Comparison of Concurrent and Same-Day Balance Measurement Approaches in a Large Sample of Uninjured Collegiate Athletes

Jessica Saalfield, Kelsey L. Piersol, Robert Monaco, Jason Womack, Scott A. Weismiller, Carrie Esopenko, Sabrina M. Todaro, Fiona N. Conway, Kyle Brostrand, Jennifer F. Buckman

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background Measures of postural stability are useful in assisting the diagnosing and managing of athlete concussion. Error counting using the Balance Error Scoring System (BESS) is the clinical standard, but has notable limitations. New technologies offer the potential to increase precision and optimize testing protocols; however, whether these devices enhance clinical assessment remains unclear. Purpose To examine the relationships between metrics of balance performance using different measurement systems in uninjured, healthy collegiate athletes. Study Design Cross-sectional. Methods Five hundred and thirty uninjured collegiate athletes were tested using the C3Logix app, which computes ellipsoid volume as a measure of postural stability during the six standard BESS conditions, while concurrently, errors were manually counted during each condition per standard BESS protocols. The association between concurrently measured ellipsoid volumes and error counts were examined with Spearman’s correlations. From this sample, 177 participants also performed two double-leg conditions on the Biodex BioSway force plate system on the same day. This system computes Sway Index as a measure of postural stability. The association of ellipsoid volume (C3Logix) and Sway Index (Biodex) was examined with Spearman’s correlations. Individual-level data were plotted to visually depict the relationships. Results C3Logix ellipsoid volume and concurrently recorded error counts were significantly correlated in five of the six BESS conditions (rs:.22-.62; p< 0.0001). C3Logix ellipsoid volume and Biodex Sway Index were significantly correlated in both conditions (rs=.22-.27, p< 0.004). However, substantial variability was shown in postural stability across all three measurement approaches. Conclusion Modest correlation coefficients between simultaneous and same-day balance assessments in uninjured collegiate athletes suggest a need to further optimize clinical protocols for concussion diagnosis. Level of Evidence 2b.

Original languageEnglish (US)
Pages (from-to)228-236
Number of pages9
JournalInternational Journal of Sports Physical Therapy
Issue number2
StatePublished - 2022

All Science Journal Classification (ASJC) codes

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Orthopedics and Sports Medicine


Dive into the research topics of 'Comparison of Concurrent and Same-Day Balance Measurement Approaches in a Large Sample of Uninjured Collegiate Athletes'. Together they form a unique fingerprint.

Cite this