On-Field Testing Environment and Balance Error-Scoring System Performance During Preseason Screening of Healthy Collegiate Baseball Players (Original Research) (Report‪)‬

Sport-related concussions can produce catastrophic or debilitative injuries if proper initial management is not provided. (1-3) Individuals suspected of sustaining a sport-related concussion require a sound, evidence-based plan for proper immediate assessment and objective criteria for an informed return-to-play decision. (4) Proactive approaches to the prevention of adverse consequences in managing mild head injuries have led to the formation of various preseason baseline protocols to develop objective criteria for the difficult clinical return-to-play decision process. The examination of baseline information relative to neuropsychological testing, (5-10) symptoms, (11-13) and postural control (14-17) has been proposed to improve the sports medicine clinician's ability to make objective return-to-play decisions during both sideline and follow-up assessments. Objective sideline assessment of mild head injury (MHI) includes the use of symptom checklists, (12,13) cognitive tests, (10) and postural control tests. (18) Various methods of postural stability analyses have been proposed for assessing mild head injury, yet few of these tests can be used for immediate sideline assessment of MHI. The Balance Error Scoring System (BESS) was developed as a standardized, objective assessment tool for the clinical sideline assessment of postural control. (18) The BESS uses 3 stances (double, single, and tandem), on both firm and foam surfaces, and was found to have an intratester reliability coefficient ranging from .78 to .96. (15,17,19) The primary objective of the BESS is to provide clinicians with an immediate measure of postural control when assessing a patient with a potential MHI during a sideline clinical evaluation.