IJPR.2016.208

Type of Article:  Original Research

Volume 5; Issue 1 (February 2017)

Page No.: 1863-1871

DOI: https://dx.doi.org/10.16965/ijpr.2016.208

THE VALIDITY OF THE MODIFIED STAR EXCURSION BALANCE TEST AS A PREDICTOR OF KNEE EXTENSOR AND HIP ABDUCTOR STRENGTH

Lee Shimwell *1, Francis Fatoye 2, James Selfe 3.

*1 Extended Scope Physiotherapist, Integrated Musculoskeletal, Pain and Rheumatology Service, East Lancashire Hospitals NHS Trust (United kingdom).

2 Professor of Health Economics and Outcomes, Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University (United kingdom).

3 Professor of Physiotherapy, Department of Health Professions, Manchester Metropolitan University (United kingdom).

Address for correspondence: Mr. Lee Shimwell, Extended Scope Physiotherapist, Integrated Musculoskeletal, Pain and Rheumatology Service, East Lancashire Hospitals NHS Trust (United kingdom). E-Mail: lee-shimwell@hotmail.com

ABSTRACT

Objectives: To test the construct validity of the modified Star Excursion Balance Test (SEBT) in predicting the strength of knee extensors and hip abductors and to compare performance between dominant and non-dominant legs.

Strength, as measured using hand held dynamometry, has been used as one of a variety of measures in order to subgroup patients with patellofemoral pain. This method is not well received in clinical practice due to time constraints and cost. In contrast, the SEBT is a quick and simple functional measure of dynamic stability. This study examined the validity of the SEBT as an alternate strength measure.

Design: Within subject correlation. Each participant recorded maximum isometric contractions for hip abduction and knee extension using a HHD and performed the modified SEBT, on both legs, within one test period. Paired t tests were used to compare dominant and non-dominant legs and Pearson’s correlation analyses were used to explore for associations.

Setting:  Non-clinical environment,

Participants: Eighteen healthy male amateur runner’s between 18 and 39 years old (mean age 36.1 years).

Main outcome measures: Knee and hip moments normalised for leg length (Nm/m) for the HHD and percent of leg length reach score for each SEBT reach as well as a composite of all three.

Results: There was no significant difference between dominant and non-dominant legs for all the tests (knee extension p = 0.72, hip abduction p = 0.90, SEBT composite p = 0.86) therefore data was combined into one set. There was no significant relationship between either hip abduction strength (r = 0.28, p = 0.11), or knee extension strength (r= 0.16, p = 0.17), with any combination of the SEBT. A moderate relationship (r = 0.52, p = 0.38) between hip abduction and SEBT posterolateral reach was seen, however, this was not statistically significant.

Conclusion: There was no statistically significant association between either knee extension or hip abduction strength with the modified SEBT. This suggests that strength is unlikely to be a primary construct of the test and the SEBT is not a useful replacement for the HHD when testing strength.

Key Words: SEBT, Patellofemoral, Subgroups, Hand held dynamometer, Runners.

REFERENCES

  1. Witvrouw E, Callaghan MJ, Stefanik JJ, et al. Patellofemoral pain: consensus statement from the 3rd International Patellofemoral Pain Research Retreat held in Vancouver, September 2013. Brit J Sports Med. 2014;48:411-414.
  2. Selfe J, Dey P, Callaghan M et al. Are there three main subgroups within the patellofemoral pain population?  A detailed characterisation study of 127 patients to help develop targeted Intervention (TIPPs). Brit J Sports Med. 2016;0:1-9. doi:10.1136/bjsports-2015-094792.
  3. Weng P, Janssen J, Richards JD, Selfe J. Validity of Two Clinical Knee Strength Assessments Compared to the Reference Standard. International Journal of Physiotherapy and Research. 2015;3(6):1264-1270.
  4. Katoh M, Hiiragi Y, Uchida M. Validity of Isometric Muscle Strength Measurements of the Lower Limbs Using a Hand-held Dynamometer and Belt: a Comparison with an Isokinetic Dynamometer. J Phs Ther Sci. 2011;23:553-557.
  5. Martin HJ, Yule V, Syddall HE, Dennison EM, Cooper C, Aihie Sayer A. Is Hand-Held Dynamometery useful for the measurement of Quadriceps Strength in Older People? A comparison with the Gold standard Biodex Dynamometry. Gerontology. 2006;52:154-159.
  6. Clark N. Functional performance testing following knee ligament injury. Phys Ther Sport. 2001;2:91-105.
  7. 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. Part 2. The tests for the hip, thigh, foot and ankle including the star excursion balance test. Br J sports Med. 2015; 49:642-648.
  8. Noyes FR, Barber-Westin SD, Smith ST, et al. A training program to improve neuromuscular indices in female high school volleyball players. J Strength Cond Res. 2011;25:2151–60.
  9. Gribble P, Hertel J. Considerations for Normalizing Measures of the Star Excursion Balance Test. Meas Phys Educ Exerc Sci. 2003;7(2):89-100.
  10. McMullen KL, Cosby NL, Hertel J, Ingersoll CD. Hart JM. Lower Extremity Neuromuscular Control Immediately After Fatiguing Hip-Abduction Exercise. J Athl Train. 2011;46(6):607-614.
  11. Gribble PA, Robinson RH, Hertel J, Denegar CR. The effects of gender and fatigue on dynamic postural-control. J Sport Rehabil. 2009;18(2):240-257.
  12. Clagg S, Paterno MV, Hewett TE, Schmitt LC. Performance on the Modified Star Excursion Balance Test at the Time of Return to Sport Following Anterior Cruciate Ligament Reconstruction. J Orthop Sports Phys Ther. 2015;45(6):444-452.
  13. Thorpe JL, Ebersole KT. Unilateral Balance Performance in Female Collegiate Soccer Athletes. Journal of Strength and Conditioning Research. 2008;22(5):1429-1433.
  14. Gribble PA, Hertel J, Plisky P. Using the Star Excursion Balance Test to Assess Dynamic Postural-control Deficits and Outcomes in lower Extremity Injury: A Literature and Systematic Review. J Athl Train. 2012;47(3):339-357.
  15. Fitzgerald D, Trakarnratanakul N, Smyth B, Caulfield B. Effects of a wobble board-based therapeutic exergaming system for balance training on dynamic postural stability and intrinsic motivation levels. J Orthop Sports Phys Ther. 2010;40(1):11-19.
  16. Gabbard C and Hart S. A question of foot dominance. J Gen Psychol. 1996;123:289-296.
  17. Schneiders AG, Sullivan JS, O’Malley KJ, Clarke SV, Knappstein SA, and Taylor LJ. A Valid and Reliable Clinical Determination of Footedness. American Academy of Physical Medicine and Rehabilitation. 2010;2:835-841. DOI: 10.1016/j.pmrj.2010.06.004
  18. Kollock RO, Onate JA, Van Lunen B. The Reliability of Portable Fixed Dynamometry During Hip and Knee Strength Assessments. J Athl Train. 2010;45(4):349-356.
  19. Plisky PJ, Gormann PP, Butler RJ, Kiesel KB, Underwood FB, Elkins B. The reliability of an instrumented device for measuring components of the star excursion balance test. N Am J Sports Phys Ther. 2009;4(2):92-99.
  20. Maffiuletti NA. Assessment of Hip and Knee Function in Orthopaedic Practice and Research. J Bone Joint Surg. 2010;92(1):220-229.
  21. Selfe J, Callaghan M, Witvrouw E et al. Targeted interventions for patellofemoral pain syndrome (TIPPS): classification of clinical subgroups. BMJ open. 2013;3: e003795. Doi:10.1136/bmjopen-2013-003795.
  22. Robinson RH, Gribble PA. Support for a reduction in the number of trials needed for the Star Excursion Balance Test. Arch Phys Med Rehabil. 2008;89(2):364-370.
  23. Munro AG, Herrington LC. Between-session reliability of the star excursion balance test. Phys Ther Sport. 2010;11(4):128-132.
  24. Hoch MC, Staton GS, McKeon PO. Dorsiflexion range of motion significantly influences dynamic balance. J Sci Med Sport. 2011;14(1):90-92.
  25. Guette M, Gondin J, Martin A. Time-of-day effect on the torque and neuromuscular properties of dominant and non-dominant quadriceps femoris. Chrono Biol Int. 2005;22:541-58.
  26. Gribble PA, Hertel J, Denegar CR. Chronic Ankle Instability and Fatigue create Proximal Joint Alterations during Performance of the Star Excursion Balance Test. Int J Sports Med. 2007;28(3):236-242.
  27. Plisky PJ, Rauh MJ, Kaminski TW, Underwood FB. Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players. J Orthop Sports Phys Ther. 2006;36(12):911-919.
  28. Eltoukhy M, Kuenze C, Jun H-P, Asfour S, Travascio, F. Assessment of dynamic balance via measurement of lower extremities tortuosity. Sports Biomech, 2015; 14(1):18-27. DOI: 10.1080/14763141.2015.1025238
  29. Hamilton RT, Shultz SS, Schmitz RJ, Perrin DH. Triple-Hop Distance as a Valid Predictor of Lower Limb Strength and Power. J Athl Train. 2008;43(2):144-151.

Cite this article: Lee Shimwell, Francis Fatoye, James Selfe. THE VALIDITY OF THE MODIFIED STAR EXCURSION BALANCE TEST AS A PREDICTOR OF KNEE EXTENSOR AND HIP ABDUCTOR STRENGTH. Int J Physiother Res 2017;5(1):1863-1871. DOI: 10.16965/ijpr.2016.208
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