Keller Army Community Hospital, West Point, NY.
University of Kentucky, Lexington, Kentucky.
Sports Health. 2023 May;15(3):427-432. doi: 10.1177/19417381221093566. Epub 2022 Jun 3.
The Balance Error Scoring System (BESS) is commonly accepted as a valid measure of postural stability. However, reliability values have varied, and subtle changes undetectable with the human eye may exist postinjury. The inertial measurement unit in commercially available tablets has been used to quantify postural sway (instrumented Balance Error Scoring System [iBESS] volume). However, iBESS has not been validated in a military population, and the stability of the tests beyond 1 week is unknown.
iBESS volume is capable of objectively measuring postural sway during the traditional BESS.
Prospective repeated-measures study.
Level 3.
Eighty-three cadets (40.96% women; age 20.0 ± 1.44 years; height 68.7 ± 4.1 inches; weight 166.7 ± 30.2 lb) with no history of concussion or lower extremity injury agreed to participate. All participants completed the BESS at baseline and 6 months post baseline. During testing, a tablet equipped with an inertial measurement unit was positioned on the participant's sacrum to capture postural sway.
Moderate to strong correlations were exhibited between baseline measurements for single-limb (SL)-firm ( = 0.84; < 0.01), tandem (TAN)-firm ( = 0.85; < 0.01), double-limb (DL)-foam ( = 0.50; < 0.01), SL-foam ( = 0.59; < 0.01), and TAN-foam ( = 0.79; < 0.01). Balance improved significantly at 6 months for SL-firm human-rated errors (Effect Size [ES] = 0.32) and for SL-firm (ES = 0.38), DL-foam (ES = 0.21), and SL-foam iBESS volume (ES = 0.35). Moderate to strong correlations were exhibited between human-rated and iBESS change scores for SL-firm ( = 0.71; < 0.01), TAN-firm ( = 0.75; < 0.01), and TAN-foam ( = 0.71; < 0.01), and a weak correlation was exhibited for DL-foam ( = 0.29; 0.01) and SL-foam ( = 0.40; < 0.01).
Moderate to strong correlations existed between human-rated BESS errors and iBESS volume at baseline and between change scores. In addition, iBESS volume may be more sensitive to balance changes than the human-rated BESS.
This evidence supports the use of iBESS volume as a valid measure of postural stability in military cadets. iBESS volume may provide clinicians with an objective and more sensitive measure of postural stability than the traditional human-rated BESS.
平衡错误评分系统（BESS）通常被认为是一种有效的姿势稳定性测量方法。然而，可靠性值存在差异，并且受伤后可能存在人眼无法察觉的细微变化。商用平板电脑中的惯性测量单元已被用于量化姿势摆动（仪器化平衡错误评分系统[iBESS]体积）。然而，iBESS 尚未在军事人群中得到验证，并且其测试的稳定性超过 1 周的情况尚不清楚。
iBESS 体积能够在传统 BESS 中客观测量姿势摆动。
前瞻性重复测量研究。
3 级。
83 名学员（40.96%为女性；年龄 20.0 ± 1.44 岁；身高 68.7 ± 4.1 英寸；体重 166.7 ± 30.2 磅）无脑震荡或下肢损伤史，同意参与。所有参与者均在基线和基线后 6 个月进行 BESS 测试。在测试过程中，将配备惯性测量单元的平板电脑放置在参与者的骶骨上，以捕捉姿势摆动。
基线时，单腿（SL）-坚固（ = 0.84； < 0.01）、串联（TAN）-坚固（ = 0.85； < 0.01）、双腿（DL）-泡沫（ = 0.50； < 0.01）、SL-泡沫（ = 0.59； < 0.01）和 TAN-泡沫（ = 0.79； < 0.01）的单腿和双足测量值之间存在中度至高度相关性。6 个月时，SL-坚固的人类评定错误（效应大小[ES] = 0.32）和 SL-坚固（ES = 0.38）、DL-泡沫（ES = 0.21）和 SL-泡沫 iBESS 体积（ES = 0.35）的平衡均显著改善。SL-坚固（ = 0.71； < 0.01）、TAN-坚固（ = 0.75； < 0.01）和 TAN-泡沫（ = 0.71； < 0.01）的人类评定和 iBESS 变化评分之间存在中度至高度相关性，而 DL-泡沫（ = 0.29； 0.01）和 SL-泡沫（ = 0.40； < 0.01）之间存在弱相关性。
基线时，人类评定的 BESS 错误与 iBESS 体积之间以及变化分数之间存在中度至高度相关性。此外，iBESS 体积可能比人类评定的 BESS 更敏感地反映平衡变化。
该证据支持在军事学员中使用 iBESS 体积作为一种有效的姿势稳定性测量方法。iBESS 体积可能为临床医生提供比传统的人类评定 BESS 更客观和更敏感的姿势稳定性测量方法。
