Sensitivity and Specificity of the Modified Balance Error Scoring System in Concussed Collegiate Student Athletes

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To assess the efficacy of the modified Balance Error Scoring System (mBESS) compared with the Balance Error Scoring System (BESS) in an acutely concussed population.


Prospective observational study.


University athletic training room.


Thirty-five collegiate student-athletes (18 Female, 18.9 ± 0.8 year old, height: 1.71 ± 0.12 m, weight: 76.3 ± 24.1 kg) with diagnosed concussions and baseline BESS/mBESS tests.


All participants completed the BESS and mBESS on the day after the concussion (acute) and were retested daily until their BESS score achieved baseline value (recovery).

Main Outcome Measures:

The number of errors committed during the BESS and mBESS at each time point were recorded. The sensitivity and specificity of the BESS and mBESS compared with the baseline test was calculated for acute and recovery as well as the mBESS compared with the BESS.


At acute, the sensitivity of the BESS and mBESS were 60.0% and 71.4%, respectively. Relative to mBESS baseline, 60% of participants were misclassified at either acute or recovery.


The mBESS had higher sensitivity at acute and identified lingering deficits at BESS recovery. Use of the mBESS is likely to produce different results than the BESS; however, the clinical implications of this warrant further investigation.

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