The Balance Error Scoring System (BESS) is a subjective clinical balance assessment frequently used by various healthcare providers. The test consists of three different stances (feet together, tandem, and single leg) that are each 20 seconds long. An administrator carefully observes and records the number of pre-defined balance or stability errors committed by the test subject. However, it is unclear if test administrators are able to observe all errors committed by the subject in real-time. 53 subjects were scored in person and recorded on video for slow-motion access while performing two series of BESS trials by an experienced BESS rater. No significant difference between means in overall total score in real-time or slow-motion (9.8 + 6.7 and 9.7 + 5.5 errors, respectively) were reported. Results of this study suggest that experienced BESS raters score balance errors consistently whether the test is in real-time or recorded and viewed in slow-motion.

The Balance Error Scoring System (BESS) is a subjective clinical balance assessment frequently used by various healthcare providers. The test consists of a total of three stances including bipedal standing (feet together), non-dominant single-leg stance, and tandem standing (heel-to-toe with non-dominant foot behind the dominant foot). Stances are first performed on a firm surface, and then on a compliant foam surface. For each 20 second trial, a test administrator records the number of pre-defined errors committed by the test subject. A total score is calculated by summing the total number of errors committed. A modified version of the BESS has also been developed. This version omits the stances performed on a foam surface. However, with both the full and abbreviated versions of the assessment, it is unclear if test administrators are able to observe all errors committed by the subject in real time. PURPOSE: The purpose of this study was to determine if there is a difference in the number of observed errors when scoring the BESS assessment in real time versus while watching a slow-motion video recording. METHODS: Fifty-three subjects (23 male, 30 female; aged 52.8 ± 16.5 yrs) participated in this study, which was IRB approved. Subjects performed a familiarization trial immediately followed by an experimental trial. All trials were recorded on video and BESS scoring was completed by a certified Athletic Trainer. RESULTS: Total BESS scores evaluated in real time and evaluated with slow-motion video were 9.8 (± 6.7) and 9.7(± 5.5) respectively. Paired samples t-test revealed no significant difference between the means. CONCLUSION: No significant difference in mean errors was observed between the BESS assessment scored in real time versus the BESS assessment scored with slow-motion video recording. This indicates that real-time observation by an experienced test administrator is sufficient for scoring the BESS assessment.