scholarly journals Clinician-Friendly Physical Performance Tests for the Hip, Ankle, and Foot

2017 ◽  
Vol 52 (9) ◽  
pp. 861-862 ◽  
Author(s):  
Joseph H. Vogler ◽  
Alexander J. Csiernik ◽  
Marissa K. Yorgey ◽  
Jerrod J. Harrison ◽  
Kenneth E. Games
Keyword(s):  
Lower Extremity ◽  
Physical Performance ◽  
Injury Risk ◽  
Evidence Synthesis ◽  
Measurement Properties ◽  
Performance Tests ◽  
Health Measurement ◽  
Balance Test ◽  
Best Evidence Synthesis ◽  
Star Excursion Balance Test

Reference:  Hegedus EJ, McDonough SM, Bleakley C, Baxter D, Cook CE. Clinician-friendly lower extremity physical performance tests in athletes: a systematic review of measurement properties and correlation with injury. Part 2: the tests for the hip, thigh, foot, and ankle including the Star Excursion Balance Test. Br J Sports Med. 2015;49(10):649–656. Clinical Question:  Do individual physical performance tests (PPTs) for the lower extremity have any relation to injury in athletes 12 years of age and older? Data Sources:  The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to locate articles. Three databases were searched from inception to January 13, 2014: PubMed, CINAHL, and SPORTDiscus. Search phrases were sport, athletics, athletes, and injuries combined with strength, power, endurance, agility, and function. Reference lists of all remaining articles and personal collections of the authors were then reviewed for any missing articles. Study Selection:  Studies were included according to the following criteria: (1) published in English, (2) presented as complete articles (ie, no abstracts or posters), and (3) involved human participants. Studies were excluded on the following criteria: (1) a combination of PPTs was examined, (2) the results were measured using equipment that was expensive or not readily available to the average clinician, (3) the PPTs examined impairment-level data, (4) the PPTs examined tasks not relevant to the lower extremity, or (5) the participants scored 4 or less on the Tegner Activity Scale. The final analysis involved 31 studies. Data Extraction:  The name of the PPT and methods were extracted. Each PPT was then critiqued using the Consensus-Based Standards for the Selection of Health Measurement Instruments, a 4-point Likert scale. Data were also summarized using a score of unknown, strong, moderate, limited, or conflicting for the best evidence synthesis. Main Results:  A total of 14 PPTs were examined; however, names and methods of the PPTs were inconsistent throughout the literature. In descending order, based on frequency of appearance in the literature, the PPTs were (1) 1-legged hop for distance, (2) vertical jump, (3) Star Excursion Balance Test, (4) shuttle run, (5) 6-m timed hop, (6) triple hop, (7) 40-yd sprint, (8) triple crossover hop for distance, (9) 6-m timed crossover hop, (10) T-agility, (11) hexagon hop, (12) medial hop, (13) lateral hop, and (14) multi-stage fitness (beep test). The Star Excursion Balance Test in the anterior, posteromedial, and posterolateral directions was the only test that could help identify injury risk. The 1-legged hop for distance and hexagon hop showed a moderate ability to differentiate between normal and unstable ankles. In dancers, the medial hop in dancers differentiated between painful and normal hips with moderate evidence. Conclusions:  Very little evidence supports the use of PPTs for athletes with lower extremity injuries. A panel of experts needs to standardize the names and methods of widely accepted tests.

scholarly journals Clinician-Friendly Physical Performance Tests for the Knee

2017 ◽  
Vol 52 (11) ◽  
pp. 1068-1069 ◽  
Author(s):  
Jerrod J. Harrison ◽  
Marissa K. Yorgey ◽  
Alexander J. Csiernik ◽  
Joseph H. Vogler ◽  
Kenneth E. Games
Keyword(s):  
Systematic Review ◽  
Lower Extremity ◽  
Physical Performance ◽  
Knee Injury ◽  
Measurement Properties ◽  
Performance Tests ◽  
Health Measurement ◽  
Methodologic Quality ◽  
Fair Poor

Reference:  Hegedus EJ, McDonough S, Bleakley C, Cook CE, Baxter GD. Clinician-friendly lower extremity physical performance measures in athletes: a systematic review of measurement properties and correlation with injury. Part 1: the tests for knee function including the hop tests. Br J Sports Med. 2015;49(10):642−648. Clinical Question:  Do individual physical performance tests (PPTs) used as measures for lower extremity function have any relationship to injuries in athletes aged 12 years or older? Data Sources:  Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to locate articles. The authors searched PubMed, EMBASE, and SPORTDiscus, in addition to searching by hand. The search strategy combined the terms athlete, lower extremity, and synonyms of performance test with the names of performance tests. Study Selection:  Studies were included if they involved a test that met the operational definition for a PPT. The included studies assessed components of sport function (eg, speed, agility, and power), determined readiness for return to sport, or predicted injury to the lower extremity. All PPT measures could be performed on the field, courtside, or in a gym with affordable, portable, and readily available equipment. Studies were excluded if they made use of 3-dimensional motion capture, force platforms, timing gates, treadmills, stationary bikes, metabolic charts, or another nonportable, costly testing device. Athletes were categorized on the Tegner Scale at a minimum of level 5, which is the lowest level that still encompasses competitive athletes. Studies were included if 50% or more of the participants were rated above 5 on the Tegner Scale. Studies were excluded if the sole purpose was to judge movement quality or range of motion. Studies were selected if they identified the knee or a knee injury as a focal point of the paper. Data Extraction:  The Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) was used to critique the methodologic quality of each paper with a 4-point Likert scale. The title and methods of each paper were extracted. Extracted data were summarized using ratings of unknown, conflicting, limited, moderate, and strong. Main Results:  An initial search revealed 3379 original articles for consideration. After initial review, 169 full-text articles were evaluated and 29 articles were included in the systematic review. Six tests were examined for the best evidence of methodologic quality: (1) 1-legged single hop for distance, (2) 1-legged triple hop for distance, (3) 6-m timed hop, (4) crossover hop for distance, (5) triple jump, and (6) 1-legged vertical jump. A summary of the methodologic properties of the 6 tests showed fair/poor reliability, fair/poor hypothesis testing, good criterion validity, and good/poor responsiveness. No tests predicted knee injury in athletes. Conclusions:  Although numerous authors have evaluated PPTs at the knee, evidence for the measurement quality of these functional tests is limited and conflicting. Ample opportunity exists for researchers to further examine PPTs for the knee. Until more knowledge is gained about these PPTs, clinicians should exercise caution when making clinical decisions based on the results of these tests.

scholarly journals EFFECTIVENESS OF PRE-SEASON PHYSICAL PERFORMANCE TESTS IN IDENTIFYING IN-SEASON LOWER EXTREMITY INJURIES IN ADOLESCENT GYMNASTS

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0014
Author(s):  
Danielle A Farzanegan ◽  
Emily Francione ◽  
Nicole Melfi
Keyword(s):  
Lower Extremity ◽  
Physical Performance ◽  
Performance Tests ◽  
Kinetic Chain ◽  
Chi Square ◽  
Balance Test ◽  
Lower Extremity Injuries ◽  
Common Location ◽  
Acute Injuries ◽  
Extremity Injuries

Background: Artistic competitive gymnastics results in a wide, unique spectrum of injuries. Due to the high number of injuries and the current lack of research related to pre-competitive testing in adolescent gymnasts, it is crucial to find a method to predict the likelihood of an athlete sustaining an in-season injury. Purpose: The purpose of this study was to 1) describe the frequency and type of pre-season and in-season injuries, 2) determine if there were differences in physical performance tests between those who had a lower extremity (LE) injury in-season and those who did not, and 3) determine if there were differences in age, level, sex, BMI, sport modifications, previous injury, and current injury between those who had a LE injury and those who didn’t. Methods: Thirty-seven adolescent gymnasts (average age: 12.81 years) were included with levels ranging from 5 (novice) to 10 (elite). Participants (15 males and 22 females) were surveyed for previous and current injury. The athletes completed a performance battery before the competition season including: Lower Quarter Y-Balance Test (LQYBT), Closed Kinetic Chain dorsiflexion (CKCDF), single hop (SH), triple hop (TH), and the Functional Movement Screen (FMS). Follow-up data was collected at the end of the competitive season for comparison. The data was analyzed using descriptive methods and comparative analyses including chi-square and independent t-tests with an alpha level set at .05. Results: Sixty-five percent reported an injury in the last year and seventy-eight percent reported pre-season injuries at testing day. The most common location for pre-season injury was the ankle/foot (24% and 31% respectively). There were no differences between injured and non-injured athletes when comparing asymmetries in CKCDF, LQYBT posteromedial or posterolateral reach, hop testing, or FMS. The LQYBT-anterior scores were significantly different at p=.049 between the injured versus uninjured groups, with 91% of the in-season injury group having a difference <4cm. Similarly, the LQYBT-composite score using a cut-off of 95% was significant at p=.043 with those >95% category being more likely to get injured. There were no significant differences in demographic information comparing injury occurrence. Conclusion: The tested physical performance battery may be useful in tracking gymnasts over time, but may not be beneficial in forecasting injuries in a sport with high percentages of acute injuries. The collected injury volume may not be reflective of a standard season as COVID-19 decreased the number of competitions. Additional research to identify athletes at risk for injury requires further investigation.

scholarly journals Y-Balance test asymmetry is greater in collegiate athletes with a history of concussion

Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S26.1-S26
Author(s):  
Hoch Matthew ◽  
Curry Nicole ◽  
Hartley-Gabriel Emily ◽  
Heebner Nicholas ◽  
Hoch Johanna
Keyword(s):  
Lower Extremity ◽  
Injury Risk ◽  
Collegiate Athletes ◽  
Lower Extremity Injury ◽  
Absolute Difference ◽  
Group Differences ◽  
Extremity Injury ◽  
Balance Test ◽  
Increased Risk ◽  
History Of

Athletes with a history of concussion (HC) are at an increased risk of sustaining lower extremity injuries. It is unclear if these individuals exhibit dynamic postural control deficits associated with lower extremity injury risk. The purpose of this study was to determine if collegiate athletes with a HC demonstrate differences in Y-Balance Test (YBT) performance compared to athletes with no history of concussion (NHC). A total of 116 varsity and club athletes from a Division-I university participated. Forty participants reported a HC (female/male: 31/9, age: 20.0 ± 1.4 years, height: 169.3 ± 13.1 cm, mass: 68.4 ± 14.0 kg) while 76 reported NHC (female/male: 60/16, age: 20.0 ± 1.7 years, height: 168.5 ± 12.9 cm, mass: 68.7 ± 14.6 kg). Individuals with a current concussion or lower extremity injury, or a history of lower extremity surgery were excluded. Participants completed the YBT anterior reach direction barefoot on both limbs. The YBT was completed by maximally reaching anteriorly, maintaining balance, and returning to the starting position without errors. Participants completed 4 practice trials and 3 test trials. Reach distances were averaged and normalized to leg length. Between-limb asymmetry was calculated as the absolute difference between the left and right limbs. Separate independent t-tests examined group differences in normalized reach distances and asymmetry. The proportion of participants in each group with >4 cm of asymmetry was compared using a χ2 test. Alpha was set at 0.05 for all analyses. No group differences were identified in normalized reach distances for the left (HC: 61.4% ± 9.2%, NHC: 60.8% ± 6.2%, p = 0.88, ES = 0.08) or right (HC: 61.4% ± 6.2%, NHC: 60.2% ± 6.8%, p = 0.51, ES = 0.17) limbs. However, a greater proportion of HC participants demonstrated >4 cm asymmetry (HC: 40.0%, NHC: 19.7%; p = 0.02) and these participants exhibited greater asymmetry (HC: 3.87 ± 3.69 cm, NHC: 2.40 ± 2.13 cm, p = 0.03; ES = 0.53). Athletes with a HC exhibited greater asymmetry compared to athletes with NHC. Anterior reach asymmetries of >4 cm are associated with greater lower extremity injury risk. The YBT may provide a clinical technique to further explore the relationship between concussion and lower extremity injury.

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

2015 ◽  
Vol 50 (6) ◽  
pp. 651-664 ◽  
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 &lt; .01). This observation was associated with altered temporal sagittal-plane kinematic profiles throughout each reach attempt and at the point of maximum reach (P &lt; .05). This result was associated with a reduced FD of the COP path for each reach direction on the injured limb only (P &lt; .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.

scholarly journals Comparison of Lower Extremities Physical Performance on Male Young Adult Athletes with Normal Foot and Flatfoot

2019 ◽  
Vol 1 (1) ◽  
pp. 6
Author(s):  
Mira Saraswita Kumala ◽  
Damayanti Tinduh ◽  
Dewi Poerwandari
Keyword(s):  
Physical Performance ◽  
Lower Extremities ◽  
Kinetic Chain ◽  
Motor Tasks ◽  
Balance Test ◽  
Male Athletes ◽  
Male Athlete ◽  
Hop Test ◽  
Star Excursion Balance Test ◽  
The Difference

Background: Motor tasks involving the lower legs activate a closed kinetic chain, with the foot being the terminal part of that chain. It is known that when a part of this chain is disturbed, it will affect other parts of the chain, including the effect on the motor performance of lower extremities.Aims: To see the difference of physical performance on athlete age 14 – 17 years with flatfoot and normal foot on strength, balance and agility factors.Methods: Male athletes age 14 – 17 years enrolled in Sport Senior High School at Sidoarjo who underwent athletes screening at Sport Clinic of dr. Soetomo General Hospital and fulfill the inclusion criteria. The subject were 29 boys, the normal foot were 22 boys and the flatfoot were 7 boys. Subjects were examined for Clarke’s angle and Chippaux-Smirak index to diagnose flatfoot and did Single-leg Hop for Distance, One Leg Test, Star Excursion Balance Test, and Hexagon Hop Test.Result: The statistical analysis showed no difference of lower extremities’ physical performance in strength using Single-leg Hop for Distance (p>0.05), balance using One Leg Test and Star Excursion Balance Test (p>0.05), and agility using Hexagon Hop Test (p>0.05) on male athletes age 14-17 years with normal foot and flatfoot.Conclusion: There are no difference of lower extremities’ physical performance in strength, balance and agility on male athlete age 14-17 years with normal foot and flatfoot.

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