Scottish Rite for Children, Division Director of Movement Science Lab, Frisco, Texas, USA.
University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Brain Inj. 2022 Jul 3;36(8):921-930. doi: 10.1080/02699052.2022.2109736. Epub 2022 Aug 11.
Accurate assessment of balance recovery throughout treatment of a sport-related concussion is imperative. This study examined differences in balance from diagnosis to return-to-play initiation in adolescent patients post-concussion. Second, this study investigated the extent to which the Balance Error Scoring System (BESS) correlated with center-of-pressure (COP) measures.
Forty participants performed the BESS while standing on a force platform such that COP data were obtained simultaneously. Spatial and velocity COP-based measures were computed for the double-stance conditions.
BESS scores and COP-based measures indicated improved balance performance between visits. Specifically, 62.5/65.0% of participants exhibited improved firm/foam BESS final scores, respectively, and 56.4-71.8% exhibited improved COP-based measures. However, once normative ranges were referenced to identify maintained performance, the percentage of participants who substantially improved differed from initial findings (BESS: 2.5/7.5%, COP: 48.7-69.2%). Additionally, positive correlations between balance measures were primarily found at diagnosis (r=0.33-0.53), while only three correlations were maintained at return-to-play initiation (r=0.34-0.39).
BESS scores successfully identified poor balance performance at diagnosis when symptoms were most pronounced, but failed to accurately depict performance once balance impairment, indicated by COP-based measures, became less apparent. Further work is needed to implement more advanced balance assessments into clinical environments.
准确评估运动相关性脑震荡治疗过程中的平衡恢复至关重要。本研究探讨了青少年患者脑震荡后从诊断到重返赛场期间平衡的变化。其次，本研究调查了平衡错误评分系统（BESS）与压力中心（COP）测量的相关性程度。
40 名参与者在力台上进行 BESS 测试，同时获取 COP 数据。计算了双足支撑条件下的空间和速度 COP 测量值。
BESS 评分和 COP 测量值表明平衡表现从就诊到随访有所改善。具体来说，分别有 62.5%/65.0%的参与者在最终的 firm/foam BESS 评分上表现出改善，而 56.4%-71.8%的参与者在 COP 测量值上表现出改善。然而，一旦参考正常范围来确定维持的表现，在最初发现的基础上，表现出显著改善的参与者比例有所不同（BESS：2.5%/7.5%，COP：48.7%-69.2%）。此外，在诊断时主要发现平衡测量之间存在正相关（r=0.33-0.53），而在重返赛场时仅保持了三个相关性（r=0.34-0.39）。
BESS 评分在症状最明显时成功识别了平衡表现不佳，但当 COP 测量值表明平衡受损变得不那么明显时，无法准确描绘表现。需要进一步努力将更先进的平衡评估纳入临床环境。
