Balance Assessment in Sports-Related Concussion: Evaluating Test–Retest Reliability of the Equilibrate System


This study evaluated the test–retest reliability of a novel computer-based, portable balance assessment tool, the Equilibrate System (ES), used to diagnose sports-related concussion. Twenty-seven students participated in ES testing consisting of three sessions over 4 weeks. The modified Balance Error Scoring System was performed. For each participant, test–retest reliability was established using the intraclass correlation coefficient (ICC). The ES test–retest reliability from baseline to week 2 produced an ICC value of 0.495 (95% CI, 0.123–0.745). Week 2 testing produced ICC values of 0.602 (95% CI, 0.279–0.803) and 0.610 (95% CI, 0.299–0.804), respectively. All other single measures test–retest reliability values produced poor ICC values. Same-day ES testing showed fair to good test–retest reliability while interweek measures displayed poor to fair test–retest reliability. Testing conditions should be controlle when using computerized balance assessment methods. ES testing should only be used as a part of a comprehensive assessment. (Journal of Surgical Orthopaedic Advances 25(2):93–98, 2016)
Keywords: balance, BESS, concussion, modified balance assessment scoring system, postural stability, sports

Mitchell J. Odom, BS; Young M. Lee, BSPH; Scott L. Zuckerman, MD; Rachel P. Apple, MD; Theodore Germanos, BS; Gary S. Solomon, PhD; and Allen K. Sills, MD