Which test is used to assess balance during sideline concussion evaluation?

• A. SAC
• B. BESS
• C. Symptom checklists
• D. None of the above

Answer: (B)

In sideline concussion evaluation, assessing balance with an objective, quick test is essential to detect postural stability problems that can accompany a concussion. The Balance Error Scoring System (BESS) serves this purpose well. It has you examine balance in three stances—double-leg, single-leg, and tandem—on two surfaces (firm and foam). Each stance is typically held for about 20 seconds while the evaluator counts observable balance errors (like stepping, lifting hands off hips, opening eyes, losing balance, etc.). The total number of errors across all trials provides a score: higher scores indicate greater balance impairment, which can point to a concussion and help track recovery over time.

This test is distinct from other sideline checks. A cognitive test like the SAC focuses on orientation, immediate memory, and concentration rather than balance, while symptom checklists gather subjective reports of symptoms rather than objective performance. Those tools are valuable, but they don’t quantify postural control the way the BESS does.

So, the test best suited for assessing balance during sideline concussion evaluation is the Balance Error Scoring System, because it provides an objective, rapid measure of postural stability that complements other concussion assessments.