HQ BaselineInstrumented balance
BTrackS and Force Plate Balance Testing: When You Need More Precision Than the Naked Eye
The gold standard for objective balance assessment — and why it detects deficits subjective scoring misses.
Force plate balance testing represents the gold standard for objective balance assessment in concussion management — replacing subjective clinician observation with quantified biomechanical data.
What BTrackS measures
The BTrackS (Balance Tracking System) balance plate is a portable, relatively affordable force plate (approximately $1,500–$3,000) that measures center-of-pressure (COP) sway during quiet standing with millimeter precision. During a typical assessment, the athlete stands on the plate in standard BESS stances while the system records continuous COP displacement, velocity, and path length. The resulting data is far more granular than an error count — it quantifies the subtle oscillations of the body’s postural control system that are invisible to the naked eye.
Why precision matters
This precision matters because research consistently demonstrates that instrumented balance deficits persist longer than clinically observable ones. Studies published in the Journal of Athletic Training (Cavanaugh et al., 2005, 2006) using force plates found that postural sway abnormalities can persist up to 30 days post-concussion — well beyond the 3–5 day window where subjective BESS scores typically return to normal. The NeuroCom Sensory Organization Test (SOT), a more complex force plate system used in clinical vestibular laboratories, provides even more detailed analysis of the sensory systems contributing to balance (visual, vestibular, somatosensory).
Other instrumented systems
The Tekscan MobileMat system combined with SportsAT software offers another approach — a pressure-sensitive mat that automates BESS scoring using pressure distribution data rather than force plate sway metrics. Research by Caccese and Kaminski at the University of Delaware validated this system against traditional observational scoring.
When to invest in instrumented testing
For programs that can invest in instrumented measurement, force plates provide baseline data with superior test-retest reliability and the sensitivity to detect balance changes that subjective scoring misses. For research programs studying subconcussive exposure and cumulative effects, instrumented balance data is essentially required.
At Headquarters, we use instrumented balance assessment in our clinical baseline facilities. For field-based and large-volume testing, we pair mBESS with smartphone-based objective measurement through platforms like Sway Medical — bringing technology-assisted precision to every setting.