Automated system for balance error scoring

The Balance Error Scoring System (BESS) test is a commonly used tool for assessing static postural stability after concussion that quantifies compensatory arm, eye and trunk movements. However, since it is scored by clinician observation, it is potentially susceptible to biased and inaccurate test scores. It is further limited by the need for properly trained clinicians to simultaneously administer, score and interpret the test. Such personnel may not always be available when concussion testing is needed such as at amateur sporting events or in military field situations. In response, we are creating a system to automatically administer and score the BESS in field conditions. The system is based on the Microsoft Kinect, which is an inexpensive commodity motion capture system originally developed for gaming applications. The Kinect can be interfaced to a custom-programmed laptop computer in order to quantitatively measure patient posture compensations for preventing balance loss such as degree of hip abduction/flexion, heel lift, eye opening, and hand movement. By (a) removing the need for an adequately trained clinician, (b) improving accuracy, and (c) using rugged off-the-shelf system components, it will be possible to administer better, more accurate concussion assessments outside of standard clinical settings.