Response times are greater , gait strategies are less efficient , and postural control deficits are greater in concussed participants compared with healthy controls both immediately and for some period following concussive injury , specifically under divided attention conditions .
Dual task assessment s in some cases were more reliable than single task assessment s and may be better able to detect lingering effects following concussion .
This article is a systematic review of the literature on divided attention assessment inclusive of a cognitive and motor task ( balance or gait ) for use in concussion management .
Intrarater and interrater reliability of the Balance Error Scoring System (BESS).
OBJECTIVE The purpose of this study was to determine the intrarater and interrater reliability of the Balance Error Scoring System ( BESS ) . DESIGN A prospect i ve 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
Response times are greater , gait strategies are less efficient , and postural control deficits are greater in concussed participants compared with healthy controls both immediately and for some period following concussive injury , specifically under divided attention conditions .
Dual task assessment s in some cases were more reliable than single task assessment s and may be better able to detect lingering effects following concussion .
This article is a systematic review of the literature on divided attention assessment inclusive of a cognitive and motor task ( balance or gait ) for use in concussion management .