DYNAMIC LEAP AND BALANCE TEST (DLBT): ABILITY TO DISCRIMINATE BALANCE DEFICITS IN INDIVIDUALS WITH CHRONIC ANKLE INSTABILITY

Open Access
Author:
Jaffri, Abbis Haider
Graduate Program:
Kinesiology
Degree:
Master of Science
Document Type:
Master Thesis
Date of Defense:
June 20, 2016
Committee Members:
  • Sayers John Miller III, Thesis Advisor
  • Giampietro Luciano Vairo, Committee Member
  • William E Buckley, Committee Member
Keywords:
  • Balance
  • Chronic Ankle Instability
  • SEBT
  • Postural Control
  • lower extremity
Abstract:
Clinicians commonly explore functional testing methods that can help them identify individuals with conditions of interest and measure the progress of rehabilitation programs. The Modified Star Excursion Balance Test (mSEBT) is a measure of dynamic balance commonly used in the assessment of lower extremity injuries. It has previously been used to identify dynamic balance deficits in individuals with chronic ankle instability (CAI). The mSEBT measures the dynamic control of body movements over an unchanging base of support (BOS). Most running sports require serial changes in BOS alternating from limb to limb requiring reestablishment of dynamic stability with each change. We created a new dynamic balance test, the Dynamic Leap and Balance Test (DLBT) that requires changes in BOS and recovery of dynamic stability. It is purported to more closely mimic the balance requirements of running sports which can provide clinicians with a more robust measure of dynamic balance for identifying injured populations and physical rehabilitative progression. The secondary purpose of this study was to compare dynamic balance performance between the DLBT and the mSEBT in participants with unilateral CAI. It was hypothesized that the DLBT will show significant differences between the involved and uninvolved limbs between either of the two CAI and control groups. Thirty-six college-aged students were recruited and divided in two groups. Eighteen participants with a unilateral history of CAI were designated as the injured group and eighteen participants without a history of CAI were designated as healthy controls. CAI subjects were identified using the Identification of Functional Ankle Instability (IdFAI) questionnaire. In this case-control study participants were randomly assigned to complete the mSEBT or DLBT on either their CAI (or healthy matched) or uninvolved limb on Day 1 and the same tasks on Day 2 with the other limb. There were no statistically significant differences (P < 0.05) seen between any of the four conditions for composite or individual reach (anterior, posteromedial, posterolateral) distance measures (% leg lengths) of the mSEBT. Statistically significant differences (P<0.001) in DLBT time were found between limbs. The DLBT time (seconds) for the CAI involved limb (51.85 ± 4.04, 95% CI = 51.18, 53.52) was significantly greater than for the CAI uninvolved limb (44.12 ± 3.60, 95 % CI = 42.52, 45.78) and the control matched limb (41.88 ± 3.36, 95% CI = 40.21, 43.55). There were no significant differences in the DLBT time between the limbs in the control participants. These results suggest that the DLBT may be a more robust measure for detecting dynamic balance deficits as compared to the mSEBT in individuals with unilateral CAI. The DLBT is more challenging than the mSEBT as participants have to change the BOS and reestablish dynamic balance. Moreover, the leaping task involved in the DLBT appears to require greater production and attenuation of acceleration and deceleration forces and is more functionally similar to walking, running, cutting and jumping activities. The DLBT is a cost-effective tool that can be used to assess dynamic balance that may be more robust in identifying individuals with CAI than previously proposed measures of dynamic balance such as the modified SEBT.