Effects of Landing Impacts and Running on Balance Error Scoring System Performance.

Sideline concussion checks often rely on the Balance Error Scoring System (BESS), a balance test that's known to be affected by fatigue. But most athletes aren't tested at rest, they've often just been running or jumping. This study asked whether a brief bout of running or jumping and landing changes how people perform on a repeat BESS test compared with simply resting. Fifty-two recreationally active people were split into three groups: drop jumps, treadmill running, or quiet sitting as a control.

Everyone did the BESS before and after their assigned activity. The control group improved on the second test, likely reflecting a practice effect, while neither the running group nor the jumping group showed that same improvement. This suggests that even modest exercise can mask the usual improvement seen on repeat testing, which could complicate how clinicians interpret balance scores after athletes have been active.

The main limitation is that this was a small trial of recreational, not necessarily injured or concussed, participants.

If you've ever watched a sideline concussion check, you may have seen an athlete stand still with eyes closed as part of a balance test called the BESS. This test is often given both before the season and again if a head injury is suspected, but this study looked at whether recent physical activity, like running or jumping, changes how someone performs on it. Researchers had 52 physically active people take the balance test twice, with either a short treadmill run, a set of jumps and landings, or just quiet sitting in between.

People who rested quietly generally scored better the second time around, which is expected since people often improve slightly with practice. But those who ran or jumped beforehand didn't show that same improvement. This matters because athletes are rarely tested for concussion right after sitting calmly, they've usually just been moving.

The findings suggest recent exercise could affect balance test results in ways that aren't fully understood yet, and this was a small study that didn't include actual concussion cases.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This randomized trial examined whether a brief bout of running or drop-jump landing alters BESS performance on repeat testing, using a 2 (time) by 3 (group) repeated-measures ANOVA with sex as covariate. Fifty-two recreationally active participants were randomized after a baseline BESS to control (quiet sitting), treadmill running (3 minutes), or drop jumps (10 repetitions from a 50 cm box).

A significant time-by-group interaction was found (F=7.396, P=.002). Post hoc analysis showed the control group significantly improved on repeat testing (13.9 to 10.5 errors, P=.019, d=0.89), consistent with a practice or learning effect commonly seen with repeat BESS administration. Neither the running group (P=.579) nor the landing group (P=.849) showed significant improvement, indicating that brief exercise, even at low to moderate intensity, may blunt the expected practice effect. Clinically, this raises interpretive concerns for serial BESS testing protocols, since a lack of improvement after exercise could be misread as a meaningful decline if baseline testing occurred at rest.

Limitations include the small, recreationally active (non-injured, non-athlete-specific) sample, and the abstract does not report direct between-exercise-group comparisons, only comparisons against control.