Normative data for the balance error scoring system: Implications for brain injury evaluations

Abstract

Patients who sustain traumatic brain injuries can experience temporary or permanent deficits in static or dynamic balance. The Balance Error Scoring System (BESS) is a brief, easily-administered test of static balance that recently has been recommended for use with military personnel who do not recover rapidly from a mild traumatic brain injury. However, the test lacks normative reference values for healthy adults, which greatly limits its clinical usefulness. The purpose of this study is to provide normative data for healthy men and women across the lifespan. Community-dwelling adults (n = 589) between the ages of 20-69 (M = 49.75, SD = 10.81) were administered the BESS. They did not have significant medical, neurological or lower extremity problems that might have an adverse effect on balance. There was no relation between BESS and height and a very small correlation between BESS and weight. There was a small correlation between BESS and waist girth and body mass index. BESS performance was similar in men and women. BESS scores were consistent across the age groups until the 50s, when they worsened. Normative reference values stratified by age groups are presented. These normative data provide a frame of reference for interpreting BESS performance in civilians and military personnel who sustain traumatic brain injuries and adults with diverse neurological problems.