Term of Award

Spring 2010

Degree Name

Master of Science in Kinesiology (M.S.)

Document Type and Release Option

Thesis (open access)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


Department of Health and Kinesiology

Committee Chair

Thomas C. T. Buckley

Committee Member 1

Barry Joyner

Committee Member 2

Barry Munkasy

Committee Member 3

Thomas Buckley

Committee Member 3 Email



The Balance Error Scoring System (BESS) is a widely utilized concussion assessment tool used to assess postural stability. Baseline testing is used for comparison if an athlete receives a concussion for diagnosis and return to play guidelines. It is unknown if playing a competitive sports season has any effect on the BESS score. Objective: To determine if playing in a competitive sports season has an effect on the BESS score. Design: A three group pre-post test study. Setting: This study was performed in a controlled laboratory setting. Subjects: Fifty-five college females, including twenty-two division one soccer players (age = 19.5 ± 1.6 years, height = 165.3±5.9 cm, weight = 58.8 ± 7.8 kg), fourteen division one volleyball players (age = 19.4 ± 1.2 years, height = 177.4 ± 5.2 cm, weight = 70.1 ± 6.8 kg), and nineteen controls (age = 22.1 ± 1.7 years, height = 163.9 ± 6.5 cm, weight = 62.5 ± 9.0 kg) with no current concussion or injury of the lower extremity that would affect postural stability participated in this study. Interventions: The BESS score, including the overall score and the individual stance scores, was measured for women's soccer, women's volleyball and the control at preseason and postseason. Main Outcome Measures: Two, two-way ANOVAs with repeated measures, one 3-level, two-way ANOVA with repeated measures, two, 7-level MANOVAs, and one 3-level ANOVA were used to analyze our data. Results: Differences were found for all subjects between preseason and postseason with a mean change in total BESS score of 1.04 ± 2.38; P=.005. Differences were also found for all subjects between preseason and postseason with a mean change in the absolute value of the total BESS score of 1.96 ± 1.69; P<.001. Conclusions: There may be a learning effect over a 13 week time period for the BESS. Clinicians should account for this possible learning effect when administering the BESS. This would improve clinicians' diagnoses as well as providing more accurate and confident references for returning an athlete to play post concussion.

Research Data and Supplementary Material