Context: A dynamic postural-control task that has gained notoriety in the clinical and research settings is the Star Excursion Balance Test (SEBT). Researchers have suggested that, with appropriate instruction and practice by the individual and normalization of the reaching distances, the SEBT can be used to provide objective measures to differentiate deficits and improvements in dynamic postural-control related to lower extremity injury and induced fatigue, and it has the potential to predict lower extremity injury. However, no one has reviewed this body of literature to determine the usefulness of the SEBT in clinical applications.Objective: To provide a narrative review of the SEBT and its implementation and the known contributions to task performance and to systematically review the associated literature to address the SEBT's usefulness as a clinical tool for the quantification of dynamic postural-control deficits from lower extremity impairment.Data Sources: Databases used to locate peer-reviewed articles published from 1980 and 2010 included Derwent Innovations Index, BIOSIS Previews, Journal Citation Reports, and MEDLINE.Study Selection: The criteria for article selection were (1) The study was original research. (2) The study was written in English. (3) The SEBT was used as a measurement tool.Data Extraction: Specific data extracted from the articles included the ability of the SEBT to differentiate pathologic conditions of the lower extremity, the effects of external influences and interventions, and outcomes from exercise intervention and to predict lower extremity injury.Data Synthesis: More than a decade of research findings has established a comprehensive portfolio of validity for the SEBT, and it should be considered a highly representative, noninstrumented dynamic balance test for physically active individuals. The SEBT has been shown to be a reliable measure and has validity as a dynamic test to predict risk of lower extremity injury, to identify dynamic balance deficits in patients with a variety of lower extremity conditions, and to be responsive to training programs in both healthy people and people with injuries to the lower extremity. Clinicians and researchers should be confident in employing the SEBT as a lower extremity functional test.
The Functional Movement Screen (FMS) is a series of 7 tests that categorize fundamental movement. Each test is scored on an ordinal scale with 4 categories. The purpose of this study was to determine the interrater reliability of the FMS. Forty healthy subjects were videotaped while performing the FMS. The videos were independently scored by 4 raters, including 2 experts who instruct FMS training courses and 2 novices who completed a standardized training course on the FMS. Interrater reliability was analyzed using the weighted kappa statistic. The novice raters demonstrated excellent or substantial agreement on 14 of the 17 tests, whereas the expert raters did the same on 13 of the 17 tests. When the novice raters were paired with the expert raters, all 17 components demonstrated excellent or substantial agreement. These data indicate that the FMS can confidently be applied by trained individuals. This would suggest that the FMS can be confidently used to assess the movement patterns of athletes and to make decisions related to interventions for performance enhancement, and the FMS may assist in identifying athletes at risk for injury.
Testing balance and fall risk with older adults of varying abilities is of increasing importance. The primary aim of this study was to evaluate the validity of the lower quarter Y-balance test (YBT-LQ) in older adults. A secondary aim was to provide estimates of reliability with this population. A total of 30 male (n = 15) and female (n = 15) subjects (66.8 ± 6.5 years) performed the YBT-LQ, 30-s chair stand test, 8-foot up and go test, timed up and go test, single-leg stance, and Activities-Specific Balance Confidence Scale questionnaire. The YBT-LQ was performed on two separate occasions by two investigators in random order. YBT-LQ was significantly correlated with age (p < .01), timed up and go test (p = .003), 8-foot up and go test (p < .001), 30-s chair stand test (p < .001), Activities-Specific Balance Confidence Scale (p = .002), and single-leg stance (p = .005) performance. The intraclass correlation coefficient(3,1) score for the reliability of the YBT-LQ was .95 (95% confidence interval [.89, .97]). The YBT-LQ appears to be a valid and reliable assessment to use with older adults.
BackgroundMusculoskeletal injuries are a primary source of disability in the US Military, and low back pain and lower extremity injuries account for over 44% of limited work days annually. History of prior musculoskeletal injury increases the risk for future injury. This study aims to determine the risk of injury after returning to work from a previous injury. The objective is to identify criteria that can help predict likelihood for future injury or re-injury.MethodsThere will be 480 active duty soldiers recruited from across four medical centres. These will be patients who have sustained a musculoskeletal injury in the lower extremity or lumbar/thoracic spine, and have now been cleared to return back to work without any limitations. Subjects will undergo a battery of physical performance tests and fill out sociodemographic surveys. They will be followed for a year to identify any musculoskeletal injuries that occur. Prediction algorithms will be derived using regression analysis from performance and sociodemographic variables found to be significantly different between injured and non-injured subjects.DiscussionDue to the high rates of injuries, injury prevention and prediction initiatives are growing. This is the first study looking at predicting re-injury rates after an initial musculoskeletal injury. In addition, multivariate prediction models appear to have move value than models based on only one variable. This approach aims to validate a multivariate model used in healthy non-injured individuals to help improve variables that best predict the ability to return to work with lower risk of injury, after a recent musculoskeletal injury.Trial registration numberNCT02776930.
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