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Mason D. Smith and David R. Bell

Context:

Anterior cruciate ligament (ACL) reconstruction is the standard of care for individuals with ACL rupture. Balance deficits have been observed in patients with ACL reconstruction (ACLR) using advanced posturography, which is the current gold standard. It is unclear if postural-control deficits exist when assessed by the Balance Error Scoring System (BESS), which is a clinical assessment of balance.

Objective:

The purpose of this study is to determine if postural-control deficits are present in individuals with ACLR as measured by the BESS.

Participants:

Thirty participants were included in this study. Fifteen had a history of unilateral ACLR and were compared with 15 matched controls.

Interventions:

The BESS consists of 3 stances (double-limb, single-limb, and tandem) on 2 surfaces (firm and foam). Participants begin in each stance with hands on their hips and eyes closed while trying to stand as still as possible for 20 s.

Main Outcome Measures:

Each participant performed 3 trials of each stance (18 total), and errors were assessed during each trial and summed to create a total score.

Results:

We observed a significant group × stance interaction (P = .004) and a significant main effect for stance (P < .001). Post hoc analysis revealed that the ACLR group had worse balance on the single-leg foam stance than did controls. Finally, the reconstructed group had more errors when total BESS score was examined (P = .02).

Conclusions:

Balance deficits exist in individuals with ACLR as measured by the BESS. Total BESS score was different between groups. The only condition that differed between groups was the single-leg stance on the unstable foam surface.

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Jaclyn B. Caccese, Thomas A. Buckley, and Thomas W. Kaminski

The Balance Error Scoring System (BESS) is often used for sport-related concussion balance assessment. However, moderate intratester and intertester reliability may cause low initial sensitivity, suggesting that a more objective balance assessment method is needed. The MobileMat BESS was designed for objective BESS scoring, but the outcome measures must be validated with reliable balance measures. Thus, the purpose of this investigation was to compare MobileMat BESS scores to linear and nonlinear measures of balance. Eighty-eight healthy collegiate student-athletes (age: 20.0 ± 1.4 y, height: 177.7 ± 10.7 cm, mass: 74.8 ± 13.7 kg) completed the MobileMat BESS. MobileMat BESS scores were compared with 95% area, sway velocity, approximate entropy, and sample entropy. MobileMat BESS scores were significantly correlated with 95% area for single-leg (r = .332) and tandem firm (r = .474), and double-leg foam (r = .660); and with sway velocity for single-leg (r = .406) and tandem firm (r = .601), and double-leg (r = .575) and single-leg foam (r = .434). MobileMat BESS scores were not correlated with approximate or sample entropy. MobileMat BESS scores were low to moderately correlated with linear measures, suggesting the ability to identify changes in the center of mass–center of pressure relationship, but not higher-order processing associated with nonlinear measures. These results suggest that the MobileMat BESS may be a clinically-useful tool that provides objective linear balance measures.

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Jason P. Mihalik, Elizabeth F. Teel, Robert C. Lynall, and Erin B. Wasserman

assessments is the Balance Error Scoring System (BESS). The BESS is a valid 8 – 10 tool designed to detect subtle balance deficits following concussion. Its reliability, however, varies from poor to moderate 11 , 12 to good. 13 , 14 In many cases, the BESS is completed at baseline and compared to

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Laura A. Linnan and Bess Marcus

Most adults in the U.S. are employed and spend many hours at work. Worksite-based physical activity programs have achieved modest success but are limited because they have not kept pace with changing work environments and workforce characteristics, or have problems with design, measurement, and analysis issues. This paper briefly identifies current gaps in knowledge and practice with worksite-based physical activity, including a lack of focus on the needs of older workers. Recommendations are offered for increasing worksite-based physical activity: creating partnerships with workers, management, labor, and managed care representatives to address physical activity needs; embedding physical activity programs within comprehensive health programs and employer-sponsored benefits packages; creating opportunities for small businesses; linking to larger efforts to support physical activity at the company/community level; and increasing collaborations and the political will required to conduct well-designed research to identify successful intervention strategies.

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Ainaz Shamshiri, Iman Rezaei, Ehsan Sinaei, Saeed Heidari, and Ali Ghanbari

of balance assessment tools has been developed to date, including clinical tests, which are inherently inexpensive and easily obtainable, designed for a clinical context. 3 The Balance Error Scoring System (BESS) is an easy-to-administer test widely used to evaluate static postural stability. 1 , 3

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Stephen M. Glass, Alessandro Napoli, Elizabeth D. Thompson, Iyad Obeid, and Carole A. Tucker

and testing protocols, 3 , 4 but such methods are seldom used for wide-scale or field-based testing due to their prohibitive cost and lack of accessibility. Where laboratory methods are impractical, field-based tests may be used in their place. The balance error scoring system (BESS) 5 and its

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Lucas J. Carr, Shira Dunsinger, and Bess H. Marcus

Background:

Long-term physical activity surveillance has not been conducted among Latinas. This study explored the variability of daily physical activity habits of inactive adult Latinas participating in a 12-month physical activity intervention.

Methods:

We collected objective physical activity data (pedometer) from 139 Spanish speaking Latinas (age = 41.6 ± 10.1 years; BMI = 29.6 ± 4.3 kg/m2) enrolled in a 12-month physical activity intervention. Total and aerobic steps (>100 steps/minute) were computed by year, season, month, day of week, time of day, and hour.

Results:

Participants walked an average of 6509 steps/day of which 1303 (20%) were aerobic steps. Significant physical activity differences were observed for subgroups including generational status, education, employment, income, marital status and health literacy. Significant and similar differences were observed for both total steps and aerobic steps for day of the week (weekdays > weekends) and season (summer > spring > fall > winter). Opposing trends were observed over the course of the day for total steps (early afternoon > late morning > late afternoon > early morning > evening) and aerobic steps (early morning > evening > late morning > late afternoon > early afternoon).

Conclusions:

Both seasonality and week day predicted physical activity habits of Latinas. This is the first long-term study to track daily physical activity habits of Latinas. These data have potential to inform the design of future physical activity interventions targeting Latinas.

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Eamon T. Campolettano, Gunnar Brolinson, and Steven Rowson

athletes in assessing postural control in athletes is the Balance Error Scoring System (BESS). 13 The BESS is a clinical, static balance assessment that is easy to administer and may be used without instrumented testing devices. 17 The BESS testing protocol is described in the methods section of this

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Dorothy Pekmezi, Shira Dunsiger, Ronnesia Gaskins, Brooke Barbera, Becky Marquez, Charles Neighbors, and Bess Marcus

Background:

Due to high rates of inactivity and related chronic illnesses among Latinas,1 the current study examined the feasibility and acceptability of using pedometers as an intervention tool in this underserved population.

Methods:

Data were taken from a larger randomized, controlled trial2 and focused on the subsample of participants (N = 43) who were randomly assigned to receive a physical activity intervention with pedometers and instructions to log pedometer use daily and mail completed logs back to the research center each month for 6 months.

Results:

Retention (90.7% at 6 months) and adherence to the pedometer protocol (68.89% returned ≥ 5 of the 6 monthly pedometer logs) were high. Overall, participants reported increased physical activity at 6 months and credited pedometer use for helping them achieve these gains (75.7%). Participants who completed a high proportion (≥ 5/6) of pedometer logs reported significantly greater increases in physical activity and related process variables (stages of change, self-efficacy, behavioral processes of change, social support from friends) than those who were less adherent (completed < 5 pedometer logs).

Conclusions:

Pedometers constitute a low-cost, useful tool for encouraging self-monitoring of physical activity behavior in this at-risk group.

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Bernardine M. Pinto, Bess H. Marcus, Robert B. Patterson, Mary Roberts, Andrea Colucci, and Christina Braun

Exercise has been shown to improve walking ability in individuals with arterial claudication. This study compared the effects of an on-site supervised exercise program and a home exercise program on quality of life and psychological outcomes in these individuals. Sixty individuals were randomly assigned to a 12-week on-site or a 12-week home-based exercise program. Quality of life, mood and pain symptoms, and walking ability were examined at baseline, posttreatment, and at 6 months follow-up. Individuals in the on-site exercise program showed significantly greater improvements in walking ability. Although sample size limited the ability to detect significant differences between groups on quality of life and psychological measures, both groups were comparable on improvements in quality of life and in mood. These data suggest that a home exercise program with weekly feedback may provide improved quality of life and mood benefits for individuals with arterial claudication but does not provide improvements in walking equivalent to those provided by an on-site exercise program.