The Star Excursion Balance Test: An Update Review and Practical Guidelines

Author(s):  
Brice Picot ◽  
Romain Terrier ◽  
Nicolas Forestier ◽  
François Fourchet ◽  
Patrick O. McKeon

The Star Excursion Balance Test (SEBT) is a reliable, responsive, and clinically relevant functional assessment of lower limbs’ dynamic postural control. However, great disparity exists regarding its methodology and the reported outcomes. Large and specific databases from various population (sport, age, and gender) are needed to help clinicians when interpreting SEBT performances in daily practice. Several contributors to SEBT performances in each direction were recently highlighted. The purpose of this clinical commentary is to (a) provide an updated review of the design, implementation, and interpretation of the SEBT and (b) propose guidelines to standardize SEBT procedures for better comparisons across studies.

2012 ◽  
Vol 47 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Hayley Ericksen ◽  
Phillip A. Gribble

Context: Hormonal fluctuation as a risk factor in anterior cruciate ligament injury has been investigated with conflicting results. However, the influence of hormone fluctuations on ankle laxity and function has not been thoroughly examined. Objective: To examine the potential hormone contributions to ankle laxity and dynamic postural control during the preovulatory and postovulatory phases of the menstrual cycle using an ankle arthrometer and the Star Excursion Balance Test in healthy women. The cohort group consisted of male control participants. Design: Cohort study. Setting: Research laboratory. Patients or Other Participants: Twenty healthy women (age = 23.8 ± 6.50 years, height = 163.88 ± 8.28 cm, mass = 63.08 ± 12.38 kg) and 20 healthy men (age = 23.90 ± 4.15 years, height = 177.07 ± 7.60 cm, mass = 80.57 ± 12.20 kg). Intervention(s): Ankle stability was assessed with anterior-posterior and inversion-eversion loading. Dynamic postural control was assessed with the posteromedial reaching distance of the Star Excursion Balance Test. Main Outcome Measure(s): Female participants used ovulation kits for 3 months to determine the time of ovulation; during their preovulatory and postovulatory phases, they were tested in the laboratory with an ankle arthrometer and the Star Excursion Balance Test. Male participants were tested on similar dates as controls. For each dependent variable, a time by side by sex repeated-measures analysis of variance was performed. Statistical significance was set a priori at P < .05. Results: For anterior-posterior laxity, a side main effect was noted (F1,38 = 10.93, P = .002). For inversion-eversion laxity, a sex main effect was seen (F1,38 = 10.75, P = .002). For the posteromedial reaching task, a sex main effect was demonstrated (F1,38 = 8.72, P = .005). No influences of time on the dependent variables were evident. Conclusions: Although women presented with more ankle inversion-eversion laxity and less dynamic postural control, hormonal fluctuations during the menstrual cycle (preovulatory compared with postovulatory) did not affect ankle laxity or dynamic postural control, 2 factors that are associated with ankle instability.


2009 ◽  
Vol 18 (2) ◽  
pp. 240-257 ◽  
Author(s):  
Phillip A. Gribble ◽  
Richard H. Robinson ◽  
Jay Hertel ◽  
Craig R. Denegar

Context:Deficits in static postural control related to fatigue have been investigated previously, but there is little evidence to link fatigue to performance measures of dynamic postural control.Objective:To investigate the effects of fatigue and gender on performance measures of the Star Excursion Balance Test (SEBT).Design:Mixed-model design.Setting:Research laboratory.Participants:16 healthy young adults.Intervention:Subjects performed the SEBT before and after 4 different fatiguing conditions.Main Outcome Measures:The normalized reach distances and sagittal-plane kinematics of the knee and hip were recorded.Results:Fatigue produced deficits in normalized reach distances and decreased knee flexion in all 3 reaching directions. Overall, women were able to reach farther than men while simultaneously demonstrating a greater amount of knee flexion.Conclusions:Gender differences were observed during performance of the SEBT, with women demonstrating greater reach distances and knee flexion, and fatigue amplified these differences.


2016 ◽  
Vol 21 (6) ◽  
pp. 33-39 ◽  
Author(s):  
Tyler R. Keith ◽  
Tara A. Condon ◽  
Ayana Phillips ◽  
Patrick O. McKeon ◽  
Deborah L. King

The Star Excursion Balance Test (SEBT) is a valid and reliable measure of dynamic postural control. Center of pressure (COP) behavior during the SEBT could provide additional information about direction-dependent SEBT balance strategies. The purpose of this study was to quantify spatiotemporal COP differences using COP area and velocity among three different SEBT reach directions (anterior, posteromedial, posterolateral). The anterior direction COP velocity was significantly lower than both posterior directions. However, the anterior COP area was significantly greater than posterior. Based on COP behavior, the anterior and posterior reach directions appear to use different postural control strategies on the SEBT.


2015 ◽  
Vol 50 (6) ◽  
pp. 651-664 ◽  
Author(s):  
Cailbhe Doherty ◽  
Chris M. Bleakley ◽  
Jay Hertel ◽  
Brian Caulfield ◽  
John Ryan ◽  
...  

Context No researchers, to our knowledge, have investigated the immediate postinjury-movement strategies associated with acute first-time lateral ankle sprain (LAS) as quantified by center of pressure (COP) and kinematic analyses during performance of the Star Excursion Balance Test (SEBT). Objective To analyze the kinematic and COP patterns of a group with acute first-time LAS and a noninjured control group during performance of the SEBT. Design Case-control study. Setting University biomechanics laboratory. Patients or Other Participants A total of 81 participants with acute first-time LAS (53 men, 28 women; age = 23.22 ± 4.93 years, height = 1.73 ± 0.09 m, mass = 75.72 ± 13.86 kg) and 19 noninjured controls (15 men, 4 women; age = 22.53 ± 1.68 years, height = 1.74 ± 0.08 m, mass = 71.55 ± 11.31 kg). Intervention Participants performed the anterior (ANT), posterolateral (PL), and posteromedial (PM) reach directions of the SEBT. Main Outcome Measure(s) We assessed 3-dimensional kinematics of the lower extremity joints and associated fractal dimension (FD) of the COP path during performance of the SEBT. Results The LAS group had decreased normalized reach distances in the ANT, PL, and PM directions when compared with the control group on their injured (ANT: 58.16% ± 6.86% versus 64.86% ± 5.99%; PL: 85.64% ± 10.62% versus 101.14% ± 8.39%; PM: 94.89% ± 9.26% versus 107.29 ± 6.02%) and noninjured (ANT: 60.98% ± 6.74% versus 64.76% ± 5.02%; PL: 88.95% ± 11.45% versus 102.36% ± 8.53%; PM: 97.13% ± 8.76% versus 106.62% ± 5.78%) limbs (P < .01). This observation was associated with altered temporal sagittal-plane kinematic profiles throughout each reach attempt and at the point of maximum reach (P < .05). This result was associated with a reduced FD of the COP path for each reach direction on the injured limb only (P < .05). Conclusions Acute first-time LAS was associated with bilateral deficits in postural control, as evidenced by the bilateral reduction in angular displacement of the lower extremity joints and reduced reach distances and FD of the COP path on the injured limb during performance of the SEBT.


2020 ◽  
pp. 1-6
Author(s):  
Emily H. Gabriel ◽  
Cameron J. Powden ◽  
Matthew C. Hoch

Context: The Y-Balance Test (YBT) and Star Excursion Balance Test (SEBT) are commonly used to detect deficits in dynamic postural control. There is a lack of literature on the differences in reach distances and efficiency of the tests. Objective: To compare the reach distances of the YBT and SEBT. An additional aim was to compare the time necessary to administer the 2 tests and utilize a discrete event simulation to determine the number of participants who could be screened within different scenarios. Design: Cross-sectional. Laboratory Patients: Twenty-four physically active individuals between the ages of 18–35 years volunteered to participate in this study (M/F: 11/13; age 22.78 [2.63] y, height 68.22 [4.32] cm, mass 173.27 [10.96] kg). Intervention: The participants reported to the laboratory on one occasion and performed the YBT and SEBT. The anterior, posteromedial, and posterolateral reach distances were recorded for each test. In addition, the time to administer each test was recorded in seconds. Main Outcome Measures: The average reach distances and time for each test were used for analysis. Paired t tests were utilized to compare the reach distances and time to administer the 2 tests. A discrete event simulation was used to determine how many participants could be screened using each test. Results: The anterior reach for the SEBT (64.52% [6.07%]) was significantly greater than the YBT (61.66% [6.37%]; P < .01). The administration time for the YBT (512.42 [123.97] s) was significantly longer than the administration time for the SEBT (364.96 [69.46] s; P < .01). The discrete event simulation revealed more participants could be screened using the SEBT when compared with the YBT for every situation. Conclusion: Scores on the anterior reach of the SEBT are larger when compared with the YBT. The discrete event simulation can successfully be used to determine how many participants could be screened with a certain amount of resources given the use of a specific test.


2008 ◽  
Vol 17 (4) ◽  
pp. 347-357 ◽  
Author(s):  
Richard Robinson ◽  
Phillip Gribble

Context:The Star Excursion Balance Test (SEBT) is composed of 8 reaching directions that are potentially measuring the same functional component, leading to the suggestion that the number of reach directions could be reduced without compromising the assessment of dynamic postural control.Objective:To determine whether the relationship of stance-leg angular displacement on normalized reach distance is a source of dynamic-postural-control measurement redundancy.Design:Single-session within-subjects design.Setting:Athletic training research laboratory.Participants:10 women and 10 men.Interventions:None.Main Outcome Measures:Normalized reach distance and angular displacement at the knee and hip.Results:Stepwise regression revealed that hip flexion and knee flexion, separately and in combination, accounted for 62% to 95% of the variance in reach distances.Conclusion:Similarity in lower extremity function could account for the previously observed measurement redundancy in the SEBT.


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