Star Excursion Balance Test Performance Research Articles

Impact of Sacroiliac Belt Utilization on Balance in Patients with Low Back Pain.

Low back pain (LBP) is a common problem which can affect balance and, in turn, increase fall risk. The aim of this investigation was to evaluate the impact of a Sacroiliac Belt (SB) on balance and stability in patients with LBP. Subjects with LBP and without LBP ("Asymptomatic") were enrolled. Baseline balance was assessed using the Berg Balance Scale. In a counterbalanced crossover design, LBP and Asymptomatic subjects were randomized to one of two groups: 1) start with wearing the SB (Serola Biomechanics, Inc.) followed by not wearing the SB or 2) start without wearing the SB followed by wearing the SB. For subjects in both groups, dynamic balance was then assessed using the Star Excursion Balance Test (SEBT) with each leg planted. Baseline balance was worse in LBP subjects (Berg 51/56) than Asymptomatic subjects (Berg 56/56) (p<0.01). SB significantly improved SEBT performance in LBP subjects regardless of which leg was planted (p<0.01). SB positively impacted Asymptomatic subjects' SEBT performance with the left leg planted (p=0.0002). The Serola Sacroiliac Belt positively impacted dynamic balance for subjects with low back pain. Further research is needed to examine additional interventions and outcomes related to balance in patients with back pain, and to elucidate the mechanisms behind improvements in balance related to sacroiliac belt utilization.

Greater Star Excursion Balance Test Performance in Thai Khon Masked Dancers Versus Nondancers.

The Khon masked dance drama is an authentic Thai classical performance that has been handed down for centuries. The performance has many unique choreographic patterns that are typical of the Southeast Asian performing arts. The Thai Khon masked dance consists of a combination of balance control and limb movement in different rhythms. The grace and beauty of Khon performances are dependent on the precision of the limb movement's curve, angle, and specific position. The connection between balance control and body movements during performance is crucial. The purpose of this study was to compare postural control between Thai Khon masked dancers and nondancers and explore bilateral asymmetry in postural control during single leg standing between the dominant and non -dominant legs using the Star Excursion Balance Test (SEBT). Thai Khon masked dancers (n = 25) and nondancers (n = 25) were asked to identify their dominant leg and perform the SEBT using both legs. The reaching distances in different directions from the SEBT were converted to a normalized distance for comparison. A mixed model ANOVA and t-test were applied to determine the differences between directions in both the dominant and non-dominant legs. The interaction between dancer and nondancer groups was also verified .The results showed that dancers performed better on SEBT than nondancers in all directions (p < 0.05). In conclusion, Thai Khon masked dancers demonstrated a superior ability to maintain dynamic postural control during the SEBT. When considering all directions together, the dominant side was not a factor that affected postural control during the SEBT. This study adds further supporting evidence that Khon masked dance training improves dynamic balance control and can possibly be applied as a recreational exercise to promote balance performance .

Does verbal encouragement change dynamic balance? The effect of verbal encouragement on Star Excursion Balance Test performance in chronic ankle Instability

BackgroundThe Star Excursion Balance Test (SEBT) is commonly used for testing dynamic balance in chronic ankle instability (CAI) in both clinical and research settings. However, the effect of verbal encouragement (VE) on the SEBT performance is not known. ObjectiveTo investigate the effects of VE on maximum reach distance performance between CAI and healthy participants on the SEBT. MethodThirty-four college-aged adults, 17 with CAI and 17 healthy controls, performed the SEBT in the anterior, posteromedial, and posterolateral reach directions. Independent variables (VE versus No-VE) and group (CAI versus healthy) were analyzed using Analysis of Variance (ANOVA) to determine whether VE and group affected reach performance. ResultsThere was a significant group-by-condition interaction (p = 0.02) for the anterior as well as for the posteromedial reach (p = 0.04). There was no statistically significant interaction (p = 0.48) for the posterolateral reach. There were moderate to large effect sizes in the reach distances found in the No-VE condition between the CAI and healthy controls, but with VE, the range of effect sizes from No-VE to VE were diminished. ConclusionThere was a significant group by condition interaction for anterior and posteromedial reaches which shows that providing VE resulted in a greater increase in performance for participants with CAI compared to healthy controls. Psychological constraints need to be considered while performing and interpreting the results of the SEBT.

Effect of 8-week treadmill running with peroneal muscle functional electrical stimulation on laterally deviated centre of plantar pressure position and star excursion balance test performance.

IntroductionAnkle sprain is a common injury that can have long-term sequelae resulting in pain, swelling and a reduction of physical activity participation. Previous research has shown a laterally deviated centre of pressure (COP) during running gait increases the risk of lateral ankle sprain. As a method of altering COP, electrical stimulation has been considered.MethodA group of 14 healthy males were randomly allocated to case control groups which were single blinded. The intervention involved an 8-week training programme of functional electrical stimulation to the peroneal muscles during treadmill running, with a sham control group. Outcomes were COP position and star excursion balance test. Statistical analysis was through SPSS using a combination of MANOVA, T-tests and Wilcoxon signed rankResultsThere was a significant difference in the results post intervention at max pressure for intervention M = 0.7(±0.7) and control M = −6.0 (±4.6) conditions; t(6) = −2.9, p < 0.05ConclusionIt has been demonstrated that FES can alter COP during max pressure in running gait after an 8-week training programme, although carry over effect appears limited and further testing is required.

Comparison of lower limb muscle activity during the dynamic balance test between baseball pitchers and healthy young adults

BACKGROUND: Dynamic balance is an essential factor for efficient pitching by baseball pitchers. OBJECTIVE: To compare distances reached and lower-extremity muscle activity during the star excursion balance test (SEBT) in baseball pitchers and healthy young adults. METHODS: Nineteen baseball pitchers (BPG) and 20 healthy adults (HAG) were recruited. Surface EMG was used to measure the activity of vastus medialis (VM), vastus lateralis (VL), tibialis anterior, and lateral gastrocnemius. RESULTS: The BPG exhibited greater dynamic balance than in the HAG (p&lt; 0.05) in the posteromedial (PM) and posterolateral (PL) directions. For the PM and PL directions, significantly greater muscle activity of VM and VL was found in the BPG than in the HAG (p&lt; 0.05). CONCLUSION: SEBT performance is characterized by high-level VM and VL muscle activities. Neuromuscular control of knee extensors, such as the VM and VL of pitchers, might affect the dynamic balance measured by the SEBT.

Star Excursion Balance Test (SEBT): Comparison of Results with and without Neuromuscular Ankle Bandage

Study Design: Prospective study, simple crossover design. Background: Proprioception is a cornerstone for maintaining joint and postural stability. Dynamic stability is particularly emphasized within these components. This feature is important in the rehabilitation field. Therefore, the quest for elements to improve these values ​​can bring advantages in sports. Objectives: Evaluate if there are advantages in the performance of a Star Excursion Balance Test (SEBT) using Kinesio taping. Methods: We evaluated 10 professional soccer players from the Chilean women’s national team. They were randomly divided into 2 groups. One group had Kinesio taping and their SEBT performance was evaluated. The other group performed the measurements without the use of Kinesio Taping. Afterward, each group performed the evaluation they did not do during the first stage. We then compared the performance achieved with and without the use of Kinesio Taping Results: There were significant differences in the performance achieved by the players who had the SEBT bandage applied in comparison to the players that did no. This was confirmed by using the non-parametric Wilcox test for each of the SEBT positions. Conclusions: Kinesio taping has positive implications in the SEBT. We can extrapolate that its use can improve the dynamic balance and thus become an important pillar in sports rehabilitation.

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.

Foot impairments contribute to functional limitation in individuals with ankle sprain and chronic ankle instability.

To investigate the clinical measures of foot posture and morphology, multisegmented joint motion and play, strength, and dynamic balance in recreationally active young adults with and without a history of a lateral ankle sprain (LAS), copers, and chronic ankle instability (CAI). Eighty recreationally active individuals (healthy: n = 22, coper: n = 21, LAS: n = 17, CAI: n = 20) were included. Foot posture index (FPI), morphologic measures, joint motion (weight-bearing dorsiflexion (WBDF), rearfoot dorsiflexion, plantar flexion, inversion, eversion; forefoot inversion, eversion; hallux flexion, extension), joint play (proximal and distal tibiofibular; talocrural and subtalar, forefoot; 1st tarsometatarsal and metatarsophalangeal), strength (dorsiflexion, plantar flexion, inversion, eversion, hallux flexion, lesser toe flexion), and Star Excursion Balance Test (SEBT) (anterior, posteromedial, posterolateral) were assessed. There were no group differences in FPI or morphological measures. LAS and CAI groups had decreased ankle dorsiflexion (p = 0.001) and greater frontal plane motion (p < 0.001), first MT plantar flexion, and sagittal excursion (p < 0.001); increased talocrural glide (p = 0.02) and internal rotation (p < 0.001) and decreased forefoot inversion joint play (p < 0.001); and decreased strength in all measures (p < 0.001) except dorsiflexion compared to healthy controls. The LAS group also demonstrated decreased distal tibiofibular (p = 0.04) and forefoot general laxity (p = 0.05) and SEBT performance (anterior: p = 0.02; posteromedial: p < 0.001; posterolateral: p < 0.001). Individuals with LAS or CAI have increased pain, impaired physiologic and accessory joint motion, ligamentous tenderness, and strength in the foot and ankle. Clinicians should assess the multiple segments of the ankle-foot complex when caring for individuals with an LAS or CAI. II.

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.

Profiling and predicting performance of indoor rock climbers

The aim of this study is to establish somatotype and profile the anthropometric and biomotor characteristics of indoor rock climbers. Fourteen elite level male and ten recreational female Iranian indoor rock climbers completed a battery of tests. All anthropometric measurements were performed according to the recommendations of international standards for anthropometric assessment. Upper body strength and endurance were assessed by isometric tests. Explosive power and balance were also evaluated by Sargent jump and Star Excursion Balance Test (SEBT), respectively. Samples’ somatotypes were calculated by the method of Heath and Carter. Pearson’s correlation coefficient and partial correlations were calculated and stepwise multiple regression analyses were implemented to determine a set of best predictors of elite male climbers’ ability. Shoulder width, body fat content, upper-body strength and endurance for females, showed the most correlation with the climbing ability (range: r = 0.46–0.7, p ≤ 0.05), while among the male samples, these correlations with the climbing ability were mostly between WHR, absolute and relative to body mass handgrip strength, SEBT performance and the left-hand digit ratio. The results of stepwise multiple regression revealed that the SEBT performance in the posterior direction of right foot stance and Upper Extremity Girth Index are able to explain 62% of the variance of climbing ability. It is likely that decreasing the fat mass has no direct impact on the climbers’ performance. Also, SEBT performance is able to predict 35% of climbing performance. Hence, it seems balance exercises could be effective in improvement of climbing performance.

Kinect-based assessment of lower limb kinematics and dynamic postural control during the star excursion balance test

Assessments using dynamic postural control tests, like the Star Excursion Balance Test (SEBT), in combination with three-dimensional (3D) motion analysis can yield critical information regarding a subject’s lower limb movement patterns. 3D analysis can provide a clear understanding of the mechanisms that lead to specific outcome measures on the SEBT. Currently, the only technology for 3D motion analysis during such tests is expensive marker-based motion analysis systems, which are impractical for use in clinical settings. In this study we validated the use of the Microsoft Kinect as a cost-effective and marker-less alternative to more complex and expensive gold-standard motion analysis systems. Ten healthy subjects performed the SEBT while their lower limb kinematics were measured concurrently using a traditional motion capture system and a single Kinect v2 sensor. Analyses revealed errors in lower limb kinematics of less than 5°, except for the knee frontal-plane angle (5.7°) in the posterior-lateral direction. Ensemble curve analyses supported these findings, showing minimal between-system differences in all directions. Additionally, we found that the Kinect displayed excellent agreement (ICC3,k=0.99) and consistency (ICC2,k=0.99) when assessing reach distances in all directions. These results indicate that this low-cost and easy to implement technology may provide to clinicians a simple tool to simultaneously assess reach distances while developing a clearer understanding of the lower extremity movement patterns associated with SEBT performance in healthy and injured populations.

Associations Between Functional and Isolated Performance Measures in College Women's Soccer Players.

The Star Excursion Balance Test (SEBT) and Functional Movement Screen (FMS) are functional performance measures capable of predicting lower-extremity injury risk. While suboptimal SEBT and FMS performances are influenced by multiple factors, the contribution of hip strength and flexibility to these tests is mostly unknown. Examination of hip strength and flexibility influences on the SEBT and FMS may direct clinicians to better methods of correcting functional deficits. Determine the relationships of isometric hip strength and hip passive range of motion (PROM) with functional performance measures. Cross-sectional. Athletic training facility. 43 NCAA Division I women's soccer players (19.65 ± 1.12 y; 166.93 ± 3.84 cm; 60.99 ± 4.31 kg) volunteered. All participants were tested bilaterally in the SEBT; the deep squat, in-line lunge, hurdle step, and straight leg raise, comprising a lower-extremity FMS (FMS-LE); hip internal and external rotation PROM; and isometric hip extension strength (HEXT). The mean of the 3 averaged, normalized SEBT scores was used as a composite score. Pearson product moment correlations assessed relationships of SEBT and FMS-LE scores with PROM and HEXT. Significance was set a priori at P < .05. Pearson correlations revealed anterior (ANT) SEBT scores had a low negative association with HEXT (r = -0.33,P = .004) and a low positive association with hip internal rotation PROM (PROM-IR) (r = .43,P = .003). All other correlations were negligible. Flexibility training aimed at PROM-IR may contribute to improved ANT scores. Targeting HEXT and hip external rotation PROM are likely not preferred means of correcting deficits in SEBT and FMS-LE performance.

Lower-Extremity Muscle Activity, Kinematics, and Dynamic Postural Control in Individuals With Patellofemoral Pain

Altered lower-extremity muscle activity has been associated with lower-extremity kinematics in individuals with patellofemoral pain (PFP). However, few studies have examined these relationships, and the results are inconsistent. To compare the lower-extremity muscle activity, kinematics, pain level, and reach distance during the anterior reach of the star excursion balance test (SEBT) between participants with PFP and healthy individuals (control [CON] group). Case control. Research laboratory. Twenty-eight (PFP = 14 and CON = 14) participants volunteered. Each participant performed 3 maximal voluntary isometric contractions of the gluteus maximus, gluteus medius (GMED), adductor longus (AL), and vastus medialis, and 5 anterior reaches of the SEBT. Three-dimensional joint kinematics of the hip and knee at the time of touchdown of the SEBT and integrated electromyography of each muscle were recorded during the descent phase of the SEBT. Coactivation ratios between the GMED and AL were calculated (GMED/AL). Pain level was assessed at the baseline and during performance of the SEBT, using a visual analog scale. Participants with PFP demonstrated decreased GMED/AL coactivation ratio (P = .01) and shorter reach distance (P = .01) during anterior reach of the SEBT compared with the CON group. Participants with PFP demonstrated higher pain levels at baseline (P = .03) and during test performance (P < .001) compared with the CON group and increased pain level during the test performance compared with the baseline (P < .001). No other significant differences were observed. There were alterations in muscle activity during SEBT performance, suggesting that overactivity of AL relative to GMED is a unique neural recruitment pattern in those with PFP. However, hip and knee joint kinematics did not seem to contribute to deficits in the anterior reach distance, suggesting a need for continued assessment of these deficiencies.

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.

An anterior cruciate ligament injury does not affect the neuromuscular function of the non-injured leg except for dynamic balance and voluntary quadriceps activation

PurposeThe function of the anterior cruciate ligament (ACL) patients’ non-injured leg is relevant in light of the high incidence of secondary ACL injuries on the contralateral side. However, the non-injured leg’s function has only been examined for a selected number of neuromuscular outcomes and often without appropriate control groups. We measured a broad array of neuromuscular functions between legs of ACL patients and compared outcomes to age, sex, and physical activity matched controls.MethodsThirty-two ACL-deficient patients (208 ± 145 days post-injury) and active and less-active controls (N = 20 each) participated in the study. We measured single- and multi-joint neuromuscular function in both legs in each group and expressed the overall neuromuscular function in each leg by calculating a mean z-score across all neuromuscular measures. A group by leg MANOVA and ANOVA were performed to examine group and leg differences for the selected outcomes.ResultsAfter an ACL injury, duration (−4.3 h/week) and level (Tegner activity score of −3.9) of sports activity decreased and was comparable to less-active controls. ACL patients showed bilateral impairments in the star excursion balance test compared to both control groups (P ≤ 0.004) and for central activation ratio compared to active controls (P ≤ 0.002). There were between-leg differences within each group for maximal quadriceps and hamstring strength, voluntary quadriceps activation, star excursion balance test performance, and single-leg hop distance (all P < 0.05), but there were no significant differences in quadriceps force accuracy and variability, knee joint proprioception, and static balance. Overall neuromuscular function (mean z-score) did not differ between groups, but ACL patients’ non-injured leg displayed better neuromuscular function than the injured leg (P < 0.05).ConclusionsExcept for poorer dynamic balance and reduced quadriceps activation, ACL patients had no bilateral neuromuscular deficits despite reductions in physical activity after injury. Therapists can use the non-injured leg as a reference to assess the injured leg’s function for tasks measured in the present study, excluding dynamic balance and quadriceps activation. Rehabilitation after an ACL injury should be mainly focused on the injured leg.Level of evidenceIII.

Kinematic predictors of star excursion balance test performance in individuals with chronic ankle instability

BackgroundThe Star Excursion Balance Test has identified dynamic postural control deficits in individuals with chronic ankle instability. While kinematic predictors of Star Excursion Balance Test performance have been evaluated in healthy individuals, this has not been thoroughly examined in individuals with chronic ankle instability. MethodsFifteen individuals with chronic ankle instability completed the anterior reach direction of the Star Excursion Balance Test and weight-bearing dorsiflexion assessments. Maximum reach distances on the Star Excursion Balance Test were measured in cm and normalized to leg length. Three-dimensional trunk, hip, knee, and ankle motion of the stance limb were recorded during each anterior reach trial using a motion capture system. Sagittal, frontal, and transverse plane displacement observed from trial initiation to the point of maximum reach was calculated for each joint or segment and averaged for analysis. Pearson product–moment correlations were performed to examine the relationships between kinematic variables, maximal reach, and weight-bearing dorsiflexion. A backward multiple linear regression model was developed with maximal reach as the criterion variable and kinematic variables as predictors. FindingsFrontal plane displacement of the trunk, hip, and ankle and sagittal plane knee displacement were entered into the analysis. The final model (p=0.004) included all three frontal plane variables and explained 81% of the variance in maximal reach. Maximal reach distance and several kinematic variables were significantly related to weight-bearing dorsiflexion. InterpretationIndividuals with chronic ankle instability who demonstrated greater lateral trunk displacement toward the stance limb, hip adduction, and ankle eversion achieved greater maximal reach.

Variations in Star Excursion Balance Test Performance Between High School and Collegiate Football Players.

The Star Excursion Balance Test (SEBT) is a reliable inexpensive tool used to assess dynamic postural control deficits and efficacy in the prediction of musculoskeletal injuries, but with little previous consideration for performance differences across age and skill levels. The purpose of this study was to examine differences in SEBT scores between high school and collegiate football players. Three-hundred eighteen high school football players and 180 National Collegiate Athletic Association Division I collegiate football players volunteered to participate. Star Excursion Balance Test scores were obtained bilaterally for anterior (ANT), posterolateral (PL), and posteromedial (PM) directions, and for an overall composite (COMP) score. The mean of 3 trials from each leg was normalized to stance leg length and presented as a percentage score. Bilaterally averaged scores were compared between high school and collegiate football players using separate independent t-tests. A multiple linear backward regression determined the amount of variance in SEBT scores explained by age, mass, and height. Compared with collegiate athletes, high school athletes had lower PL (72.8 ± 11.4% vs. 77.1 ± 10.2%; p < 0.001), PM (83.5 ± 10.2% vs. 86.7 ± 10.7%; p = 0.001), and COMP (75.4 ± 8.5% vs. 78.0 ± 7.4%; p = 0.001) scores. Anterior scores did not differ between high school (69.9 ± 7.9%) and collegiate (70.3 ± 7.1%) athletes (p = 0.545). Age, mass, and height were not meaningful contributors to ANT (R = 0.089; p < 0.001), PL (R = 0.032; p < 0.001), PM (R = 0.030; p = 0.002), and COMP (R = 0.048; p < 0.001) variances. Disparity between high school and collegiate athletes should be considered when using the SEBT to identify risk of or deficits related to lower extremity injury in football players.

The Association between Foot Morphology and Dynamic Balance Performance as Measured by the Star Excursion Balance Test

The purposes of this descriptive study were to explore the association between foot morphology, severity of past injuries and Star Excursion Balance Test (SEBT) performance in recreational runners. We interviewed 20 healthy recreational runners (aged 23-58 years) about their running habits and history of injuries. We calculated arch height index, a measure of foot morphology, from their static footprint. Participants performed the SEBT. Participants with lower medial longitudinal foot arch reached significantly farther on all SEBT directions except for anterolateral. The Spearman correlation (Rs) between arch index and those 7 directions ranged from 0.455 to 0.617 (p values ranging from 0.01 to 0.05). Severity of injuries in the past was not associated with SEBT performance. Assessing parameters that are associated with balance performance can help therapists to understand the underlying impairments leading to decreased or enhanced dynamic balance performance. Researchers and clinicians need to be aware of potential differences in dynamic balance performance in individuals with different foot morphologies.

Star Excursion Balance Test Performance Varies by Sport in Healthy Division I Collegiate Athletes.

Cross-sectional. To describe performance and asymmetry on the Star Excursion Balance Test (SEBT) by sex and sport, and to determine if differences exist within a collegiate athlete population. Performance on the SEBT may differ between sexes and levels of competition, though the results of previous studies have been inconsistent. Investigation of performance and asymmetry differences between sports is limited. Sex- and sport-specific reference values likely need to be determined to best assess SEBT performance. Performance on the SEBT was retrospectively reviewed in 393 healthy National Collegiate Athletic Association Division I collegiate athletes from 8 sports. Means, standard deviations, and 95% confidence intervals were calculated for all variables. Normalized reach distance (percent limb length) and asymmetry between limbs were compared for the anterior (ANT), posterolateral (PL), and posteromedial (PM) directions and for the composite (COMP) score using a 2-way analysis of variance (ANOVA) of sex by sport, and a 1-way ANOVA to separately compare sports within each sex. Average normalized reach distance ranged from 62% to 69%, 84% to 97%, and 99% to 113% in the ANT, PL, and PM directions, respectively, and from 82% to 92% in the COMP score. Normalized asymmetry ranged from 3% to 4%, 5% to 8%, and 5% to 6% in the ANT, PL, and PM directions, respectively. A significant sex-by-sport interaction (P = .039) was observed in the ANT direction, with a sex effect for soccer players (P<.001; men less than women). Significant differences were observed in the PL and PM directions and in the COMP score among women's teams, with women's ice hockey players reaching the farthest (COMP, 90.0%). Among men's teams, significant differences were observed in all directions and in the COMP score. Men's ice hockey players (COMP, 91.9%) and wrestlers achieved the farthest distances (COMP, 88.8%). Performance on the SEBT varies by team, with a difference between sexes also present for soccer. Performance on the SEBT and potential injury risk should be interpreted within the context of the athlete's sport.

The Relationship Between A Measure Of Dynamic Balance And A Movement Assessment

The Star Excursion Balance Test (SEBT) is a valid and reliable dynamic balance test commonly used to identify functional deficits associated with lower extremity injury. Movement assessments are also used clinically to identify risk factors for injury. Predictive factors for decreased SEBT performance are unknown and identification of such factors would provide clinically useful information for injury prevention. It is hypothesized that postural deviations observed during a movement assessment would be contributing factors to dynamic balance deficits. PURPOSE: To determine the relationship between dynamic balance and a movement assessment in an effort to identify risk factors for decreased SEBT performance. METHODS: A single group study was performed in a university clinical setting with 47 division-I track and field athletes (male=25, female=22; age, 20.8±1.2 years; mass, 71.3±15.7 kg; height, 176.3±9.3 cm). All subjects underwent the SEBT (anteromedial, medial, posterior reach directions) and a movement assessment consisting of a single-leg and an overhead squat. Correlation (rpb) coefficients were calculated to determine the relationship between normalized SEBT reach distances and dichotomously scored movement assessment scores indicating the presence/absence of postural deviations at four kinetic chain checkpoints (foot/ankle, knee, lumbo-pelvic-hip complex, shoulder/c-spine). Inter-tester reliability of the movement assessment was also determined using percent agreement. RESULTS: A negative relationship reflecting a medium effect size was found between SEBT posterior reach and forward falling of the arms during the overhead squat (r = -.23, p = .03). Anteromedial SEBT reach was negatively correlated with rounding of the low back during the overhead squat (r = -.24, p = .02). Using squats as a movement assessment demonstrated fair to good percent agreement amongst raters (r =.76 - .99). CONCLUSION: We demonstrated that postural deviations in the proximal kinetic chain during an overhead squat are associated with decreased SEBT performance. These results provide some evidence for proximal chain involvement in decreased dynamic balance scores and lower extremity injury risk and support the incorporation of the proximal chain into clinical injury assessment and prevention efforts.