Balance Test Performance Research Articles

Postural stability in patients with non-specific chronic neck pain: A comparative study with healthy people.

Background: Impairment of cervical sensory input in patients with neck pain may disturb postural stability. The purpose of present study was to assess the dynamic postural stability of subjects with chronic neck pain compared to a matched control group. Methods: In this case-control study, 22 chronic non-specific neck pain and 22 healthy individuals participated. Postural stability was measured with Techno-body Prokin tilting platform. Subjects performed balance tests under two conditions: eyes open and closed. The parameters for assessment of postural stability were total stability index (TSI), anteroposterior stability index (APSI), mediolateral stability index (MLSI), and trunk deviation which demonstrated total trunk sway in medio-lateral and antero-posterior. We used a separate 2 (group) by 2 (postural difficulty) mixed-design analysis of variance (ANOVA) for analysis of postural performance. Results: There were significant differences between the chronic neck pain and matched control groups in APSI, MLSI, and TSI, p<0.001 in both eyes opened and closed conditions. The trunk deviation was greater for non-specific neck pain in comparison to healthy subjects, p<0.05 in both conditions of eyes open and closed. Conclusion: The results of this study showed that patients with chronic neck pain have poorer postural control than healthy subjects. The findings suggest that clinicians take into account the importance of dynamic postural stability assessment in patients with chronic non-specific neck pain and consider the application of intervention programs for improvement of the dynamic balance.

Modified dynamic gait index and limits of stability in myotonic dystrophy type 1.

The purpose of this study was to describe and compare the performance of balance and walking tests in relation to self-reported fall history in adults with myotonic dystrophy type 1 (DM1). Twenty-two (13 male) participants with DM1 completed, a 6-month fall history questionnaire, the modified Dynamic Gait Index (mDGI), limits of stability (LoS) testing, and 10-m walking tests. Mean (SD) falls in 6 months was 3.7 (3.1), and 19 (86%) participants reported at least 1 fall. Significant differences in mDGI scores (P = 0.006) and 10-m fast walking gait velocity (P = 0.02) were found between those who had been classified as "fallers" and those who had been classified as "nonfallers." Significant correlations were found between mDGI scores and 10-m walking time. Falls are common in DM1, and the mDGI may have potential to distinguish fallers from nonfallers, whereas the LoS failed to detect such impairment. Future studies should further explore use of the mDGI in DM1. Muscle Nerve 58: 694-699, 2018.

Development of mobile application to identify fall risk in the elderly

INTRODUCTION: A fall can occur at any stage of one's life; however, it is more common in the elderly. The effects of falls are serious, in social and economic terms, in the country and worldwide. Today, the public health system extensively encourages scientific studies that help prevent these accidents effectively, reducing the demand for health services and its associated costs. OBJECTIVE: To develop an electronic mobile web tool (app) that helps health professionals to assess risk factors related to falls among elderly people, utilising validated instruments designed for this age group that are widely used in the literature and adapted to Brazilian Portuguese. METHOD: This is a project regarding the development of a prototype for use on the Android platform, programmed in JAVA. RESULTS: After analysing the criteria set out in the study, the selected tools for software development were the Dynamic Gait Index-DGI, the Berg Balance Scale, the Timed Up and Go (TUG) test and the Tinetti Balance test (Performance Oriented Mobility Assessment-POMA). The tests conducted after the software development phase showed the predetermined requirements were met 100%. CONCLUSION: The app that was developed during the process proved to be versatile, fast, includes the main instruments that are validated in the Brazilian literature, identifies the risk of falls in the elderly, is easy to use, which all are positive incentives for health professionals to use the device.

The Influence of Fatigue on Star Excursion Balance Test Performance in Dancers.

Dance is associated with a high risk of injury and fatigue is often a contributing factor. The Star Excursion Balance Test (SEBT) has been used to identify alterations in normal movement that may contribute to injury risk; however, there has been limited investigation of the potential effects of fatigue. The aim of this study was to explore the influence of dance-specific fatigue on SEBT performance, with implications for injury and performance in dance. Thirty-five university dancers completed the modified SEBT in anterior, posterolateral, and posteromedial directions prior to and immediately following the Dance Aerobic Fitness Test (DAFT). The SEBT was completed for dominant and non-dominant legs. Heart rate and rate of perceived exertion were quantified as measures of fatigue. Post-DAFT, the mean SEBT percentage maximized reach distances for dominant and nondominant legs were non-significant compared to pre-DAFT scores. Lack of a main effect for exercise was observed in each of the anterior dominant and non-dominant, posterolateral dominant and non-dominant, and posteromedial dominant and non-dominant scores. It is concluded that the limited changes in the ability of dancers to perform the SEBT suggest that they were able to maintain SEBT performance in both dominant and non-dominant legs following exercise. This resistance to fatigue may demonstrate a dance-specific performance adaptation so that potential alterations in movement performance that may increase injury risk were not observed.

Collegiate baseball players with more optimal functional movement patterns demonstrate better athletic performance in speed and agility

ABSTRACTSports injuries are common among baseball players and may result in abnormal movement patterns, increased risks of future injury, and unsatisfactory performance. The Functional Movement Screen (FMS™) has been developed to detect abnormal functional movement patterns and can be used for predicting risks of sports injury. However, whether FMS™ scores are associated with athletic performance remains unclear. The goal of this study was to determine the association between functional movements and athletic performance in elite baseball players. Core stability, muscular strength and flexibility of the lower extremities, and FMS™, as well as athletic performance in sprinting, agility, and balance tests were assessed in 52 male collegiate Division I baseball players placed into two groups based on FMS™ scores. The high-scoring group demonstrated better athletic performance than the low-scoring group, with a shorter duration of the agility test. No group differences were found in core stability, muscular strength, or muscle flexibility, except for rectus femoris flexibility. Thus, the FMS™ score is associated with sprinting and agility performance in elite baseball players. These findings indicate that the FMS™ may have a role in predicting athletic performance and thereby help determine the goals of training regimens or return-to-play strategies.

Vestibular Deficits with Type 2 Diabetes Assayed by Motion Perception Thresholds

Postural control depends on the coordinated action of many physiologic systems, and sensory feedback about body motion plays a critical role. Individuals with diabetes have increased postural sway and risk of falling. Many studies have implicated somatosensory neuropathy, but a vestibular role has also been suggested. To further explore vestibular deficits, we measured vestibular perceptual thresholds in subjects with type 2 diabetes. These thresholds quantify the smallest motion that an individual can reliably sense. We selected this approach because thresholds are sensitive to pathology, age and balance test performance. We tested four human subjects (ages 52-69, one female) who received a diagnosis of type 2 diabetes between 12 and 17 years before testing. Subjects were not screened for neuropathy or blood sugar control (HbA1c: 6.8, 9.1, 13 and 7.6). Thresholds were tested with the subject sitting in a chair on a moving platform with the head held firmly by a helmet. The platform repeatedly exposed subjects to small motions and subjects reported their perception (“press the button in your left hand if you thought you moved to the left and the button in your right hand if you thought you moved to the right.”) Motion amplitudes were adaptively adjusted to find the stimulus amplitude at which subjects were about 80% correct. Five motion conditions were tested. Subjects with diabetes had higher thresholds than published normative data (repeated-measures ANOVA, p=0.0059): +36% for yaw rotation, +15% for lateral translation, +220% for vertical translation, +13% for roll tilt (1 s motions), +3% for roll tilt (5 s motions). These results emphasize the need for further studies on the effects of diabetes on the vestibular system. Disclosure S. King: None. D.J. Wexler: None. T. Leeder: None. F. Karmali: Employee; Spouse/Partner; Biogen.

Sensory Cutoff Value for Predicting Postural Instability in People with Peripheral Neuropathy Secondary to Diabetes

People with peripheral neuropathy (PN) secondary to diabetes have higher risks of falls due to loss of the somatosensation of the feet. The purpose of this study was to investigate the cutoff values of the vibration threshold and the monofilament test to predict postural instability. Ten healthy younger adults, ten healthy older adults and ten people with PN secondary to diabetes were recruited in this study. A handheld bio-thesiometer and a set of monofilaments were used to measure the vibration threshold (VT) and tactile sensitivity (TS), respectively. VT and TS were measured at six different sites on the plantar surface, including big toe, 1st metatarsus, little toe, 5th metatarsus, middle arch, and calcaneus (heel), plus the lateral and medial malleoli. Subjects also underwent a Sensory Organization Test (SOT) to identify postural instability, defined as equilibrium scores less than age matched norms. Linear regression was used to determine which site(s) was able to predict the balance test performance. Receiver operating characteristic curves were used to compute the VT and TS cutoff values associated with postural instability. A cutoff value of 10V for lateral malleolus VT was able to predict postural abnormality with 100% Sensitivity and 54.5% Specificity. A cutoff value of 3.61 for middle arch TS was able to predict postural abnormality with 100% Sensitivity and 86.4% Specificity. Postural instability appears earlier than the current recommended clinical cutoff values for peripheral neuropathy (25V for VT and 5.07 for TS). Although current cutoff values of the vibration threshold and the monofilament test are useful for detecting a propensity for neuropathic foot ulcer, they may not be adequate for detecting early postural instability. Fall prevention strategies may be needed early in the progression of PN. Disclosure N. Aung: None. S.A. Meardon: None. C. Lin: None. R.J. Tanenberg: None.

Avaliação do equilíbrio corporal em idosas praticantes de atividade física segundo a idade

The aim was to verify the relationship of body balance, according to age and groups of age in elderly women engaged in physical activity. Method130 elderly divided into four age groups: from 60 to 64 years (G1); 65‐69 (G2); 70‐74 (G3); and 75 to 79 (G4). For assessment was used the Timed Up and Go test (TUG), One Leg Stand (OLS) Sit back and Lift 5 times (CS5) and Functional Reach (FR). For statistical analysis, we used Spearman correlation and Kruskal‐Wallis. ResultsThere was a correlation between age and the TUG and AU tests. It showed a statistically significant difference in the TUG between G1 and G4 and for OLS, between G1 and G4 and G2 and G4. Conclusionunger seniors have better performance in balance tests like TUG and OLS.

Association between Y Balance Test Performance and Noncontact Lower Extremity Injury in High School Athletes

Association between Y Balance Test Performance and Noncontact Lower Extremity Injury in High School Athletes

Comparison of Lower Extremity Recovery After Anterior Cruciate Ligament Reconstruction With Transphyseal Hamstring Versus Extraphyseal Iliotibial Band Techniques in Skeletally Immature Athletes.

Background:The influence of graft type on recovery after anterior cruciate ligament reconstruction (ACLR) has not been adequately studied in pediatric patients.Purpose:To describe lower extremity functional recovery parameters at the 6-month mark after ACLR across 3 distinct groups of skeletally immature patients: pediatric male patients with transphyseal hamstring grafts (PM-HS), pediatric female patients with transphyseal hamstring grafts (PF-HS), and pediatric male patients with extraphyseal iliotibial band grafts (PM-ITB).Study Design:Cohort study; Level of evidence, 3.Methods:Thigh circumference, knee range of motion, lower extremity strength, dynamic balance, and hop test performance were assessed in all patients 6 months postoperatively. All participants were ≤15 years of age with open physes. The limb symmetry index was used to compare deficits between the operated and uninvolved limbs for all 3 groups (PM-HS, PF-HS, and PM-ITB). Analysis of variance with post hoc correction was employed.Results:A total of 93 pediatric patients who underwent ACLR (PM-HS: n = 21 [mean age, 13.6 ± 1.0 years]; PF-HS: n = 33 [mean age, 13.4 ± 0.7 years]; PM-ITB: n = 39 [mean age, 12.5 ± 1.3 years]) were examined. There was no statistically significant difference in thigh circumference, range of motion, dynamic balance, or hop test performance between the groups. Of the various additional comparisons analyzed, there were statistical differences in hamstring strength deficits among the 3 groups (P = .004). The PM-HS group showed a greater hamstring strength deficit (–32.2% relative to healthy limb) than the PM-ITB group (–5.4% relative to healthy limb) (P = .012). The hamstring strength deficit of the PF-HS group (–18.7% relative to healthy limb) was less than that of the PM-HS group and greater than that of the PM-ITB group but not statistically significant in either case.Conclusion:Significant hamstring strength deficits were detected in the PM-HS group compared with the PM-ITB group at 6 months following ACLR. Such findings may influence decisions regarding graft selection, timing of return to sports, and postoperative rehabilitation regimens.

Hip Strength and Range of Movement Are Associated With Dynamic Postural Control Performance in Individuals Scheduled for Arthroscopic Hip Surgery.

Study Design Cross-sectional. Background Hip pain is associated with reduced muscle strength and range of movement (ROM). These impairments may contribute to decreased postural stability and balance. The Star Excursion Balance Test (SEBT) is a reliable and valid method to measure dynamic postural control. Objectives To evaluate the association between SEBT performance and hip strength, hip ROM, trunk endurance, and group characteristics in individuals with hip pain. Methods One hundred eleven individuals with hip pain, scheduled for arthroscopic hip surgery, were matched with 62 healthy controls. Hip ROM and muscle strength, trunk endurance, and SEBT reach were measured prior to surgery. Data were analyzed for between-group differences using t tests, and associations between SEBT reach and hip strength, hip ROM, and population characteristics were evaluated with Pearson correlation coefficients and stepwise backward regression analyses. Results Star Excursion Balance Test performance (P<.01), hip strength (P<.01), and hip ROM (P<.05) were lower in the presurgery group compared to controls. In the presurgery group, when adjusted for height and weight, hip flexion strength and internal rotation ROM accounted for 44% of the variance in anteromedial SEBT reach. In the posteromedial direction, hip adduction strength and sex accounted for 53% of the variance. For the posterolateral direction, hip adduction and internal rotation strength accounted for 46% of reach variance. Conclusion The individuals who were scheduled for arthroscopic hip surgery were significantly weaker, had less hip mobility, and had reduced dynamic balance compared to controls. In this population, dynamic balance performance was associated with various hip strength and ROM measurements in a direction-specific manner. J Orthop Sports Phys Ther 2018;48(4):280-288. doi:10.2519/jospt.2018.7946.

Relationship between anthropometry and balance of postural control in children 6-9 years old

Objective: to determinate the relationship between the anthropometric profile and the postural and dynamic balance in children from six to nine years old. Background: balance or postural control is a complex motor skill that aims to achieve an adequate postural balance from multiple sensorimotor processes in both static and dynamic activities. Although the relationship between anthropometric measurements and postural balance in children has not been clearly defined, it has been suggested that they could negatively influence postural control. Methods: the sample included 158 schoolchildren (88 men and 70 women) who were between six and nine years old. The variables of the anthropometric profile studied were body mass, bipedal stature, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), sum skin-folds, body composition and somatotype. In addition, the static and dynamic postural balance was measured through posturography and the Y-Balance Test, respectively. The anthropometric measurements were correlated with the results of the postural balance tests. Results: moderate positive correlations between static postural balance, mainly in closed eyes condition, and BMI, PC, sum skin-folds, fat mass and endomorphy were found. Regarding the dynamic postural balance, moderate negative correlations were observed between the performance of the Y-Balance Test and body mass, bipedal stature, BMI, sum skin-folds, fat mass, skin mass and endomorphy. Conclusion: children with higher adiposity and/or predominance of the endomorphic component have a lower performance in static and dynamic postural balance tests.

SPINAL AND PERIPHERAL DRY NEEDLING VERSUS PERIPHERAL DRY NEEDLING ALONE AMONG INDIVIDUALS WITH A HISTORY OF LATERAL ANKLE SPRAIN: A RANDOMIZED CONTROLLED TRIAL.

In addition to established interventions, dry needling may reduce impairments leading to greater functional abilities for individuals following ankle sprain. The purpose of this study was to compare effects of spinal and peripheral dry needling (DN) with peripheral DN alone on impairments and functional performance among individuals with a history of lateral ankle sprain. Randomized controlled trial. Twenty individuals with a history of lateral ankle sprain (18 bilateral, 2 unilateral) participated in this study (4 males, 16 females; mean age 28.9 + /- 9.2 years). During the first of two sessions, participants completed the Foot and Ankle Disability Index (FADI) and the Cumberland Ankle Instability Tool (CAIT) and their strength, unilateral balance, and unilateral hop test performance was assessed. Participants were randomly assigned to a spinal and peripheral DN group (SPDN), or a peripheral only DN group (PDN). Participants in the SPDN site group received DN to bilateral L5 multifidi and fibularis longus and brevis muscles on the involved lower extremity. Participants in the PDN group received DN to the fibularis muscles alone. Participants' strength, balance and hop test performance were reassessed immediately following the intervention, and at follow-up 6-7 days later, all outcome measures were reassessed. Three-way mixed model ANOVAs and Mann-Whitney U tests assessed between group differences for outcome variables with normal distributions and non-normal distributions, respectively. ANOVAs showed significant group by time interaction (p<0.05) for invertor strength, significant side by group and time by group interactions (p<0.05) for plantarflexor-evertor strength, no significant findings for dorsiflexor-invertor strength, significant side by time interaction (p<0.05) for unilateral balance, significant main effect of time (p<0.05) for triple hop for distance test, and significant main effect of side (p<0.05) for the CAIT. Mann-Whitney U tests showed no significance (p>0.05) for the side hop test or FADI. The results suggest that DN of the multifidi in addition to fibularis muscles does not result in improvements in strength, unilateral balance or unilateral hop test performance, compared to DN the fibularis muscles alone among individuals with a history of ankle sprain.

Balance Screening of Vestibular Function in Subjects Aged 4 Years and Older: A Living Laboratory Experience.

To better understand the various individual factors that contribute to balance and the relation to fall risk, we performed the modified Romberg Test of Standing Balance on Firm and Compliant Support, with 1,174 participants between 4 and 83 years of age. This research was conducted in the Living Laboratory® at the Museum of Science, Boston. We specifically focus on balance test condition 4, in which individuals stand on memory foam with eyes closed, and must rely on their vestibular system; therefore, performance in this balance test condition provides a proxy for vestibular function. We looked for balance variations associated with sex, race/ethnicity, health factors, and age. We found that balance test performance was stable between 10 and 39 years of age, with a slight increase in the failure rate for participants 4–9 years of age, suggesting a period of balance development in younger children. For participants 40 years and older, the balance test failure rate increased progressively with age. Diabetes and obesity are the two main health factors we found associated with poor balance, with test condition 4 failure rates of 57 and 19%, respectively. An increase in the odds of having fallen in the last year was associated with a decrease in the time to failure; once individuals dropped below a time to failure of 10 s, there was a significant 5.5-fold increase in the odds of having fallen in the last 12 months. These data alert us to screen for poor vestibular function in individuals 40 years and older or suffering from diabetes, in order to undertake the necessary diagnostic and rehabilitation measures, with a focus on reducing the morbidity and mortality of falls.

Constant performance in balance and proprioception tests across the menstrual cycle - a pilot study in well trained female ice hockey players on hormonal contraception.

IntroductionIt has yet to be explained why female athletes appear to suffer more often from non‐contact ligament injuries during the first half of the menstrual cycle. Fluctuations in balance, caused by impaired proprioception due to increased fluid retention, may be relevant factors contributing to this anomaly in distribution. The aim of this study was therefore to uncover relationships between dynamic stability, proprioception and fluid retention in association with the menstrual cycle as a possible explanation for the observed changes in injury rates.MethodsNine healthy, female, well trained ice hockey players on hormonal contraception with regular cycles were tested at least twelve times during one menstrual cycle. Bioimpedance analysis was applied to investigate body composition and fluid distribution. A joint position sense test was performed to characterize changes in proprioception, while unexpected perturbations on a balance board were used to obtain measures for dynamic postural control.ResultsNo distinct changes in proprioception, dynamic stability and fluid retention were identified across the menstrual cycle in this population. Weak correlations were found between parameters for dynamic stability and proprioception.ConclusionVariations in proprioception, dynamic stability and fluid retention seem unlikely to be major contributors to injury risk peaks, at least in this population of healthy trained athletes using hormonal contraception.

Multivariate Analyses of Balance Test Performance, Vestibular Thresholds, and Age

We previously published vestibular perceptual thresholds and performance in the Modified Romberg Test of Standing Balance in 105 healthy humans ranging from ages 18 to 80 (1). Self-motion thresholds in the dark included roll tilt about an earth-horizontal axis at 0.2 and 1 Hz, yaw rotation about an earth-vertical axis at 1 Hz, y-translation (interaural/lateral) at 1 Hz, and z-translation (vertical) at 1 Hz. In this study, we focus on multiple variable analyses not reported in the earlier study. Specifically, we investigate correlations (1) among the five thresholds measured and (2) between thresholds, age, and the chance of failing condition 4 of the balance test, which increases vestibular reliance by having subjects stand on foam with eyes closed. We found moderate correlations (0.30–0.51) between vestibular thresholds for different motions, both before and after using our published aging regression to remove age effects. We found that lower or higher thresholds across all threshold measures are an individual trait that account for about 60% of the variation in the population. This can be further distributed into two components with about 20% of the variation explained by aging and 40% of variation explained by a single principal component that includes similar contributions from all threshold measures. When only roll tilt 0.2 Hz thresholds and age were analyzed together, we found that the chance of failing condition 4 depends significantly on both (p = 0.006 and p = 0.013, respectively). An analysis incorporating more variables found that the chance of failing condition 4 depended significantly only on roll tilt 0.2 Hz thresholds (p = 0.046) and not age (p = 0.10), sex nor any of the other four threshold measures, suggesting that some of the age effect might be captured by the fact that vestibular thresholds increase with age. For example, at 60 years of age, the chance of failing is roughly 5% for the lowest roll tilt thresholds in our population, but this increases to 80% for the highest roll tilt thresholds. These findings demonstrate the importance of roll tilt vestibular cues for balance, even in individuals reporting no vestibular symptoms and with no evidence of vestibular dysfunction.

Trends in Motor Performance of First Graders: A Comparison of Cohorts from 2006 to 2015.

Motor performance is an important factor for health. Already in childhood, motor performance is associated with, e.g., obesity and risk factors for cardiovascular diseases. It is widely believed that the motor performance of children has declined over recent years. However, this belief is lacking clear evidence. The objective of this study was to examine trends in motor performance of first grade students during a period of 10 years (2006-2015). We examined trends in (a) aerobic fitness, (b) strength, (c) speed, and (d) balance for boys and girls separately and considered body mass index (BMI) as a potential confounder. From 2006 to 2015, we tested 5,001 first graders [50.8% boys; mean age 6.76 (0.56) years] of 18 primary schools in Germany. Each year between 441 and 552 students of the same schools were surveyed. Performance tests were taken from the Motorik-Module Study and the "German Motor Ability Test": "6-min run," "push-ups," "20-m sprint," and "static stand." Linear regression models were conducted for statistical analysis. A slightly negative trend in aerobic fitness performance was revealed in boys (β = -0.050; p = 0.012) but not in girls. In the strength performance test no trend over time was detected. Performance in speed (boys: β = -0.094; girls: β = -0.143; p ≤ 0.001) and balance tests (boys: β = -0.142; girls: β = -0.232; p ≤ 0.001) increased over time for both boys and girls. These findings held true when BMI was considered. This study only partly supported the assumption that motor performance of children has declined: in our study, aerobic fitness declined (only in boys), while strength remained stable and speed and balance even increased in both sexes. Moreover, it seems as if BMI can explain changes in performance only to a small extent. Changed lifestyles might be a substantial cause. Further research on recent trends of motor performance and interacting variables is needed to support the results of our study and to provide more knowledge on causes of these trends.

Sex Differences in Balance Among Alpine Ski Racers: Cross-Sectional Age Comparisons.

Although balance is a key ability in the strength demands of alpine ski racing, affecting both performance and injury prevention, few studies have examined balance or related sex differences among still-maturing athletes. In this 10-year study, we investigated cross-sectional balance performances at different age periods of a representative sample of over 500 11-18-year-old elite skiers of both genders. Participants performed balance tests using the MFT S3-Check. Left-right and forward-backward movements were used to calculate sensory and symmetry balance scores, which were both incorporated into a stability score. Mann-Whitney U tests assessed gender-specific differences by age-group with a significance level set at p < .05. Results showed gender differences only on forward-backward measurements for 14-16-year-olds, with females showing better stability and sensory (but not symmetry) scores than males. Thus, gender interacted with age and maturation to influence balance ability in these participants. Additionally, these rare 10-year data support coaches in their training and talent development of maturing athletes by providing important sport-, age-, and gender-specific normative comparison data for individual trainees.

The Relationship Between Hip Strength and the Y Balance Test.

The Y Balance Test was developed as a test of dynamic postural control and has been shown to be predictive of lower-extremity injury. However, the relationship between hip strength and performance on the Y Balance Test has not been fully elucidated. The goal of this study was to identify the relationship between components of isometric hip strength and the Y Balance Test, to provide clinicians better guidance as to specific areas of muscle performance to address in the event of poor performance on the Y Balance Test. Laboratory study. Biomechanics laboratory. A total of 73 healthy participants (40 males and 33 females) volunteered for this study. None. Participants completed the Y Balance Test on the right leg. The authors then measured peak isometric torque in hip external rotation, abduction, and extension. Correlations were calculated between torque measurements, normalized for mass and Y Balance Test performance. Significant relationships were used in linear regression models to determine which variables were predictive of the Y Balance Test performance. The authors found significant positive correlations between Y Balance Test performance and hip abduction strength. They also found correlations between the Y Balance Test and hip extension and external rotation strengths. Linear regression analysis showed hip abduction to be the only significant predictor of Y Balance performance. The authors found the strongest association between the Y Balance Test and hip abduction strength. They also showed smaller but significant associations with hip extension and external rotation strength. When entered into a linear regression analysis, hip abduction strength was the only significant predictor of Y Balance performance. Using this information, practitioners should look to hip abduction strength when patients exhibit deficits in the Y Balance Test.

Star Excursion Balance Test Anterior Asymmetry Is Associated With Injury Status in Division I Collegiate Athletes.

Study Design Retrospective cohort. Background Star Excursion Balance Test (SEBT) performance differs by sport in healthy collegiate athletes, and lower extremity injury rates also vary by sport, sex, and athletic exposure. The relationship between SEBT performance and injury risk has not been evaluated with consideration of these additional variables, which may be necessary to fully describe the relationship between SEBT performance and injury risk. Objectives To assess the association between preseason SEBT performance and noncontact injury occurrence to the knee or ankle in Division I collegiate athletes when controlling for sport, sex, and athletic exposure. Methods Star Excursion Balance Test performance, starting status, and injury status were reviewed retrospectively in National Collegiate Athletic Association Division I collegiate athletes from a single institution. A total of 147 athletes were healthy at the time of preseason SEBT testing and either remained healthy (n = 118) or sustained a noncontact injury to the knee or ankle (n = 29) during their sport's subsequent competitive season. Side-to-side asymmetries were calculated in each direction as the absolute difference in reach distance between limbs. Star Excursion Balance Test reach distances and asymmetries were compared between groups using multivariable regression, controlling for sport, sex, and athletic exposure (starter, nonstarter). Receiver operating characteristic curves were used to determine optimal sensitivity and specificity for significant models. Results When controlling for sport, sex, and athletic exposure, SEBT side-to-side asymmetry in the anterior direction, expressed as an absolute or normalized to limb length, discriminated between injured and noninjured athletes (area under the curve greater than 0.82). Conclusion Assessing side-to-side reach asymmetry in the anterior direction of the SEBT may assist in identifying collegiate athletes who are at risk for sustaining noncontact injuries to the knee or ankle. Level of Evidence Prognosis, level 2b. J Orthop Sports Phys Ther 2017;47(5):339-346. Epub 29 Mar 2017. doi:10.2519/jospt.2017.6974.