Normative Performance on the Balance Error Scoring System by Youth, High School, and Collegiate Athletes

摘要

Context: Annually, more than 1 million youth athletes in the United States receive or are suspected of receiving a concussion. The Balance Error Scoring System (BESS) is the most commonly used clinical balance evaluation designed to provide a better understanding of the motor-control processes of individuals with concussion. Despite the widespread use of the BESS, a fundamental gap exists in applying this tool to young athletes, as normative values are lacking for this population. Objective: To determine age- and sex-specific normative values for the BESS in youth, high school, and collegiate athletes. Design: Cross-sectional study. Setting: Local youth sport organizations, high schools, and colleges. Patients or Other Participants: Student-athletes (N = 6762) completed preseason baseline concussion testing as part of a comprehensive concussion-management program. Groups were youth males aged 5 to 13 years (n = 360), high school males aged 14 to 18 years (n = 3743), collegiate males aged 19 to 23 years (n = 497), youth females aged 5 to 13 years (n = 246), high school females aged 14 to 18 years (n = 1673), and collegiate females aged 19 to 23 years (n = 243). Main Outcome Measure(s): Errors according to the BESS specifications. Results: Performance on the BESS was worse (P .01) in youth athletes than in high school and collegiate athletes. In the youth and high school cohorts, females exhibited better scores than males (P .05). Sex was not a factor for collegiate athletes. Data from the youth cohort were further subdivided into 4-year bins to evaluate potential motor-development differences. The error count was highest for 5- to 9-year-old males and decreased with age. Conclusions: Performance on the BESS depended on sex and age, particularly in youth athletes. These sex- and age-specific normative values provide a reference to facilitate and unify clinical decision making across multiple providers caring for youth athletes with concussions.