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

Background: Chronic ankle instability as a prevalent consequence of ankle sprain causes various impairments such as balance and postural control deficits. Foot orthoses are one of the common interventions for rehabilitation of patients with chronic ankle instability. Objectives: To investigate the effect of custom-molded foot orthoses with textured surfaces on dynamic balance of chronic ankle instability patients and to compare their effects with other types of foot orthoses. Study design: This is a repeated measure design. Methods: A total of 30 participants were recruited based on the guideline introduced by the International Ankle Consortium. The effect of prefabricated, custom-molded, and custom-molded with textured surface foot orthoses was evaluated on dynamic balance by the Star Excursion Balance Test. Normalized reach distances in anteromedial, medial, and posteromedial directions of the test were computed to be used for statistical analysis. Results: The foot orthoses increased reach distances compared to the no-orthosis conditions in all three directions. The custom-molded with textured surface foot orthosis has significant differences compared with prefabricated foot orthosis ( p = 0.001) in all measured directions and with custom-molded foot orthosis ( p < 0.01) in medial and posteromedial directions. Conclusion: Foot orthoses improve reach distances in patients with chronic ankle instability. Custom-molded with textured surface foot orthosis has a more pronounced effect compared with other foot orthoses. Clinical relevance The custom-molded foot orthosis with textured surface could be an effective device to improve dynamic balance in chronic ankle instability (CAI) patients. It may be considered as an efficient intervention to reduce ankle sprain recurrence in these individuals, although further research should be conducted.

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

Clinical Biomechanics ◽

10.1016/j.clinbiomech.2016.04.008 ◽

2016 ◽

Vol 35 ◽

pp. 37-41 ◽

Cited By ~ 9

Author(s):

Matthew C. Hoch ◽

Stacey L. Gaven ◽

Joshua T. Weinhandl

Keyword(s):

Test Performance ◽

Ankle Instability ◽

Chronic Ankle Instability ◽

Balance Test ◽

Star Excursion Balance Test

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Contributing factors to Star Excursion Balance Test performance in individuals with chronic ankle instability

Gait & Posture ◽

10.1016/j.gaitpost.2015.03.013 ◽

2015 ◽

Vol 41 (4) ◽

pp. 912-916 ◽

Cited By ~ 28

Author(s):

Michael L. Gabriner ◽

Megan N. Houston ◽

Jessica L. Kirby ◽

Matthew C. Hoch

Keyword(s):

Test Performance ◽

Ankle Instability ◽

Chronic Ankle Instability ◽

Contributing Factors ◽

Balance Test ◽

Star Excursion Balance Test

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Erratum: Harkey et al (2014)

Journal of Sport Rehabilitation ◽

10.1123/jsr.2015-0084 ◽

2015 ◽

Vol 24 (2) ◽

pp. 197

Keyword(s):

Range Of Motion ◽

Ankle Instability ◽

Dynamic Balance ◽

Chronic Ankle Instability ◽

Correct Version ◽

Balance Test ◽

Neural Excitability ◽

Joint Mobilization ◽

Star Excursion Balance Test

In Table 2 in the article by Harkey M, McLeod M, Van Scoit A, et al, “The Immediate Effects of an Anterior-to-Posterior Talar Mobilization on Neural Excitability, Dorsiflexion Range of Motion, and Dynamic Balance in Patients With Chronic Ankle Instability,” in J Sport Rehabil. 23(4):351–359, the composite and anterior scores for the Star Excursion Balance Test in the joint-mobilization group were transposed. Printed here is the correct version of the table.

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Trunk-Rotation Differences at Maximal Reach of the Star Excursion Balance Test in Participants With Chronic Ankle Instability

Journal of Athletic Training ◽

10.4085/1062-6050-49.3.74 ◽

2015 ◽

Vol 50 (4) ◽

pp. 358-365 ◽

Cited By ~ 16

Author(s):

Sarah de la Motte ◽

Brent L. Arnold ◽

Scott E. Ross

Keyword(s):

Test Performance ◽

Sports Medicine ◽

Ankle Instability ◽

Chronic Ankle Instability ◽

Trunk Rotation ◽

Trunk Flexion ◽

Balance Test ◽

Medicine Research ◽

3 Dimensional ◽

Star Excursion Balance Test

Context Functional reach on the Star Excursion Balance Test is decreased in participants with chronic ankle instability (CAI). However, comprehensive 3-dimensional kinematics associated with these deficits have not been reported. Objective To determine if lower extremity kinematics differed in CAI participants during anteromedial, medial, and posteromedial reach on the Star Excursion Balance Test. Design Case-control study. Setting Sports medicine research laboratory. Patients or Other Participants Twenty CAI participants (age = 24.15 ± 3.84 years, height = 168.95 ± 11.57 cm, mass = 68.95 ± 16.29 kg) and 20 uninjured participants (age = 25.65 ± 5.58 years, height = 170.14 ± 8.75 cm, mass = 69.89 ± 10.51 kg) with no history of ankle sprain. We operationally defined CAI as repeated episodes of ankle “giving way” or “rolling over” or both, regardless of neuromuscular deficits or pathologic laxity. All CAI participants scored ≤26 on the Cumberland Ankle Instability Tool. Intervention(s) Star Excursion Balance Test reaches in the anteromedial, medial, and posteromedial directions. The CAI participants used the unstable side as the stance leg. Control participants were sex, height, mass, and side matched to the CAI group. The 3-dimensional kinematics were assessed with a motion-capture system. Main Outcome Measure(s) Group differences on normalized reach distance, trunk, pelvis, and hip-, knee-, and ankle-joint angles at maximum Star Excursion Balance Test reach. Results No reach-distance differences were detected between CAI and uninjured participants in any of the 3 reach directions. With anteromedial reach, trunk rotation (t1,38 = 3.06, P = .004), pelvic rotation (t1,38 = 3.17, P = .003), and hip flexion (t1,38 = 2.40, P = .002) were greater in CAI participants. With medial reach, trunk flexion (t1,38 = 6.39, P = .05) was greater than for uninjured participants. No differences were seen with posteromedial reach. Conclusions We did not detect reach-distance differences in any direction. However, participants with CAI rotated the trunk and pelvis more toward the stance leg than did stable-ankle participants during anteromedial and medial reach, possibly to help maintain a proximal stable posture and compensate for distal instability. These joint-angle differences with Star Excursion Balance Test performance may represent unique compensatory patterns for those with CAI.

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Short-Term Effects of Balance Training with Stroboscopic Vision for Patients with Chronic Ankle Instability: A Single-Blinded Randomized Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105364 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5364

Author(s):

Kyung-Min Kim ◽

María D. Estudillo-Martínez ◽

Yolanda Castellote-Caballero ◽

Alejandro Estepa-Gallego ◽

David Cruz-Díaz

Keyword(s):

Randomized Controlled Trial ◽

Outcome Measures ◽

Ankle Instability ◽

Controlled Trial ◽

Balance Training ◽

Chronic Ankle Instability ◽

Balance Test ◽

Training Groups ◽

Randomized Controlled ◽

Star Excursion Balance Test

Chronic Ankle Instability (CAI) is one of the most common musculoskeletal dysfunctions. Stroboscopic vision (SV) training has been deemed to enhance somatosensorial pathways in this population group; nevertheless, until recently no studies have addressed the additional effects of this treatment option to the traditional therapeutic approach. Methods: To evaluate the effectiveness of a partial visual deprivation training protocol in patients with CAI, a randomized controlled trial was carried out. Patients with CAI (n = 73) were randomized into either a balance training, SV training, or a control (no training) group. For participants assigned into training groups, they received 18 training sessions over 6 weeks. The primary outcome was dynamic balance as measured by the Star Excursion Balance Test assessed at baseline and after 6 weeks of intervention. Secondary outcome measures included ankle dorsiflexion range of motion, self-reported instability feeling, and ankle functional status. Results: Better scores in stroboscopic training and balance training groups in all outcome measures were observed in comparison with the control group with moderate to large effect sizes. Stroboscopic training was more effective than neuromuscular training in self-reported instability feeling (cohen’s d = 0.71; p = 0.042) and anterior reach distance of the star excursion balance test (cohen’s d = 1.23; p = 0.001). Conclusions: Preliminary findings from the effects of SV Stroboscopic training in patients with CAI, suggest that SV may be beneficial in CAI rehabilitation.

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Dynamic Leap and Balance Test: Ability to Discriminate Balance Deficits in Individuals With Chronic Ankle Instability

Journal of Sport Rehabilitation ◽

10.1123/jsr.2018-0380 ◽

2020 ◽

Vol 29 (3) ◽

pp. 263-270 ◽

Cited By ~ 1

Author(s):

Abbis H. Jaffri ◽

Thomas M. Newman ◽

Brent I. Smith ◽

Giampietro L. Vairo ◽

Craig R. Denegar ◽

...

Keyword(s):

Dynamic Stability ◽

Healthy Subjects ◽

Ankle Instability ◽

Dynamic Balance ◽

Chronic Ankle Instability ◽

Assessment Tools ◽

Balance Test ◽

Balance Task ◽

History Of ◽

Base Of Support

Context: The Dynamic Leap Balance Test (DLBT) is a new dynamic balance task that requires serial changes in base of support with alternating limb support and recovery of dynamic stability, as compared with the Y modification of the Star Excursion Balance Test (Y-SEBT), which assesses dynamic stability over an unchanging base of support. Objectives: To assess the dynamic balance performance in 2 different types of dynamic balance tasks, the DLBT and the SEBT, in subjects with unilateral chronic ankle instability (CAI) when compared with matched controls. The authors hypothesized that the DLBT score would significantly differ between the CAI involved and uninvolved limbs (contralateral and healthy matched) and demonstrate a modest (r = .50) association with the SEBT scores. Design: Case-control. Setting: Controlled laboratory. Participants: A total of 36 physically active adults, 18 with history of unilateral CAI and 18 without history of ankle injury, were enrolled in the study. CAI subjects were identified using the Identification of Functional Ankle Instability questionnaire. Interventions: The DLBT and the SEBT were performed in a randomized order on a randomly selected limb in CAI and healthy subjects. Main Outcome Measures: Time taken to complete the DLBT and the reach distances performed on the SEBT were compared between the CAI and the healthy subjects. Results: There were no statistically significant differences (P < .05) in SEBT reach distances between groups. The DLBT time was greater (P < .01) for unstable ankles compared with the stable ankle. The authors found no correlation (P > .05) between DLBT time and any of the SEBT reach distances suggesting that the DLBT provides unique information in the assessment of patients with CAI. Conclusion: The DLBT challenges the ability to maintain postural control in CAI subjects differently than the SEBT. There is a need of more dynamic balance assessment tools that are functional and clinically relevant.

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Performance Differences Between the Modified Star Excursion Balance Test and the Y-Balance Test in Individuals With Chronic Ankle Instability

Journal of Sport Rehabilitation ◽

10.1123/jsr.2018-0078 ◽

2020 ◽

Vol 29 (6) ◽

pp. 748-753

Author(s):

Jupil Ko ◽

Erik Wikstrom ◽

Yumeng Li ◽

Michelle Weber ◽

Cathleen N. Brown

Keyword(s):

Ankle Instability ◽

Chronic Ankle Instability ◽

Balance Test ◽

Cross Sectional ◽

Performance Differences ◽

Movement Strategy ◽

History Of ◽

Star Excursion Balance Test ◽

Dynamic Postural Stability ◽

Cumberland Ankle Instability Tool

Context: The modified Star Excursion Balance Test (mSEBT) and Y-Balance Test (YBT) are common dynamic postural stability assessments for individuals with chronic ankle instability (CAI). However, the reach distance measurement technique and movement strategy used during the mSEBT and YBT differ. To date, no studies have compared task performance differences on these tests in CAI patients. Objective: To determine whether individuals with CAI perform the mSEBT and YBT differently. Design: Cross-sectional. Setting: Biomechanics laboratory. Participants: Of 97 consented participants, 86 (43 females, 43 males; age 21.5 [3.3] y, height 169.8 [10.3] cm, mass 69.5 [13.4] kg), who reported ≤25 on the Cumberland Ankle Instability Tool, ≥11 on the Identification of Functional Ankle Instability, and had a history of a moderate to severe ankle sprain(s) participated. Interventions: Participants were instructed to perform the mSEBT and YBT in a predetermined counterbalanced order. Three anterior, posteromedial, and posterolateral trials of each test were completed on the involved limb after 4 practice trials. Test direction order was randomized for each participant. Main Outcome Measures: Normalized (expressed in percentage) reach distance in each direction. Paired sample t tests were performed to compare each of the 3 directions between the mSEBT and YBT. Results: Significantly shorter reach distances in the anterior (58.9% [5.8%] vs 61.4% [5.4%], P = .001) and the posteromedial (98.8% [8.6%] vs 100.8% [8.1%], P = .003) directions were noted on the mSEBT relative to the YBT. No differences in the posterolateral directions were observed. Conclusions: Within those with CAI, mSEBT and YBT normalized reach distances differ in the anterior and posteriomedial directions. As a result, clinicians and researchers should not directly compare the results of these tests.

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