Resende R1, Pinheiro L1, Bittencourt N2, Antunes R1, Souza S1, Ocarino J1
1Universidade Federal de Minas Gerais, Physical Therapy, Belo Horizonte, Brazil, 2Minas Tênis Clube, Physical Therapy, Belo Horizonte, Brazil
Background: The modified Star Excursion Balance Test evaluates athletes' dynamic postural control. It has been used in clinical settings as a screening tool to identify athletes at increased risk of injury. The performance in this test requires movement in multiple body joints. In addition, weakness of the trunk and lower limbs muscles may also influence the performance during the modified Star Excursion Balance Test. Therefore, the lower limbs and trunk angular displacement and the lower limbs and trunk strength may influence the athlete's performance during this test.
Purpose: This study investigated the relationship of trunk, hip, knee and ankle angular displacement and trunk and hip muscles strength withthe performance during the modified Star Excursion Balance Test in runners.
Methods: Thirty-nine runners participated in this study, 14 women and 25 men, mean age 41.1 ± 9.6 years, body mass 71.2 ± 12.1 kg and height 1.72 ± 0.9 meters. The university's Ethical Research Committee approved this study, number: 65118017.5.0000.5149. The participants performed the modified Star Excursion Balance Test with the dominant limb as the support limb. A system consisting of Inertial and Magnetic Measurements Units was used to capture the angular displacements of trunk, hip, knee and ankle of the support limb during the test. The software estimated angular position values at maximal reach in each direction of the modified Star Excursion Balance Test. A handheld dynamometer was used to measure the isometric strength of the trunk and hip muscles: extensor and lateral flexor muscles of the trunk, extensors, lateral rotators and hip abductors of the support limb. Multiple linear regressions were used to assess the association between trunk, hip, knee and ankle angular displacement of the support limb and trunk and hip muscles strength of the support limb and performance during the modified Star Excursion Balance Test. The significance was set at α = 0.05.
Results: Reduced hip flexion and greater knee flexion predicted the anterior reach in the modified Star Excursion Balance Test (F=9.88; r=0.80; r2=0.65; p 0.01) and greater hip flexion, adduction and greater ankle dorsiflexion predicted posterolateral reach (F=8.07; r=0.77; r2=0.60; p 0.01). Lower limbs and trunk angular displacement also predicted the reach distance in the posteromedial direction (F=5.39; r=0.70; r2=0.50; p 0.01). In addition, hip extensors strength predicted posteromedial (F=4.09; r=0.61; r2=0.37; p 0.01), posterolateral (F=4.34; r=0.62; r2=0.39; p 0.01) and composite reaches (F=4.88; r=0.64; r2=0.41; p 0.01).
Conclusion(s): Hip, knee and ankle kinematics in the sagittal and frontal planes explained 60-65% of the athlete´s performance in the modified Star Excursion Balance Test and strength of the hip extensors explained 37-41% of this test performance. Future studies should investigate if strength of other lower limb muscles, such as knee extensors and ankle plantarflexors also influence on this test performance.
Implications: These results suggest that clinicians should evaluate hip strength and movement and knee and ankle movement in athletes demonstrating poor performance during the modified Star Excursion Balance Test.
Keywords: Modified Star Excursion Balance Test, Kinematics, Muscle Strength
Funding acknowledgements: Brazilian funding agencies CNPQ, FAPEMIG and CAPES.
Purpose: This study investigated the relationship of trunk, hip, knee and ankle angular displacement and trunk and hip muscles strength withthe performance during the modified Star Excursion Balance Test in runners.
Methods: Thirty-nine runners participated in this study, 14 women and 25 men, mean age 41.1 ± 9.6 years, body mass 71.2 ± 12.1 kg and height 1.72 ± 0.9 meters. The university's Ethical Research Committee approved this study, number: 65118017.5.0000.5149. The participants performed the modified Star Excursion Balance Test with the dominant limb as the support limb. A system consisting of Inertial and Magnetic Measurements Units was used to capture the angular displacements of trunk, hip, knee and ankle of the support limb during the test. The software estimated angular position values at maximal reach in each direction of the modified Star Excursion Balance Test. A handheld dynamometer was used to measure the isometric strength of the trunk and hip muscles: extensor and lateral flexor muscles of the trunk, extensors, lateral rotators and hip abductors of the support limb. Multiple linear regressions were used to assess the association between trunk, hip, knee and ankle angular displacement of the support limb and trunk and hip muscles strength of the support limb and performance during the modified Star Excursion Balance Test. The significance was set at α = 0.05.
Results: Reduced hip flexion and greater knee flexion predicted the anterior reach in the modified Star Excursion Balance Test (F=9.88; r=0.80; r2=0.65; p 0.01) and greater hip flexion, adduction and greater ankle dorsiflexion predicted posterolateral reach (F=8.07; r=0.77; r2=0.60; p 0.01). Lower limbs and trunk angular displacement also predicted the reach distance in the posteromedial direction (F=5.39; r=0.70; r2=0.50; p 0.01). In addition, hip extensors strength predicted posteromedial (F=4.09; r=0.61; r2=0.37; p 0.01), posterolateral (F=4.34; r=0.62; r2=0.39; p 0.01) and composite reaches (F=4.88; r=0.64; r2=0.41; p 0.01).
Conclusion(s): Hip, knee and ankle kinematics in the sagittal and frontal planes explained 60-65% of the athlete´s performance in the modified Star Excursion Balance Test and strength of the hip extensors explained 37-41% of this test performance. Future studies should investigate if strength of other lower limb muscles, such as knee extensors and ankle plantarflexors also influence on this test performance.
Implications: These results suggest that clinicians should evaluate hip strength and movement and knee and ankle movement in athletes demonstrating poor performance during the modified Star Excursion Balance Test.
Keywords: Modified Star Excursion Balance Test, Kinematics, Muscle Strength
Funding acknowledgements: Brazilian funding agencies CNPQ, FAPEMIG and CAPES.
Topic: Sport & sports injuries; Musculoskeletal
Ethics approval required: Yes
Institution: Universidade Federal de Minas Gerais
Ethics committee: Universidade Federal de Minas Gerais Ethical Research Committee
Ethics number: 65118017.5.0000.5149
All authors, affiliations and abstracts have been published as submitted.
