Dynamic balance performance and noncontact lower extremity injury in college football players: an initial study

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.

Keywords: Star Excursion Balance Test; field testing; injury screening.

Figure 1.

Flow diagram indicating selection of subjects in the study and injuries incurred. LE, lower extremity.

Figure 2.

(a-c) Lower Quarter Y-Balance Test reach directions.

Figure 3.

Likelihood ratio nomogram showing how the SEBT cut-off point changes the probability of sustaining a lower extremity noncontact injury. A YBT-LQ composite reach score of <89 cm increases the probability from 37.7% to 68.0%. SEBT, Star Excursion Balance Test; YBT-LQ, Lower Quarter Y-Balance Test.