An alternative to the balance error scoring system: using a low-cost balance board to improve the validity/reliability of sports-related concussion balance testing.

Objective: Recent guidelines advocate sports medicine professionals to use balance tests to assess sensorimotor status in the management of concussions. The present study sought to determine whether a low-cost balance board could provide a valid, reliable, and objective means of performing this balance testing.

Design: Criterion validity testing relative to a gold standard and 7 day test-retest reliability.

Setting: University biomechanics laboratory.

Participants: Thirty healthy young adults.

Assessment Of Risk Factors: Balance ability was assessed on 2 days separated by 1 week using (1) a gold standard measure (ie, scientific grade force plate), (2) a low-cost Nintendo Wii Balance Board (WBB), and (3) the Balance Error Scoring System (BESS).

Main Outcome Measures: Validity of the WBB center of pressure path length and BESS scores were determined relative to the force plate data. Test-retest reliability was established based on intraclass correlation coefficients.

Results: Composite scores for the WBB had excellent validity (r = 0.99) and test-retest reliability (R = 0.88). Both the validity (r = 0.10-0.52) and test-retest reliability (r = 0.61-0.78) were lower for the BESS.

Conclusions: These findings demonstrate that a low-cost balance board can provide improved balance testing accuracy/reliability compared with the BESS.

Clinical Relevance: This approach provides a potentially more valid/reliable, yet affordable, means of assessing sports-related concussion compared with current methods.