The Star Excursion Balance Test: Criterion and divergent validity on patients with femoral acetabular impingement

Abstract

PostprintThis is the accepted version of a paper published in Manual Therapy. This paper has been peerreviewed but does not include the final publisher proof-corrections or journal pagination.Citation for the original published paper (version of record):

A Combined Treatment Approach Emphasizing Impairment-Based Manual Therapy and Exercise for Hip-Related Compensatory Injury in Elite Athletes: A Case Series

“…Common anatomical features such as posture and bony hip morphology may impact function 23,24,35,36 and potentially result in pathology. However, asymptomatic findings and concurrent pathoanatomical diagnoses make treating specific structures challenging.…”

“…Sacroilliac dysfunction was assessed via provocation testing. 42 Movement testing (i.e overhead squat, lunge, single leg squat, Y-Balance Test) 18,35 was also utilized to identify aberrant or painful movement and compared to prior assessment when possible. Clinical findings that were similar across subjects were abnormal hip (decreased and/or asymmetrical, specifically in internal and external rotation, abduction, and flexion) ROM, impaired lumbopelvic strength and motor control defined by aberrant motion and/ or functional movement assessment, at least one segment of the lumbar spine that was painful and/or hypomobile, and a painful, but not necessarily concordant, FADIR test.…”

“…Additionally, a focus was placed on motor control of the lumbopelvic region and lower extremity during single leg movements. 35,36,44 The exercise progression described, particularly in the sub-acute phase, is thought to be clinically significant, as advancing a training stimulus targeting the kinetic chain 62 may have greater impact on the movement system as compared to structure specific exercise. 18 In the presence of performance limiting pathology, training load should be monitored and adjusted accordingly to address risk factors while decreasing athlete decided to initially trial conservative care, and the subject was able to complete the following competitive season with an increase in playing time from the prior season.…”

“…Inadequate strength profiles of the hip musculature have been identified in those who have sustained groin and lower extremity injury, 31,32,33,34 while individuals with groin pain and LBP have been found to demonstrate motor control deficits of the lumbopelvic region and lower quarter. 14,23,24,35 Those with FAI have been reported to demonstrate altered lower body kinetics and force attenuation, potentially resulting in excessive impulse to the joint. 36 Motor control deficits have been linked to reports of impaired sport performance and pain.…”

“…36 Motor control deficits have been linked to reports of impaired sport performance and pain. 35,37 Uneven distribution of forces across the pelvis, in part due to limited regional mobility 22 and impaired strength 31,32,33 and neuromuscular control 15,35 may result in mechanical overload and subsequent acute or chronic injury, 1,4 ultimately impacting the movement system. These previously noted findings about the hip and lumbopelvis have been proposed to be related irrespective of any individual pathoanatomical diagnosis.…”