Normative data for the balance error scoring system for patients with chronic neck pain

Braz J Phys Ther. 2026 Feb 26;30(3):101585. doi: 10.1016/j.bjpt.2026.101585. Online ahead of print.

ABSTRACT

BACKGROUND: Neck pain can have an adverse impact on balance control. The Balance Error Scoring System (BESS) is a widely used for assessing static balance across various populations. However, its application in evaluating balance in patients with chronic subclinical neck pain (SNP) has been limited by the absence of normative data.

OBJECTIVE: This study aimed to develop normative values for the BESS in participants with chronic SNP, stratified by age and gender.

METHODS: 310 participants aged 20-69 years with chronic neck pain and no balance-affecting disorders were included. Each age group had 31 participants who underwent balance assessment using the Thai BESS version (BESS-TH), involving three test positions (double leg, single leg, tandem stance) performed on two surfaces (rigid and foam).

RESULTS: The average BESS-TH score in 10 groups were 14.90 ± 4.55 and 17.55 ± 4.44 in 20-29 years, 19.29 ± 5.66 and 20.61 ± 4.40 in 30-39, 22.32 ± 5.04 and 22.23 ± 5.19 in 40-49 years, 25.00 ± 7.25 and 27.94 ± 6.40 in 50-59 years, and 30.32 ± 7.36 and 30.65 ± 8.38 scores in 60-69 years for men and women respectively. The BESS scores demonstrated an upward trend with increasing age categories.

CONCLUSIONS: This study established a comprehensive normative database for the BESS across various age groups of adults with chronic SNP, emphasizing the age-related deterioration in balance. Precise normative data tailored to specific populations are crucial for accurate balance assessment and targeted interventions.

PMID:41762473 | DOI:10.1016/j.bjpt.2026.101585