Defense Date

2009

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Educational Studies

First Advisor

Scott Ross

Abstract

The focus of this study was to determine the balance measures most sensitive and accurate in detecting balance deficits associated with functional ankle instability (FAI). Subjects consisted of those with a history of ankle sprains and resultant symptoms of giving way (N=17; Height=167.72±9.11 cm; Mass=67.81±12.29 kg; Age=23.35±3.62 yrs) and subjects without a history of ankle injuries (N=17; Height=168.16±8.32 cm; Mass=66.22±12.35 kg; Age=23.35±3.26 yrs). Data collection consisted of each subject performing static and dynamic balance tests. Static stability was assessed with force plate measures, the Balance Error Scoring System, foot lift test, and time-in-balance test. Dynamic stability was assessed with the Star Excursion Balance Test, side hop test, and figure-of-eight hop test. Significant receiver operating characteristic curves and therefore cutoff scores were found for the foot lift test (P=0.011; cutoff=4.84 foot lifts), time-in-balance test (P=0.020; cutoff=41.23 s), center-of-pressure velocity (P=0.026; cutoff=1.56 cm/s), anterior-posterior time-to-boundary standard deviation of the minima (P=0.054; cutoff=3.72 s), posteromedial reach direction of the Star Excursion Balance Test (P=0.039; cutoff=0.91 normalized to leg length) and side hop test (P=0.044; cutoff=12.88 s). The associated positive (≥2) and negative (≤0.05) likelihood ratios with each cutoff score indicated that changes in positive and negative posttest probabilities from the pretest probability of 50% were small, yet significant. Essentially, the significant change between pretest and posttest probabilities indicates that clinically relevant information was gained by conducting these balance measure because they quantified a high proportion of individuals with a positive test who have FAI and a low proportion of individuals with a negative test who have FAI. No significance was found for the Balance Error Scoring System (P=0.249), center-of-pressure area (P=0.547), anteromedial (P=0.134) and medial (P=0.125) reach directions of the Star Excursion Balance Test, and the figure-of-eight hop test (P=0.117). In conclusion, we found the foot lift test, time-in-balance test, center-of-pressure velocity, anterior-posterior time-to-boundary standard deviation of the minima, posteromedial reach direction of the Star Excursion Balance Test, and the side hop test to be sensitive and accurate balance measures for detecting balance deficits associated with FAI. We suggest utilizing these measures and their cutoff scores to evaluate balance deficits associated with FAI.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

August 2009

Included in

Education Commons

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