minimum of 5 seconds are assigned the highest possible score (10) for that testing condition.
Notation: Shoes are removed and pants are rolled up above ankle (if applicable). Each of the six testing positions is tested for 20 seconds.