Intrarater and Interrater Reliability of the Balance Error Scoring System (BESS)
Received 23 April 2008; accepted 16 June 2008. published online 11 December 2008.
Objective
The purpose of this study was to determine the intrarater and interrater reliability of the Balance Error Scoring System (BESS).
Design
A prospective observational study.
Setting
Academic sports medicine center.
Participants
Three scorers participated in this study.
Methods
Three scorers experienced in using the BESS viewed a videotape depicting 30 consecutive individuals performing the BESS stance positions. The 3 scorers independently scored each of the 30 videotaped individuals using the BESS scoring criteria. A week later, the same 3 subjects viewed and scored the videotape again.
Main Outcome Measurements
The interrater and intrarater reliability of the BESS was determined using intraclass correlation coefficients (ICC), reported with 95% confidence intervals. The minimum detectible change was also determined.
Results
The interrater and intrarater reliability ICCs for the total BESS scores were 0.57 and 0.74, respectively. The interrater reliability ICCs for the 6 different stance positions were between 0.44 and 0.83, while the intrarater reliability ICCs were between 0.50 and 0.88. The interrater and intrarater minimum detectible change for the total BESS score were 9.4 and 7.3 points, respectively.
Conclusion
This study suggests that certain subcategories of the BESS have sufficient reliability to be used in the evaluation of postural stability but that the total BESS score is not reliable. In addition, a change in score of greater than 9.4 (interrater) or 7.3 (intrarater) points is required before the change in postural stability can be attributed to the balancer rather than to the scorer.
aDepartment of Physical Medicine and Rehabilitation, College of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905⁎
bSports Medicine Center, Mayo Clinic, Rochester, MN⁎
cDepartment of Physical Medicine and Rehabilitation, College of Medicine, Mayo Clinic, Rochester, MN⁎
dDepartment of Physical Medicine and Rehabilitation, College of Medicine, Mayo Clinic, Rochester, MN⁎
Address correspondence to: J.T.F.
Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org
ABSTRACT