Dynamic Balance Performance and Noncontact Lower Extremity Injury in College Football Players

Abstract

Background:Field expedient screening tools that can identify individuals at an elevated risk for injury are needed to minimize time loss in American football players. Previous research has suggested that poor dynamic balance may be associated with an elevated risk for injury in athletes; however, this has yet to be examined in college football players.Hypothesis:To determine if dynamic balance deficits are associated with an elevated risk of injury in collegiate football players. It was hypothesized that football players with lower performance and increased asymmetry in dynamic balance would be at an elevated risk for sustaining a noncontact lower extremity injury.Study Design:Prospective cohort study.Methods:Fifty-nine collegiate American football players volunteered for this study. Demographic information, injury history, and dynamic balance testing performance were collected, and noncontact lower extremity injuries were recorded over the course of the season. Receiver operator characteristic curves were calculated based on performance on the Star Excursion Balance Test (SEBT), including composite score and asymmetry, to determine the population-specific risk cut-off point. Relative risk was then calculated based on these variables, as well as previous injury.Results:A cut-off point of 89.6% composite score on the SEBT optimized the sensitivity (100%) and specificity (71.7%). A college football player who scored below 89.6% was 3.5 times more likely to get injured.Conclusion:Poor performance on the SEBT may be related to an increased risk for sustaining a noncontact lower extremity injury over the course of a competitive American football season.Clinical Relevance:College football players should be screened preseason using the SEBT to identify those at an elevated risk for injury based upon dynamic balance performance to implement injury mitigation strategies to this specific subgroup of athletes.

Sex differences in frontal and transverse plane hip and knee kinematics during the modified Star Excursion Balance Test

“…The percentage of reach distance was calculated by dividing the reach distance by the leg length for each reach direction [16][17][18]. The composite reach, considered an overall performance measure for the three directions, was calculated as the sum of the ANT, PM, and PL reach distances divided by three times the leg length and multiplied by 100 [16][17][18]. Single limb reach distance in isolation was not examined because of the unilateral nature of the testing.…”

“…The performance on the mSEBT for males and females was examined by recording the percentage of reach distance (normalized to leg length) and compos- ite reach throughout the testing [16][17][18]. The percentage of reach distance was calculated by dividing the reach distance by the leg length for each reach direction [16][17][18].…”

“…The performance on the mSEBT for both sexes was also examined to account for potential influence on kinematic strategy. This was completed by examining the percentage of reach distance (normalized to leg length) and composite reach [16][17][18].…”

“…Original testing involved reaching the lower extremity in eight directions as far as possible, extending at 45° increments from the centre of the grid, while standing on the limb being tested [17]. Outcome measures of the tested stance limb include reach distance, percentage of reach distance (normalized to leg length), and composite reach [16][17][18]. This has since been adapted by investigators to reduce the original eight reaches to three for simplicity and reduction of redundancies [17][18][19][20].…”

“…The Star Excursion Balance Test (SEBT) has demonstrated consistent reliability and validity in the literature as a dynamic test to predict lower extremity injuries [16][17][18]. Original testing involved reaching the lower extremity in eight directions as far as possible, extending at 45° increments from the centre of the grid, while standing on the limb being tested [17].…”