Publication: RELIABILITY OF THE BALANCE ERROR SCORING SYSTEM IN STUDENTS: REAL TIME VS. ASYNCHRONOUS ANALYSIS
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Date
2024-04-18
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Abstract
Abstract
Purpose/Hypothesis:
Postural control in stance is often assessed following a concussion using the Balance Error Score System (BESS). The BESS includes observation of a person’s balance in 6 different positions. The rater counts how many balance errors occur during each condition. If a patient makes a large number of errors in rapid succession, it may be difficult for the rater to count them accurately, leading to a decrease in reliability. Thus the purpose of this study was to determine whether reliability of the BESS could be improved by using a videorecording of the test, allowing raters to manipulate the recording as needed. Previous studies have shown that the reliability of the BESS is good for novice raters and much higher for experts. Our hypothesis was that viewing a video recording of a participant performing the BESS would improve the reliability for novice raters.
Methods:
Two pairs of two student researchers were trained by the primary investigator in the scoring of the BESS. Forty-six healthy participants were then recruited by word of mouth and fliers. Each participant performed the BESS while being video recorded and observed by one pair of students. Each student independently scored the participant’s performance. Six weeks later, each student independently scored the video recordings of the same participants. Intraclass Coefficients (ICC) were generated to determine interrater and intrarater reliability.
Results:
For both pairs, the ICC showed greater agreement for the total BESS scores of the live sessions (.72 and .90) as compared to the recorded sessions (.52 and .74). ICCs for intrarater reliability ranged from .34 to .71.
Conclusions:
Watching and manipulating a recording of a BESS test does not lead to improved reliability among novice raters. Scoring of the BESS test should be done based on the live session.