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      Test of Intrarater and Interrater Reliability for the Star Excursion Balance Test

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          Abstract

          [Purpose] The aim of this study was to examine the intrarater and interrater reliability of the Star Excursion Balance Test (SEBT), thereby increasing understanding of its efficient utilization. [Subjects and Methods] There were 67 subjects (49 female; 18 male). For the SEBT, eight lines were made using tape at 45-degree angles from the center of a circle. The experiment was conducted in the following order: the anterior, anterior-medial, medial, posterior-medial, posterior, posterior-lateral, lateral, and anterior-lateral directions. Intraclass correlation coefficients (ICC) (3,1) were used to evaluate the intrarater and interrater reliability (2,1) for each reach distance, while the standard error of measurement (SEM) and smallest detectable distance (SDD) were employed to assess absolute reliability. [Results] For intraratar reliability, the ICC values for all directions ranged from 0.88 to 0.96, SEM values ranged from 2.41 to 3.30, and SDD values ranged from 6.68 to 9.15. For interrater reliability, the ICC values for all directions ranged from 0.83 to 0.93, SEM values ranged from 3.19 to 4.26, and SDD values ranged from 8.85 to 11.82 [Conclusion] The SEBT is a highly reliable tool for measuring dynamic balance. Measurements for intrarater reliability are more reliable than measurements for interrater reliability. When measurement for eight directions was difficult, the SEBT was used. While the anterior, posteromedial, and posterolateral directions employed in the Y Balance Test Kit TM can be utilized, this study recommends using the reverse Y Balance Test Kit TM method with the posterior direction, not the anterior direction.

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          Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players.

          Prospective cohort. To determine if Star Excursion Balance Test (SEBT) reach distance was associated with risk of lower extremity injury among high school basketball players. Although balance has been proposed as a risk factor for sports-related injury, few researchers have used a dynamic balance test to examine this relationship. Prior to the 2004 basketball season, the anterior, posteromedial, and posterolateral SEBT reach distances and limb lengths of 235 high school basketball players were measured bilaterally. The Athletic Health Care System Daily Injury Report was used to document time loss injuries. After normalizing for lower limb length, each reach distance, right/left reach distance difference, and composite reach distance were examined using odds ratio and logistic regression analyses. The reliability of the SEBT components ranged from 0.82 to 0.87 (ICC3,1) and was 0.99 for the measurement of limb length. Logistic regression models indicated that players with an anterior right/left reach distance difference greater than 4 cm were 2.5 times more likely to sustain a lower extremity injury (P<.05). Girls with a composite reach distance less than 94.0% of their limb length were 6.5 times more likely to have a lower extremity injury (P<.05). We found components of the SEBT to be reliable and predictive measures of lower extremity injury in high school basketball players. Our results suggest that the SEBT can be incorporated into preparticipation physical examinations to identify basketball players who are at increased risk for injury.
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            Simplifying the star excursion balance test: analyses of subjects with and without chronic ankle instability.

            Case control study. The objectives of this study are: (1) to perform factor analyses on data from the 8 components of the star excursion balance test (SEBT) in subjects with and without chronic ankle instability (CAI) in an effort to reduce the number of components of the SEBT, (2) to assess the relationships between performance of the different reach directions using correlation analyses, and (3) to determine which components of the SEBT are most affected by CAI. The SEBT is a series of 8 lower-extremity-reaching tasks purported to be useful in identifying lower extremity functional deficits. Forty-eight young adults with unilateral CAI (22 males, 26 females; mean +/- SD age, 20.9 +/- 3.2 years; mean +/- SD height, 173.6 +/- 11.1 cm; mean +/- SD mass, 80.1 +/- 22.1 kg) and 39 controls (23 males, 16 females; mean +/- SD age, 20.7 +/- 2.4 years; mean +/- SD height, 174.1 +/- 12.9 cm; mean +/- SD mass, 75.1 +/- 18.6 kg) performed 3 trials of the 8 tasks with each of their limbs. Separate exploratory factor analyses were performed on data for involved limbs of the CAI group, uninvolved limbs of the CAI and control groups, and both limbs of the CAI and control groups. Pearson product moment correlations were calculated to identify the relationships between the different reach directions. A series of eight 2 x 2 analyses of variance were calculated to determine the influence of group (CAI, control) and side (involved, uninvolved) on performance of the 8 tasks. For all 3 factor analyses, only 1 factor in each analysis produced an eigenvalue greater than 1 and the posteromedial reach score was the most strongly correlated task with the computed factor (alpha > .90), although all 8 tasks produced alpha scores greater than .67. Bivariate correlations between specific reach directions ranged from .40 to .91. Subjects with CAI reached significantly less on the anteromedial, medial, and posteromedial directions when balancing on their involved limbs compared to their uninvolved limbs and the side-matched limbs of controls. The posteromedial component of the SEBT is highly representative of the performance of all 8 components of the test in limbs with and without CAI. There is considerable redundancy in the 8 tasks. The anteromedial, medial, and posteromedial reach tasks may be used clinically to test for functional deficits related to CAI in lieu of testing all 8 tasks. There is a need for a hypothesis-driven study to confirm the results of this exploratory study.
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              The reliability of an instrumented device for measuring components of the star excursion balance test.

              The Star Excursion Balance Test (SEBT) is a dynamic test that requires strength, flexibility, and proprioception and has been used to assess physical performance, identify chronic ankle instability, and identify athletes at greater risk for lower extremity injury. In order to improve the repeatability in measuring components of the SEBT, the Y Balance Test™ has been developed.
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                Author and article information

                Journal
                J Phys Ther Sci
                J Phys Ther Sci
                JPTS
                Journal of Physical Therapy Science
                The Society of Physical Therapy Science
                0915-5287
                2187-5626
                30 August 2014
                August 2014
                : 26
                : 8
                : 1139-1141
                Affiliations
                [1) ] Department of Physical Therapy, Shinsung University, Republic of Korea
                Author notes
                [* ]Corresponding author. Jae Hyun Kim, Department of Physical Therapy, Shinsung University: Daehak-ro, Jeongmi-myeon, Dangjin-si, Chungcheongnam-do, Republic of Korea. (E-mail: anatomy2@ 123456shinsung.ac.kr )
                Article
                jpts-2014-044
                10.1589/jpts.26.1139
                4155207
                2014©by the Society of Physical Therapy Science

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License.

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