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

OBJECTIVE: 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. DESIGN: Prospective observational study. SETTING: University athletic training room. PATIENTS: 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. INTERVENTIONS: 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. RESULTS: 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. CONCLUSIONS: 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.

Acute Cognitive and Physical Rest May Not Improve Concussion Recovery Time.

OBJECTIVE: To evaluate the effectiveness of an acute period of cognitive and physical rest on concussion. PARTICIPANTS: Fifty consecutive patients with a diagnosis of concussions. DESIGN: Participants were evaluated before (n = 25) and after (n = 25) a policy change that incorporated cognitive and physical rest. Patients in the rest group were withheld from activities, including classes, for the remainder of the injury day and the following day, whereas patients in the no-rest group were not provided any postinjury accommodations. MAIN MEASURES: Patients were evaluated on a graded symptom checklist, Balance Error Scoring System, Standard Assessment of Concussion, and computerized neuropsychological tests. The number of days until each test achieved baseline values was compared between groups with independent-samples t test. RESULTS: The no-rest group achieved asymptomatic status sooner than the rest group (5.2 ± 2.9 days and 3.9 ± 1.9 days, respectively; P = .047). There were no differences between groups for time to baseline values on the Balance Error Scoring System, Standard Assessment of Concussion, computerized neuropsychological tests, or time to clinical recovery. CONCLUSION: A prescribed day of cognitive and physical rest was not effective in reducing postconcussion recovery time. These results agree with a previous study and suggest that light activity postconcussion may not be deleterious to the concussion recovery process.