Date of Award

5-2014

Degree Type

Report

Degree Name

Master of Science (MS)

Department

Health, Physical Education, and Recreation

Abstract

Context: We have developed a modified approach to scoring balance errors with the Balance Error Scoring System (BESS) by eliminating two of the six original error criteria.

Objective: To measure the inter- and intra-rater reliability of this modified BESS approach. Because of the potential auditory distractions that may be present in a clinical setting, we also measured reliability for distracted rating conditions.

Design: Cross-sectional.

Setting: University sports medicine clinic.

Patients or Other Participants: Board of Certification (BOC) certified athletic trainers as raters (n=6).

Intervention: Raters used a modified approach to scoring the BESS to score 32 different sets of pre-recorded videos of balancers completing the six stance positions of the BESS. They first completed this in an undistracted condition, then one week later in a distracted condition as they performed a concurrent auditory vigilance task.

Main Outcome Measures: Two-way, random, absolute agreement intraclass correlation coefficients (ICC) measured the inter- and intra-rater reliability of the modified approach for undistracted and distracted conditions. Repeated measures ANOVAs tested for effects of condition (undistracted vs. distracted) and also BESS stance position (e.g. single-leg, foam) on the raters’ reported number of errors.

Results: For the undistracted condition, inter- and intra-rater reliability ICCs were 0.93 and 0.92, respectively. For the distracted condition, inter- and intra-rater reliability ICCs were 0.89 and 0.92, respectively. There was no significant effect of condition (undistracted vs. distracted) on the reported number of errors in the total error score or in the individual stance position scores.

Conclusions: This modified approach to scoring the BESS is reliable, even when used in a potentially distracting environment.

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