Balance Error Scoring System (BESS)
What it measures:
The Balance Error Scoring System (BESS) test was developed as an outcome measure of postural stability. It is often used in the population of athletes with concussion or mild traumatic brain injury.
The test consists of 3 positions: double-leg stance with hands on hips and feet together, single-leg stance standing on nondominant leg with hands on hips, and tandem stance with nondominant foot behind dominant foot in heel-toe fashion. Each stance is performed for up to 20 seconds on a firm surface and on a foam surface with eyes closed, for a total of 6 test stances. An evaluator scores the test by counting the number of errors observed using an objective list of errors. Each committed error is given 1 point with a maximum number of points for each position of 10 (Finnoff et al, 2009). Lower scores indicate less errors and better balance.
Errors are defined as: opening eyes, lifting hands off of iliac crest, stepping to regain balance, stumbling or falling out of position, lifting forefoot or heel, abducting or flexing the hip by more than 30 degrees, or failing to return to test position in more than 5 seconds (Bell et al, 2011).
Neurology Section of APTA’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (VEDGE)
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