Caccese, J B; Buckley, T A; Kaminski, T W
Sway area and velocity correlated with MobileMat Balance Error Scoring System (BESS) scores Journal Article
In: Journal of Applied Biomechanics, vol. 32, no. 4, pp. 329–334, 2016.
Abstract | Links | BibTeX | Tags: Approximate entropy, Balance, Balancing, Biomechanics, BIOPHYSICS, Concussion, Entropy, Linear measures, Nonlinear measure, ORTHOPEDICS, Outcome measures, postural stability, Sample entropy, Scoring systems
@article{Caccese2016,
title = {Sway area and velocity correlated with MobileMat Balance Error Scoring System (BESS) scores},
author = {Caccese, J B and Buckley, T A and Kaminski, T W},
doi = {10.1123/jab.2015-0273},
year = {2016},
date = {2016-01-01},
journal = {Journal of Applied Biomechanics},
volume = {32},
number = {4},
pages = {329--334},
abstract = {The Balance Error Scoring System (BESS) is often used for sport-related concussion balance assessment. However, moderate intratester and intertester reliability may cause low initial sensitivity, suggesting that a more objective balance assessment method is needed. The MobileMat BESS was designed for objective BESS scoring, but the outcome measures must be validated with reliable balance measures. Thus, the purpose of this investigation was to compare MobileMat BESS scores to linear and nonlinear measures of balance. Eighty-eight healthy collegiate student-athletes (age: 20.0 ± 1.4 y, height: 177.7 ± 10.7 cm, mass: 74.8 ± 13.7 kg) completed the MobileMat BESS. MobileMat BESS scores were compared with 95% area, sway velocity, approximate entropy, and sample entropy. MobileMat BESS scores were significantly correlated with 95% area for single-leg (r =.332) and tandem firm (r =.474), and double-leg foam (r =.660); and with sway velocity for single-leg (r =.406) and tandem firm (r =.601), and double-leg (r =.575) and single-leg foam (r =.434). MobileMat BESS scores were not correlated with approximate or sample entropy. MobileMat BESS scores were low to moderately correlated with linear measures, suggesting the ability to identify changes in the center of mass-center of pressure relationship, but not higher-order processing associated with nonlinear measures. These results suggest that the MobileMat BESS may be a clinically-useful tool that provides objective linear balance measures. © 2016 Human Kinetics, Inc.},
keywords = {Approximate entropy, Balance, Balancing, Biomechanics, BIOPHYSICS, Concussion, Entropy, Linear measures, Nonlinear measure, ORTHOPEDICS, Outcome measures, postural stability, Sample entropy, Scoring systems},
pubstate = {published},
tppubtype = {article}
}
Buckley, T A; Vallabhajosula, S; Oldham, J R; Munkasy, B A; Evans, K M; Krazeise, D A; Ketcham, C J; Hall, E E
Evidence of a conservative gait strategy in athletes with a history of concussions Journal Article
In: Journal of Sport and Health Science, vol. 5, no. 4, pp. 417–423, 2016.
Abstract | Links | BibTeX | Tags: Balance, Brain Injury, Gait performance, Locomotion, Mild traumatic, postural control, postural stability, Variability
@article{Buckley2016a,
title = {Evidence of a conservative gait strategy in athletes with a history of concussions},
author = {Buckley, T A and Vallabhajosula, S and Oldham, J R and Munkasy, B A and Evans, K M and Krazeise, D A and Ketcham, C J and Hall, E E},
doi = {10.1016/j.jshs.2015.03.010},
year = {2016},
date = {2016-01-01},
journal = {Journal of Sport and Health Science},
volume = {5},
number = {4},
pages = {417--423},
abstract = {Background A history of 3 or more concussions is frequently associated with numerous short- and long-term neuropathologies. Impairments in postural control are a known acute consequence of concussion; however, limited evidence exists on the effects of multiple concussions on gait. The purpose of this study was to assess gait stepping characteristics in collegiate aged student-athletes based on concussion history. Methods There were 63 participants divided into 3 even groups based on concussion history: ≥3 concussions, 1\textendash2 concussions, and 0 concussion. All participants completed 10 trials of gait on a 4.9 m instrumented walkway. The dependent variables of interest included both gait stepping characteristics (step velocity, length, and width, double support time, and the percentage of the gait cycle in stance) and coefficient of variability (CoV) measures (step length, time, and width). The gait stepping characteristics were compared first with a MANOVA with follow-up 1-way ANOVAs and Tukey post hoc tests as appropriate. The CoV measures were compared with 1-way ANOVAs and Tukey post hoc tests. Results There were main effects for group for step velocity, length, width, and double support time. Overall, the 0 concussion group displayed typical healthy young gait parameters and performed significantly better than either concussion group. The 0 concussion group had a significantly greater step length CoV, but there were no differences in the step time or width CoV. Conclusion This finding provides evidence of subtle impairments in postural control during gait among individuals with prior history of concussion which could be an early indicator of future neurological deficiencies. The limited difference in the variability measures is consistent with prior static stance studies and could suggest the individuals constrain their motor systems to reduce variability. Taken together, these findings suggest a conservative gait strategy which is adopted by individuals with a history of concussions. © 2016},
keywords = {Balance, Brain Injury, Gait performance, Locomotion, Mild traumatic, postural control, postural stability, Variability},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Meehan III, W P
Normative values for a video-force plate assessment of postural control in athletic children Journal Article
In: Journal of Pediatric Orthopaedics Part B, vol. 25, no. 4, pp. 310–314, 2016.
Abstract | Links | BibTeX | Tags: Athletes, Balance, Balance Error Scoring System, Concussion, postural stability, Sports
@article{Howell2016a,
title = {Normative values for a video-force plate assessment of postural control in athletic children},
author = {Howell, D R and {Meehan III}, W P},
doi = {10.1097/BPB.0000000000000275},
year = {2016},
date = {2016-01-01},
journal = {Journal of Pediatric Orthopaedics Part B},
volume = {25},
number = {4},
pages = {310--314},
abstract = {The objective of this study was to provide normative data for young athletes during the three stances of the modified Balance Error Scoring System (mBESS) using an objective video-force plate system. Postural control was measured in 398 athletes between 8 and 18 years of age during the three stances of the mBESS using a video-force plate rating system. Girls exhibited better postural control than boys during each stance of the mBESS. Age was not significantly associated with postural control. We provide normative data for a video-force plate assessment of postural stability in pediatric athletes during the three stances of the mBESS. © Copyright 2016 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Athletes, Balance, Balance Error Scoring System, Concussion, postural stability, Sports},
pubstate = {published},
tppubtype = {article}
}
Caccese, J B; Kaminski, T W
Comparing computer-derived and human-observed scores for the Balance Error Scoring System Journal Article
In: Journal of Sport Rehabilitation, vol. 25, no. 2, pp. 133–136, 2016.
Abstract | Links | BibTeX | Tags: Concussion, postural stability, reliability
@article{Caccese2016bb,
title = {Comparing computer-derived and human-observed scores for the Balance Error Scoring System},
author = {Caccese, J B and Kaminski, T W},
doi = {10.1123/jsr.2014-0281},
year = {2016},
date = {2016-01-01},
journal = {Journal of Sport Rehabilitation},
volume = {25},
number = {2},
pages = {133--136},
abstract = {Context: The Balance Error Scoring System (BESS) is the current standard for assessing postural stability in concussed athletes on the sideline. However, research has questioned the objectivity and validity of the BESS, suggesting that while certain subcategories of the BESS have sufficient reliability to be used in evaluation of postural stability, the total score is not reliable, demonstrating limited interrater and intrarater reliability. Recently, a computerized BESS test was developed to automate scoring. Objective: To compare computerderived BESS scores with those taken from 3 trained human scorers. Design: Interrater reliability study. Setting: Athletic training room. Patients: NCAA Division I student athletes (53 male, 58 female; 19 ± 2 y, 168 ± 41 cm, 69 ± 4 kg). Interventions: Subjects were asked to perform the BESS while standing on the Tekscan (Boston, MA) MobileMat® BESS. The MobileMat BESS software displayed an error score at the end of each trial. Simultaneously, errors were recorded by 3 separate examiners. Errors were counted using the standard BESS scoring criteria. Main Outcome Measures: The number of BESS errors was computed for the 6 stances from the software and each of the 3 human scorers. Interclass correlation coefficients (ICCs) were used to compare errors for each stance scored by the MobileMat BESS software with each of 3 raters individually. The ICC values were converted to Fisher Z scores, averaged, and converted back into ICC values. Results: The double-leg, single-leg, and tandem-firm stances resulted in good agreement with human scorers (ICC = .999, .731, and .648). All foam stances resulted in fair agreement. Conclusions: Our results suggest that the MobileMat BESS is suitable for identifying BESS errors involving each of the 6 stances of the BESS protocol. Because the MobileMat BESS scores consistently and reliably, this system can be used with confidence by clinicians as an effective alternative to scoring the BESS. © 2016 Human Kinetics, Inc.},
keywords = {Concussion, postural stability, reliability},
pubstate = {published},
tppubtype = {article}
}
Alberts, J L; Thota, A; Hirsch, J; Ozinga, S; Dey, T; Schindler, D D; Koop, M M; Burke, D; Linder, S M
Quantification of the Balance Error Scoring System with Mobile Technology Journal Article
In: Medicine & Science in Sports & Exercise, vol. 47, no. 10, pp. 2233–2240, 2015.
Abstract | Links | BibTeX | Tags: accelerometer, BESS, Concussion, GYROSCOPE, IBESS, postural stability
@article{Alberts2015b,
title = {Quantification of the Balance Error Scoring System with Mobile Technology},
author = {Alberts, J L and Thota, A and Hirsch, J and Ozinga, S and Dey, T and Schindler, D D and Koop, M M and Burke, D and Linder, S M},
doi = {10.1249/MSS.0000000000000656},
year = {2015},
date = {2015-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {47},
number = {10},
pages = {2233--2240},
abstract = {Purpose The aim of this project was to develop a biomechanically based quantification of the Balance Error Scoring System (BESS) using data derived from the accelerometer and gyroscope of a mobile tablet device. Methods Thirty-two healthy young adults completed the BESS while an iPad was positioned at the sacrum. Data from the iPad were compared to position data gathered from a three-dimensional motion capture system. Peak-to-peak (P2P), normalized path length (NPL), and root mean squared (RMS) were calculated for each system and compared. Additionally, a 95% ellipsoid volume, iBESS volume, was calculated using center of mass (CoM) movements in the anteroposterior (AP), mediolateral (ML), and trunk rotation planes of movement to provide a comprehensive, 3D metric of postural stability. Results Across all kinematic outcomes, data from the iPad were significantly correlated with the same outcomes derived from the motion capture system (rho range, 0.37-0.94; P \< 0.05). The iBESS volume metric was able to detect a difference in postural stability across stance and surface, showing a significant increase in volume in increasingly difficult conditions, whereas traditional error scoring was not as sensitive to these factors. Conclusions The kinematic data provided by the iPad are of sufficient quality relative to motion capture data to accurately quantify postural stability in healthy young adults. The iBESS volume provides a more sensitive measure of postural stability than error scoring alone, particularly in conditions 1 and 4, which often suffer from floor effects, and condition 5, which can experience ceiling effects. The iBESS metric is ideally suited for clinical and in the field applications in which characterizing postural stability is of interest. © 2015 by the American College of Sports Medicine.},
keywords = {accelerometer, BESS, Concussion, GYROSCOPE, IBESS, postural stability},
pubstate = {published},
tppubtype = {article}
}
Caccese, J B; Buckley, T A; Kaminski, T W
Sway area and velocity correlated with MobileMat Balance Error Scoring System (BESS) scores Journal Article
In: Journal of Applied Biomechanics, vol. 32, no. 4, pp. 329–334, 2016.
@article{Caccese2016,
title = {Sway area and velocity correlated with MobileMat Balance Error Scoring System (BESS) scores},
author = {Caccese, J B and Buckley, T A and Kaminski, T W},
doi = {10.1123/jab.2015-0273},
year = {2016},
date = {2016-01-01},
journal = {Journal of Applied Biomechanics},
volume = {32},
number = {4},
pages = {329--334},
abstract = {The Balance Error Scoring System (BESS) is often used for sport-related concussion balance assessment. However, moderate intratester and intertester reliability may cause low initial sensitivity, suggesting that a more objective balance assessment method is needed. The MobileMat BESS was designed for objective BESS scoring, but the outcome measures must be validated with reliable balance measures. Thus, the purpose of this investigation was to compare MobileMat BESS scores to linear and nonlinear measures of balance. Eighty-eight healthy collegiate student-athletes (age: 20.0 ± 1.4 y, height: 177.7 ± 10.7 cm, mass: 74.8 ± 13.7 kg) completed the MobileMat BESS. MobileMat BESS scores were compared with 95% area, sway velocity, approximate entropy, and sample entropy. MobileMat BESS scores were significantly correlated with 95% area for single-leg (r =.332) and tandem firm (r =.474), and double-leg foam (r =.660); and with sway velocity for single-leg (r =.406) and tandem firm (r =.601), and double-leg (r =.575) and single-leg foam (r =.434). MobileMat BESS scores were not correlated with approximate or sample entropy. MobileMat BESS scores were low to moderately correlated with linear measures, suggesting the ability to identify changes in the center of mass-center of pressure relationship, but not higher-order processing associated with nonlinear measures. These results suggest that the MobileMat BESS may be a clinically-useful tool that provides objective linear balance measures. © 2016 Human Kinetics, Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Buckley, T A; Vallabhajosula, S; Oldham, J R; Munkasy, B A; Evans, K M; Krazeise, D A; Ketcham, C J; Hall, E E
Evidence of a conservative gait strategy in athletes with a history of concussions Journal Article
In: Journal of Sport and Health Science, vol. 5, no. 4, pp. 417–423, 2016.
@article{Buckley2016a,
title = {Evidence of a conservative gait strategy in athletes with a history of concussions},
author = {Buckley, T A and Vallabhajosula, S and Oldham, J R and Munkasy, B A and Evans, K M and Krazeise, D A and Ketcham, C J and Hall, E E},
doi = {10.1016/j.jshs.2015.03.010},
year = {2016},
date = {2016-01-01},
journal = {Journal of Sport and Health Science},
volume = {5},
number = {4},
pages = {417--423},
abstract = {Background A history of 3 or more concussions is frequently associated with numerous short- and long-term neuropathologies. Impairments in postural control are a known acute consequence of concussion; however, limited evidence exists on the effects of multiple concussions on gait. The purpose of this study was to assess gait stepping characteristics in collegiate aged student-athletes based on concussion history. Methods There were 63 participants divided into 3 even groups based on concussion history: ≥3 concussions, 1\textendash2 concussions, and 0 concussion. All participants completed 10 trials of gait on a 4.9 m instrumented walkway. The dependent variables of interest included both gait stepping characteristics (step velocity, length, and width, double support time, and the percentage of the gait cycle in stance) and coefficient of variability (CoV) measures (step length, time, and width). The gait stepping characteristics were compared first with a MANOVA with follow-up 1-way ANOVAs and Tukey post hoc tests as appropriate. The CoV measures were compared with 1-way ANOVAs and Tukey post hoc tests. Results There were main effects for group for step velocity, length, width, and double support time. Overall, the 0 concussion group displayed typical healthy young gait parameters and performed significantly better than either concussion group. The 0 concussion group had a significantly greater step length CoV, but there were no differences in the step time or width CoV. Conclusion This finding provides evidence of subtle impairments in postural control during gait among individuals with prior history of concussion which could be an early indicator of future neurological deficiencies. The limited difference in the variability measures is consistent with prior static stance studies and could suggest the individuals constrain their motor systems to reduce variability. Taken together, these findings suggest a conservative gait strategy which is adopted by individuals with a history of concussions. © 2016},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Meehan III, W P
Normative values for a video-force plate assessment of postural control in athletic children Journal Article
In: Journal of Pediatric Orthopaedics Part B, vol. 25, no. 4, pp. 310–314, 2016.
@article{Howell2016a,
title = {Normative values for a video-force plate assessment of postural control in athletic children},
author = {Howell, D R and {Meehan III}, W P},
doi = {10.1097/BPB.0000000000000275},
year = {2016},
date = {2016-01-01},
journal = {Journal of Pediatric Orthopaedics Part B},
volume = {25},
number = {4},
pages = {310--314},
abstract = {The objective of this study was to provide normative data for young athletes during the three stances of the modified Balance Error Scoring System (mBESS) using an objective video-force plate system. Postural control was measured in 398 athletes between 8 and 18 years of age during the three stances of the mBESS using a video-force plate rating system. Girls exhibited better postural control than boys during each stance of the mBESS. Age was not significantly associated with postural control. We provide normative data for a video-force plate assessment of postural stability in pediatric athletes during the three stances of the mBESS. © Copyright 2016 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Caccese, J B; Kaminski, T W
Comparing computer-derived and human-observed scores for the Balance Error Scoring System Journal Article
In: Journal of Sport Rehabilitation, vol. 25, no. 2, pp. 133–136, 2016.
@article{Caccese2016bb,
title = {Comparing computer-derived and human-observed scores for the Balance Error Scoring System},
author = {Caccese, J B and Kaminski, T W},
doi = {10.1123/jsr.2014-0281},
year = {2016},
date = {2016-01-01},
journal = {Journal of Sport Rehabilitation},
volume = {25},
number = {2},
pages = {133--136},
abstract = {Context: The Balance Error Scoring System (BESS) is the current standard for assessing postural stability in concussed athletes on the sideline. However, research has questioned the objectivity and validity of the BESS, suggesting that while certain subcategories of the BESS have sufficient reliability to be used in evaluation of postural stability, the total score is not reliable, demonstrating limited interrater and intrarater reliability. Recently, a computerized BESS test was developed to automate scoring. Objective: To compare computerderived BESS scores with those taken from 3 trained human scorers. Design: Interrater reliability study. Setting: Athletic training room. Patients: NCAA Division I student athletes (53 male, 58 female; 19 ± 2 y, 168 ± 41 cm, 69 ± 4 kg). Interventions: Subjects were asked to perform the BESS while standing on the Tekscan (Boston, MA) MobileMat® BESS. The MobileMat BESS software displayed an error score at the end of each trial. Simultaneously, errors were recorded by 3 separate examiners. Errors were counted using the standard BESS scoring criteria. Main Outcome Measures: The number of BESS errors was computed for the 6 stances from the software and each of the 3 human scorers. Interclass correlation coefficients (ICCs) were used to compare errors for each stance scored by the MobileMat BESS software with each of 3 raters individually. The ICC values were converted to Fisher Z scores, averaged, and converted back into ICC values. Results: The double-leg, single-leg, and tandem-firm stances resulted in good agreement with human scorers (ICC = .999, .731, and .648). All foam stances resulted in fair agreement. Conclusions: Our results suggest that the MobileMat BESS is suitable for identifying BESS errors involving each of the 6 stances of the BESS protocol. Because the MobileMat BESS scores consistently and reliably, this system can be used with confidence by clinicians as an effective alternative to scoring the BESS. © 2016 Human Kinetics, Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Alberts, J L; Thota, A; Hirsch, J; Ozinga, S; Dey, T; Schindler, D D; Koop, M M; Burke, D; Linder, S M
Quantification of the Balance Error Scoring System with Mobile Technology Journal Article
In: Medicine & Science in Sports & Exercise, vol. 47, no. 10, pp. 2233–2240, 2015.
@article{Alberts2015b,
title = {Quantification of the Balance Error Scoring System with Mobile Technology},
author = {Alberts, J L and Thota, A and Hirsch, J and Ozinga, S and Dey, T and Schindler, D D and Koop, M M and Burke, D and Linder, S M},
doi = {10.1249/MSS.0000000000000656},
year = {2015},
date = {2015-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {47},
number = {10},
pages = {2233--2240},
abstract = {Purpose The aim of this project was to develop a biomechanically based quantification of the Balance Error Scoring System (BESS) using data derived from the accelerometer and gyroscope of a mobile tablet device. Methods Thirty-two healthy young adults completed the BESS while an iPad was positioned at the sacrum. Data from the iPad were compared to position data gathered from a three-dimensional motion capture system. Peak-to-peak (P2P), normalized path length (NPL), and root mean squared (RMS) were calculated for each system and compared. Additionally, a 95% ellipsoid volume, iBESS volume, was calculated using center of mass (CoM) movements in the anteroposterior (AP), mediolateral (ML), and trunk rotation planes of movement to provide a comprehensive, 3D metric of postural stability. Results Across all kinematic outcomes, data from the iPad were significantly correlated with the same outcomes derived from the motion capture system (rho range, 0.37-0.94; P \< 0.05). The iBESS volume metric was able to detect a difference in postural stability across stance and surface, showing a significant increase in volume in increasingly difficult conditions, whereas traditional error scoring was not as sensitive to these factors. Conclusions The kinematic data provided by the iPad are of sufficient quality relative to motion capture data to accurately quantify postural stability in healthy young adults. The iBESS volume provides a more sensitive measure of postural stability than error scoring alone, particularly in conditions 1 and 4, which often suffer from floor effects, and condition 5, which can experience ceiling effects. The iBESS metric is ideally suited for clinical and in the field applications in which characterizing postural stability is of interest. © 2015 by the American College of Sports Medicine.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Caccese, J B; Buckley, T A; Kaminski, T W
Sway area and velocity correlated with MobileMat Balance Error Scoring System (BESS) scores Journal Article
In: Journal of Applied Biomechanics, vol. 32, no. 4, pp. 329–334, 2016.
Abstract | Links | BibTeX | Tags: Approximate entropy, Balance, Balancing, Biomechanics, BIOPHYSICS, Concussion, Entropy, Linear measures, Nonlinear measure, ORTHOPEDICS, Outcome measures, postural stability, Sample entropy, Scoring systems
@article{Caccese2016,
title = {Sway area and velocity correlated with MobileMat Balance Error Scoring System (BESS) scores},
author = {Caccese, J B and Buckley, T A and Kaminski, T W},
doi = {10.1123/jab.2015-0273},
year = {2016},
date = {2016-01-01},
journal = {Journal of Applied Biomechanics},
volume = {32},
number = {4},
pages = {329--334},
abstract = {The Balance Error Scoring System (BESS) is often used for sport-related concussion balance assessment. However, moderate intratester and intertester reliability may cause low initial sensitivity, suggesting that a more objective balance assessment method is needed. The MobileMat BESS was designed for objective BESS scoring, but the outcome measures must be validated with reliable balance measures. Thus, the purpose of this investigation was to compare MobileMat BESS scores to linear and nonlinear measures of balance. Eighty-eight healthy collegiate student-athletes (age: 20.0 ± 1.4 y, height: 177.7 ± 10.7 cm, mass: 74.8 ± 13.7 kg) completed the MobileMat BESS. MobileMat BESS scores were compared with 95% area, sway velocity, approximate entropy, and sample entropy. MobileMat BESS scores were significantly correlated with 95% area for single-leg (r =.332) and tandem firm (r =.474), and double-leg foam (r =.660); and with sway velocity for single-leg (r =.406) and tandem firm (r =.601), and double-leg (r =.575) and single-leg foam (r =.434). MobileMat BESS scores were not correlated with approximate or sample entropy. MobileMat BESS scores were low to moderately correlated with linear measures, suggesting the ability to identify changes in the center of mass-center of pressure relationship, but not higher-order processing associated with nonlinear measures. These results suggest that the MobileMat BESS may be a clinically-useful tool that provides objective linear balance measures. © 2016 Human Kinetics, Inc.},
keywords = {Approximate entropy, Balance, Balancing, Biomechanics, BIOPHYSICS, Concussion, Entropy, Linear measures, Nonlinear measure, ORTHOPEDICS, Outcome measures, postural stability, Sample entropy, Scoring systems},
pubstate = {published},
tppubtype = {article}
}
Buckley, T A; Vallabhajosula, S; Oldham, J R; Munkasy, B A; Evans, K M; Krazeise, D A; Ketcham, C J; Hall, E E
Evidence of a conservative gait strategy in athletes with a history of concussions Journal Article
In: Journal of Sport and Health Science, vol. 5, no. 4, pp. 417–423, 2016.
Abstract | Links | BibTeX | Tags: Balance, Brain Injury, Gait performance, Locomotion, Mild traumatic, postural control, postural stability, Variability
@article{Buckley2016a,
title = {Evidence of a conservative gait strategy in athletes with a history of concussions},
author = {Buckley, T A and Vallabhajosula, S and Oldham, J R and Munkasy, B A and Evans, K M and Krazeise, D A and Ketcham, C J and Hall, E E},
doi = {10.1016/j.jshs.2015.03.010},
year = {2016},
date = {2016-01-01},
journal = {Journal of Sport and Health Science},
volume = {5},
number = {4},
pages = {417--423},
abstract = {Background A history of 3 or more concussions is frequently associated with numerous short- and long-term neuropathologies. Impairments in postural control are a known acute consequence of concussion; however, limited evidence exists on the effects of multiple concussions on gait. The purpose of this study was to assess gait stepping characteristics in collegiate aged student-athletes based on concussion history. Methods There were 63 participants divided into 3 even groups based on concussion history: ≥3 concussions, 1\textendash2 concussions, and 0 concussion. All participants completed 10 trials of gait on a 4.9 m instrumented walkway. The dependent variables of interest included both gait stepping characteristics (step velocity, length, and width, double support time, and the percentage of the gait cycle in stance) and coefficient of variability (CoV) measures (step length, time, and width). The gait stepping characteristics were compared first with a MANOVA with follow-up 1-way ANOVAs and Tukey post hoc tests as appropriate. The CoV measures were compared with 1-way ANOVAs and Tukey post hoc tests. Results There were main effects for group for step velocity, length, width, and double support time. Overall, the 0 concussion group displayed typical healthy young gait parameters and performed significantly better than either concussion group. The 0 concussion group had a significantly greater step length CoV, but there were no differences in the step time or width CoV. Conclusion This finding provides evidence of subtle impairments in postural control during gait among individuals with prior history of concussion which could be an early indicator of future neurological deficiencies. The limited difference in the variability measures is consistent with prior static stance studies and could suggest the individuals constrain their motor systems to reduce variability. Taken together, these findings suggest a conservative gait strategy which is adopted by individuals with a history of concussions. © 2016},
keywords = {Balance, Brain Injury, Gait performance, Locomotion, Mild traumatic, postural control, postural stability, Variability},
pubstate = {published},
tppubtype = {article}
}
Howell, D R; Meehan III, W P
Normative values for a video-force plate assessment of postural control in athletic children Journal Article
In: Journal of Pediatric Orthopaedics Part B, vol. 25, no. 4, pp. 310–314, 2016.
Abstract | Links | BibTeX | Tags: Athletes, Balance, Balance Error Scoring System, Concussion, postural stability, Sports
@article{Howell2016a,
title = {Normative values for a video-force plate assessment of postural control in athletic children},
author = {Howell, D R and {Meehan III}, W P},
doi = {10.1097/BPB.0000000000000275},
year = {2016},
date = {2016-01-01},
journal = {Journal of Pediatric Orthopaedics Part B},
volume = {25},
number = {4},
pages = {310--314},
abstract = {The objective of this study was to provide normative data for young athletes during the three stances of the modified Balance Error Scoring System (mBESS) using an objective video-force plate system. Postural control was measured in 398 athletes between 8 and 18 years of age during the three stances of the mBESS using a video-force plate rating system. Girls exhibited better postural control than boys during each stance of the mBESS. Age was not significantly associated with postural control. We provide normative data for a video-force plate assessment of postural stability in pediatric athletes during the three stances of the mBESS. © Copyright 2016 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Athletes, Balance, Balance Error Scoring System, Concussion, postural stability, Sports},
pubstate = {published},
tppubtype = {article}
}
Caccese, J B; Kaminski, T W
Comparing computer-derived and human-observed scores for the Balance Error Scoring System Journal Article
In: Journal of Sport Rehabilitation, vol. 25, no. 2, pp. 133–136, 2016.
Abstract | Links | BibTeX | Tags: Concussion, postural stability, reliability
@article{Caccese2016bb,
title = {Comparing computer-derived and human-observed scores for the Balance Error Scoring System},
author = {Caccese, J B and Kaminski, T W},
doi = {10.1123/jsr.2014-0281},
year = {2016},
date = {2016-01-01},
journal = {Journal of Sport Rehabilitation},
volume = {25},
number = {2},
pages = {133--136},
abstract = {Context: The Balance Error Scoring System (BESS) is the current standard for assessing postural stability in concussed athletes on the sideline. However, research has questioned the objectivity and validity of the BESS, suggesting that while certain subcategories of the BESS have sufficient reliability to be used in evaluation of postural stability, the total score is not reliable, demonstrating limited interrater and intrarater reliability. Recently, a computerized BESS test was developed to automate scoring. Objective: To compare computerderived BESS scores with those taken from 3 trained human scorers. Design: Interrater reliability study. Setting: Athletic training room. Patients: NCAA Division I student athletes (53 male, 58 female; 19 ± 2 y, 168 ± 41 cm, 69 ± 4 kg). Interventions: Subjects were asked to perform the BESS while standing on the Tekscan (Boston, MA) MobileMat® BESS. The MobileMat BESS software displayed an error score at the end of each trial. Simultaneously, errors were recorded by 3 separate examiners. Errors were counted using the standard BESS scoring criteria. Main Outcome Measures: The number of BESS errors was computed for the 6 stances from the software and each of the 3 human scorers. Interclass correlation coefficients (ICCs) were used to compare errors for each stance scored by the MobileMat BESS software with each of 3 raters individually. The ICC values were converted to Fisher Z scores, averaged, and converted back into ICC values. Results: The double-leg, single-leg, and tandem-firm stances resulted in good agreement with human scorers (ICC = .999, .731, and .648). All foam stances resulted in fair agreement. Conclusions: Our results suggest that the MobileMat BESS is suitable for identifying BESS errors involving each of the 6 stances of the BESS protocol. Because the MobileMat BESS scores consistently and reliably, this system can be used with confidence by clinicians as an effective alternative to scoring the BESS. © 2016 Human Kinetics, Inc.},
keywords = {Concussion, postural stability, reliability},
pubstate = {published},
tppubtype = {article}
}
Alberts, J L; Thota, A; Hirsch, J; Ozinga, S; Dey, T; Schindler, D D; Koop, M M; Burke, D; Linder, S M
Quantification of the Balance Error Scoring System with Mobile Technology Journal Article
In: Medicine & Science in Sports & Exercise, vol. 47, no. 10, pp. 2233–2240, 2015.
Abstract | Links | BibTeX | Tags: accelerometer, BESS, Concussion, GYROSCOPE, IBESS, postural stability
@article{Alberts2015b,
title = {Quantification of the Balance Error Scoring System with Mobile Technology},
author = {Alberts, J L and Thota, A and Hirsch, J and Ozinga, S and Dey, T and Schindler, D D and Koop, M M and Burke, D and Linder, S M},
doi = {10.1249/MSS.0000000000000656},
year = {2015},
date = {2015-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {47},
number = {10},
pages = {2233--2240},
abstract = {Purpose The aim of this project was to develop a biomechanically based quantification of the Balance Error Scoring System (BESS) using data derived from the accelerometer and gyroscope of a mobile tablet device. Methods Thirty-two healthy young adults completed the BESS while an iPad was positioned at the sacrum. Data from the iPad were compared to position data gathered from a three-dimensional motion capture system. Peak-to-peak (P2P), normalized path length (NPL), and root mean squared (RMS) were calculated for each system and compared. Additionally, a 95% ellipsoid volume, iBESS volume, was calculated using center of mass (CoM) movements in the anteroposterior (AP), mediolateral (ML), and trunk rotation planes of movement to provide a comprehensive, 3D metric of postural stability. Results Across all kinematic outcomes, data from the iPad were significantly correlated with the same outcomes derived from the motion capture system (rho range, 0.37-0.94; P \< 0.05). The iBESS volume metric was able to detect a difference in postural stability across stance and surface, showing a significant increase in volume in increasingly difficult conditions, whereas traditional error scoring was not as sensitive to these factors. Conclusions The kinematic data provided by the iPad are of sufficient quality relative to motion capture data to accurately quantify postural stability in healthy young adults. The iBESS volume provides a more sensitive measure of postural stability than error scoring alone, particularly in conditions 1 and 4, which often suffer from floor effects, and condition 5, which can experience ceiling effects. The iBESS metric is ideally suited for clinical and in the field applications in which characterizing postural stability is of interest. © 2015 by the American College of Sports Medicine.},
keywords = {accelerometer, BESS, Concussion, GYROSCOPE, IBESS, postural stability},
pubstate = {published},
tppubtype = {article}
}