Concurrent and Discriminant Validity of the Star Excursion Balance Test for Military Personnel With Lateral Ankle Sprain

The Star Excursion Balance Test (SEBT) has frequently been used to measure motor control and residual functional deficits at different stages of recovery from lateral ankle sprain (LAS) in various populations. However, the validity of the measure used to characterize performance—the maximal reach distance (MRD) measured by visual estimation—is still unknown.Objectives:To evaluate the concurrent validity of the MRD in the SEBT estimated visually vs the MRD measured with a 3D motion-capture system and evaluate and compare the discriminant validity of 2 MRD-normalization methods (by height or by lower-limb length) in participants with or without LAS (n = 10 per group).Results:There is a high concurrent validity and a good degree of accuracy between the visual estimation measurement and the MRD gold-standard measurement for both groups and under all conditions. The Cohen d ratios between groups and MANOVA products were higher when computed from MRD data normalized by height.Conclusion:The results support the concurrent validity of visual estimation of the MRD and the use of the SEBT to evaluate motor control. Moreover, normalization of MRD data by height appears to increase the discriminant validity of this test.

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Using Balance Tests to Discriminate Between Participants With a Recent Index Lateral Ankle Sprain and Healthy Control Participants: A Cross-Sectional Study

Journal of Athletic Training ◽

10.4085/1062-6050-51.4.11 ◽

2016 ◽

Vol 51 (3) ◽

pp. 213-222 ◽

Cited By ~ 12

Author(s):

Fereshteh Pourkazemi ◽

Claire Hiller ◽

Jacqueline Raymond ◽

Deborah Black ◽

Elizabeth Nightingale ◽

...

Keyword(s):

Discriminant Analysis ◽

Ankle Sprain ◽

Control Group ◽

Stepwise Discriminant Analysis ◽

Ankle Sprains ◽

Balance Test ◽

Cross Sectional ◽

Lateral Ankle Sprain ◽

Lateral Ankle ◽

Star Excursion Balance Test

The first step to identifying factors that increase the risk of recurrent ankle sprains is to identify impairments after a first sprain and compare performance with individuals who have never sustained a sprain. Few researchers have restricted recruitment to a homogeneous group of patients with first sprains, thereby introducing the potential for confounding.Context: To identify impairments that differ in participants with a recent index lateral ankle sprain versus participants with no history of ankle sprain.Objective: Cross-sectional study.Design: We recruited a sample of convenience from May 2010 to April 2013 that included 70 volunteers (age = 27.4 ± 8.3 years, height = 168.7 ± 9.5 cm, mass = 65.0 ± 12.5 kg) serving as controls and 30 volunteers (age = 31.1 ± 13.3 years, height = 168.3 ± 9.1 cm, mass = 67.3 ± 13.7 kg) with index ankle sprains.Patients or Other Participants: We collected demographic and physical performance variables, including ankle-joint range of motion, balance (time to balance after perturbation, Star Excursion Balance Test, foot lifts during single-legged stance, demi-pointe balance test), proprioception, motor planning, inversion-eversion peak power, and timed stair tests. Discriminant analysis was conducted to determine the relationship between explanatory variables and sprain status. Sequential discriminant analysis was performed to identify the most relevant variables that explained the greatest variance.Main Outcome Measure(s): The average time since the sprain was 3.5 ± 1.5 months. The model, including all variables, correctly predicted a sprain status of 77% (n = 23) of the sprain group and 80% (n = 56) of the control group and explained 40% of the variance between groups ( = 42.16, P = .03). Backward stepwise discriminant analysis revealed associations between sprain status and only 2 tests: Star Excursion Balance Test in the anterior direction and foot lifts during single-legged stance ( = 15.2, P = .001). These 2 tests explained 15% of the between-groups variance and correctly predicted group membership of 63% (n = 19) of the sprain group and 69% (n = 48) of the control group.Results: Balance impairments were associated with a recent first ankle sprain, but proprioception, motor control, power, and function were not.Conclusions:

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Minimal detectable change and reliability of the star excursion balance test in patients with lateral ankle sprain

Physiotherapy Research International ◽

10.1002/pri.1850 ◽

2020 ◽

Vol 25 (4) ◽

Author(s):

Andrés Pierobon ◽

Ignacio Raguzzi ◽

Santiago Soliño ◽

Sandra Salzberg ◽

Tomás Vuoto ◽

...

Keyword(s):

Ankle Sprain ◽

Minimal Detectable Change ◽

Detectable Change ◽

Balance Test ◽

Lateral Ankle Sprain ◽

Lateral Ankle ◽

Star Excursion Balance Test

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Laboratory Measures of Postural Control During the Star Excursion Balance Test After Acute First-Time Lateral Ankle Sprain

Journal of Athletic Training ◽

10.4085/1062-6050-50.1.09 ◽

2015 ◽

Vol 50 (6) ◽

pp. 651-664 ◽

Cited By ~ 36

Author(s):

Cailbhe Doherty ◽

Chris M. Bleakley ◽

Jay Hertel ◽

Brian Caulfield ◽

John Ryan ◽

...

Keyword(s):

Lower Extremity ◽

Postural Control ◽

Ankle Sprain ◽

Control Group ◽

Injured Limb ◽

Balance Test ◽

Lateral Ankle Sprain ◽

Lateral Ankle ◽

Star Excursion Balance Test ◽

First Time

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.

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P17 Clinical use of the star excursion balance test to assess dynamic postural stability deficits following a lateral ankle sprain in prognosis of chronic ankle instability

10.1136/bjsports-2017-anklesymp.49 ◽

2017 ◽

Author(s):

AC Gaudet ◽

MD Adams ◽

AA Giorgianni ◽

GK Alcock ◽

JP Dickey

Keyword(s):

Ankle Sprain ◽

Postural Stability ◽

Ankle Instability ◽

Chronic Ankle Instability ◽

Clinical Use ◽

Balance Test ◽

Lateral Ankle Sprain ◽

Lateral Ankle ◽

Star Excursion Balance Test ◽

Dynamic Postural Stability

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Coordination and Symmetry Patterns During the Drop Vertical Jump in People With Chronic Ankle Instability and Lateral Ankle Sprain Copers

Physical Therapy ◽

10.2522/ptj.20150160 ◽

2016 ◽

Vol 96 (8) ◽

pp. 1152-1161 ◽

Cited By ~ 4

Author(s):

Cailbhe Doherty ◽

Chris Bleakley ◽

Jay Hertel ◽

Brian Caulfield ◽

John Ryan ◽

...

Keyword(s):

Motor Control ◽

Ankle Sprain ◽

Ankle Instability ◽

Phase 1 ◽

Vertical Jump ◽

Phase 2 ◽

Lateral Ankle Sprain ◽

Lateral Ankle ◽

Control Patterns ◽

Phase Phase

Abstract Background The drop vertical jump (DVJ) task has previously been used to identify movement patterns associated with a number of injury types. However, no current research exists evaluating people with chronic ankle instability (CAI) compared with people coping with lateral ankle sprain (LAS) (referred to as “LAS copers”) during this task. Objective The aim of this study was to identify the coping movement and motor control patterns of LAS copers in comparison with individuals with CAI during the DVJ task. Design This was a case-control study. Methods Seventy individuals were recruited at convenience within 2-weeks of sustaining a first-time acute LAS injury. One year following recruitment, these individuals were stratified into 2 groups: 28 with CAI and 42 LAS copers. They attended the testing laboratory to complete a DVJ task. Three-dimensional kinematic and sagittal-plane kinetic profiles were plotted for the lower extremity joints of both limbs for the drop jump phase (phase 1) and drop landing phase (phase 2) of the DVJ. The rate of impact modulation relative to body weight during both phases of the DVJ also was determined. Results Compared with LAS copers, participants with CAI displayed significant increases in hip flexion on their “involved” limb during phase 1 of the DVJ (23° vs 18°) and bilaterally during phase 2 (15° vs 10°). These movement patterns coincided with altered moment-of-force patterns at the hip on the “uninvolved” limb. Limitations It is unknown whether these movement and motor control patterns preceded or occurred as a result of the initial LAS injury. Conclusions Participants with CAI displayed hip-centered changes in movement and motor control patterns during a DVJ task compared with LAS copers. The findings of this study may give an indication of the coping mechanism underlying outcome following initial LAS injury.

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Acute lateral ankle sprain alters muscle and tendon properties: Case series

Foot and Ankle Surgery ◽

10.1016/j.fas.2021.05.008 ◽

2021 ◽

Author(s):

Henrique Mansur ◽

Marcos de Noronha ◽

Rita de Cássia Marqueti ◽

João Luiz Quagliotti Durigan

Keyword(s):

Ankle Sprain ◽

Case Series ◽

Lateral Ankle Sprain ◽

Lateral Ankle ◽

Tendon Properties

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Muscle Strength Deficit though Intact Proprioception after Lateral Ankle Sprain without Persistent Instability

Physikalische Medizin Rehabilitationsmedizin Kurortmedizin ◽

10.1055/a-1333-3638 ◽

2021 ◽

Author(s):

Adel M. Madkhali ◽

Shibili Nuhmani

Keyword(s):

Ankle Sprain ◽

Peak Torque ◽

Position Sense ◽

Joint Position Sense ◽

Joint Position ◽

Lateral Ankle Sprain ◽

Lateral Ankle ◽

Cohen’S D ◽

History Of ◽

Cohen's D

Abstract Background Lateral ankle sprain is one of the most common injuries in competitive sports. Previous studies which investigated muscle strength and proprioception (joint position sense) focused on subjects who sustained ankle sprain with instability. It is also important to investigate strength deficits and proprioception in subjects with a history of ankle sprain without instability. Therefore the aim of the study is to investigate proprioception and muscle strength deficits in athletes with lateral ankle sprain. Methods Twenty-four male athletes with a history of lateral ankle sprain and 24 age-matched controls (mean age of 22.42±4.13 years, mean height of 173±5.73 cm, and mean weight of 71.20±7.55 Kg) participated in this cross-sectional study. Peak torque and peak torque ratio at speeds of 30 and 120°/s for concentric and eccentric ankle inversion/eversion were evaluated using an isokinetic dynamometer. The joint position sense of the ankle joint was evaluated using an active angle reproduction test. Result Peak torque produced was significantly less in subjects with history of ankle sprain in concentric inversion 30°/s(t(47)=4.11; p=0.000, Cohen’s d=1.29), concentric inversion 120°/s (t(47)=3.01; p=0.006, Cohen’s d=1.13), concentric eversion 30°/s (t(47)=3.85; p=0.001, Cohen’s d=1.24) and concentric eversion 120°/s (t(47)=3.15; p=0.005, Cohen’s d=1.09). At the same time there was no significant difference observed in eccentric eversion peak torque in both speed (eccentric eversion 30°/s p=0.079; eccentric eversion 120°/s p=0.867) between experimental and control group. No significant difference was found in the joint position sense in the maximal active inversion −5° position (p=0.312) and the 15° inversion position (P=0.386) between both group. Conclusion The study’s results reported a significantly less peak torque of invertors and evertors during concentric movements in athletes with history of ankle sprain. At the same time, no significant difference reported in the evertor/invertor peak torque ratio, and active joint position sense between the 2 groups.

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Predictive Factors of Recovery after an Acute Lateral Ankle Sprain: A Longitudinal Study

Sports ◽

10.3390/sports9030041 ◽

2021 ◽

Vol 9 (3) ◽

pp. 41

Author(s):

Philippe Terrier ◽

Sébastien Piotton ◽

Ilona M. Punt ◽

Jean-Luc Ziltener ◽

Lara Allet

Keyword(s):

Ankle Sprain ◽

Strength Function ◽

Selection Procedure ◽

Ankle Sprains ◽

Lateral Ankle Sprain ◽

Lateral Ankle ◽

Functional Scores ◽

Logistic Regressions ◽

Poor Outcomes ◽

Clinical Measures

A prominent feature of ankle sprains is their variable clinical course. The difficulty of providing a reliable early prognosis may be responsible for the substantial rate of poor outcomes after an ankle sprain. The aim of the present study was to evaluate the prognostic value of objective clinical measures, pain, and functional scores for ankle sprain recovery. Fifty-two participants suffering from lateral ankle sprain were included. Sprain status was assessed four weeks following injury and included evaluations of ankle range of motion, strength, function, and pain. Seven months following injury, a second assessment classified the patients into recovered and non-recovered groups using ankle ability measures. Following a predictor pre-selection procedure, logistic regressions evaluated the association between the four-week predictors and the seven-month recovery status. Twenty-seven participants (52%) fully recovered and 25 did not (48%). The results of the logistic regressions showed that walking pain was negatively associated with the probability of recovering at seven months (odds ratio: 0.71, 95% CI: 0.53–0.95). Pain four weeks after ankle sprain had relevant predictive value for long-term recovery. Special attention should be paid to patients reporting persistent pain while walking four weeks following sprain to reduce the risk of chronicity.

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