Star Excursion Balance Test

Star Excursion Balance Test (SEBT) is a dynamic test that measures the ability of an individual to maintain a single leg stance while the contralateral leg reaches as far as possible in eight different directions. These directions are:

1. Anterior,
2. Anteromedial,
3. Medial,
4. Posteromedial,
5. Posterior,
6. Posterolateral,
7. Lateral,
8. Anterolateral.

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See Also: Gait Cycle

The Star Excursion Balance Test can be administered quickly and easily to help the clinician determine if the patient possesses or has returned to normal, symmetrical levels of dynamic balance. Because the test requires the person to maintain balance at his or her limits of stability, the Star Excursion Balance Test can be used to discriminate neuromuscular control abilities at the more demanding levels that are required for athletes, occupational workers, and active individuals. The SEBT can differentiate participants with lower extremity injuries; therefore, it might be used as a marker of normalization of neuromuscular control after those injuries.

See Also: Balance Tests

How to perform the Star Excursion Balance Test?

To begin with, the examiner places four strips of tape with a length of 6 to 8 feet in a star pattern. All the lines are separated from each other by a 45° angle. The patient stands in the center of the star balancing on one leg while extending the other leg out in different directions of the star.

The examiner measures how far the patient is able to reach in each direction along the star using a measuring tape. The test begins with balancing on the dominant or good leg and concludes with the other leg, and the values are compared. If the examiner has pre-concussion values, they can be used to compare with post-concussion values which should show decreases bilaterally with the concussion. If the values decrease unilaterally, it is probably due to a leg injury. The most important directions are anterior, posteromedial, and posterolateral.

See Also: Berg Balance Scale

Y-Balance Test

The Y-Balance Test is a modification or refinement of this test doing only the anterior, posteromedial, and posterolateral movement using a specific Y-shaped device in which boxes are pushed along a metal line while the patient balances on one foot on the center box.

In one study to simplify the star excursion balance test in analyzing of patients with and without chronic ankle instability, this study found that the posteromedial component of the SEBT is highly representative of the performance of all 8 components of the test in limbs with and without chronic ankle instability. 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 chronic ankle instability in lieu of testing all 8 tasks.

References & More

1. Orthopedic Physical Assessment by David J. Magee, 7th Edition.
2. Shaffer SW, Teyhen DS, Lorenson CL, Warren RL, Koreerat CM, Straseske CA, Childs JD. Y-balance test: a reliability study involving multiple raters. Mil Med. 2013 Nov;178(11):1264-70. doi: 10.7205/MILMED-D-13-00222. PMID: 24183777. Pubmed
3. Gribble PA, Hertel J. Considerations for normalizing measures of the star excursion balance test. Measurement Phys Educ Exerc Sci. 2003;7(2):89–100
4. Hertel J, Braham RA, Hale SA, Olmstead-Kramer LC. Simplify the star excursion balance test: analysis of subjects with and without chronic ankle instability. J Orthop Sports Phys Ther. 2006;36(3): 131–137.
5. Gribble PA, Hertel J, Plisky P. Using the Star Excursion Balance Test to assess dynamic postural-control deficits and outcomes in lower extremity injury: a literature and systematic review. J Athl Train. 2012 May-Jun;47(3):339-57. doi: 10.4085/1062-6050-47.3.08. PMID: 22892416; PMCID: PMC3392165.