II. Indications
- Sideline Concussion evaluation in age over 10 years
III. Preparation
- Shoes off and pants (if worn) rolled up to ankle
- Ankle taping removed
- Athlete stands with eyes closed and hands at hips
- Two surfaces
- Firm, flat ground
- Block of foam large enough to stand on
- Included in the original BESS, but not in the SCAT2
- Three positions for 20 seconds each
- Double leg stance (both feet on the ground)
- Single leg stance (balance on one leg)
- Tandem stance (toes of one foot to heel of the other)
- Observe for balance errors (1 point for each error)
- Stepping
- Stumbling
- Opening eyes
- Hands lifted above the iliac crests
- Forefoot or heel lifted
- Hip moved >30 degrees flexion or abduction
- Out of test position >5 seconds
IV. Technique: Balance Testing
- Patient performs 3 stances for 20 seconds each
- Count the number of times they move during each 20 second period
- Timer starts when the patient closes their eyes
- If stumbles out of position
- Open eyes, return to position and timing will resume
- Double leg stance (maximum of 10 errors)
- Feet together
- Hands on hips
- Eyes closed
- Single leg stance (maximum of 10 errors)
- Stand on non-dominant foot
- Lift the dominant leg (kicking leg)
- Hip flexion 30 degrees
- Knee flexion 45 degrees
- Tandem stance (maximum of 10 errors)
- Stand heel to toe with non-dominant foot in back
- Distribute weight equally on each foot
V. Interpretation
- Total score is 30 minus the cummulative errors on each of the 3 stances
- Maximum total score is 30 points
- Average of 12 errors following Concussion (when 3 stances each on ground and foam block are performed)
VI. Resources
VII. References
- Guskiewicz (2003) Current Sports Medicine Reports 2: 24-30
- Guskiewicz (2001) Clin J Sport Med 11:182-9 [PubMed]