Using the star excursion balance test to assess dynamic postural-control deficits and outcomes in lower extremity injury: A literature and systematic review

Context: A dynamic postural-control task that has gained notoriety in the clinical and research settings is the Star Excursion Balance Test (SEBT). Researchers have suggested that, with appropriate instruction and practice by the individual and normalization of the reaching distances, the SEBT can be used to provide objective measures to differentiate deficits and improvements in dynamic postural-control related to lower extremity injury and induced fatigue, and it has the potential to predict lower extremity injury. However, no one has reviewed this body of literature to determine the usefulness of the SEBT in clinical applications. Objective: To provide a narrative review of the SEBT and its implementation and the known contributions to task performance and to systematically review the associated literature to address the SEBT's usefulness as a clinical tool for the quantification of dynamic postural-control deficits from lower extremity impairment. Data Sources: Databases used to locate peer-reviewed articles published from 1980 and 2010 included Derwent Innovations Index, BIOSIS Previews, Journal Citation Reports, and MEDLINE. Study Selection: The criteria for article selection were (1) The study was original research. (2) The study was written in English. (3) The SEBT was used as a measurement tool. Data Extraction: Specific data extracted from the articles included the ability of the SEBT to differentiate pathologic conditions of the lower extremity, the effects of external influences and interventions, and outcomes from exercise intervention and to predict lower extremity injury. Data Synthesis: More than a decade of research findings has established a comprehensive portfolio of validity for the SEBT, and it should be considered a highly representative, noninstrumented dynamic balance test for physically active individuals. The SEBT has been shown to be a reliable measure and has validity as a dynamic test to predict risk of lower extremity injury, to identify dynamic balance deficits in patients with a variety of lower extremity conditions, and to be responsive to training programs in both healthy people and people with injuries to the lower extremity. Clinicians and researchers should be confident in employing the SEBT as a lower extremity functional test.