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The Star Excursion Balance Test (SEBT) is a reliable, responsive, and clinically relevant functional assessment of lower limbs’ dynamic postural control. However, great disparity exists regarding its methodology and the reported outcomes. Large and specific databases from various population (sport, age, and gender) are needed to help clinicians when interpreting SEBT performances in daily practice. Several contributors to SEBT performances in each direction were recently highlighted. The purpose of this clinical commentary is to (a) provide an updated review of the design, implementation, and interpretation of the SEBT and (b) propose guidelines to standardize SEBT procedures for better comparisons across studies.

Athletic preinjury function is typically determined via subjective recall; however, obtaining preinjury function before injury occurs should be attempted in order to establish an individual baseline for postinjury comparison. The purpose of this study was to obtain preinjury baseline values for the Foot and Ankle Disability Index (FADI) and Foot and Ankle Disability Index sport version (FADISP), single-leg hop for distance, and Star Excursion Balance Test anterior reach and determine if athletes returned to those values following ankle injury. Out of 41 qualifying injuries, FADI/FADISP scores were significantly reduced at initial injury compared with baseline and all other time points (p p ≥ .98). Subjective and objective preinjury function can be reestablished by discharge from supervised treatment following low-grade ankle injury and maintained for at least 6 months following the cessation of treatment. However, testing metrics should be reviewed on an individual athlete basis, because group data may mask individual patient needs.

Athletic preinjury function is typically determined via patient recall, however obtaining preinjury function before injury occurs should be attempted. The purpose of this study was to obtain preinjury physical function baseline values using the Knee Injury and Osteoarthritis Outcome Score (KOOS), single-leg hop for distance (SLH), and Star Excursion Balance Test (SEBT) anterior reach to determine if athletes return to those baseline values following knee injury. Out of 27 qualifying injuries, KOOS scores were significantly reduced at initial injury compared to baseline and all follow-up points (p ≤ .02). In most instances, baseline KOOS scores were not met at the discharge time point. SLH and SEBT recovered to baseline values by discharge. Injury severity and previous injury created variations in KOOS scores across multiple time points. Subjective and objective preinjury function can be re-established following knee injury but recovery may not occur at discharge from rehabilitation.

Focused Clinical Question: In patients who have sustained a concussion, does vestibular rehabilitation therapy improve clinical symptoms of dizziness and self-reported balance deficits and/or influ...

Multiple treatment options have been shown to improve dorsiflexion range of motion (DFROM) group means in patients with chronic ankle instability (CAI). However, not all patients with CAI respond equally to these treatments. The aim of this study was to identify predictors of successfully improving dorsiflexion range of motion (DFROM) in patients with CAI. Patients with 92% posttest probabilities. Simple pretreatment assessments can dramatically improve treatment success probability following STARS in patients with CAI.

The authors reflect on how the athletic training community was affected by the COVID-19 pandemic, including on athletic training research Topics include how the readers, editors, authors, and reviewers were affected by the pandemic, and how athletic trainers conduct research, evaluate research, and disseminate research

Single joint kinematic alterations have been identified during gait in those with chronic ankle instability (CAI). The purpose of this study was to compare sagittal plane hip, knee, and ankle kinematics during walking in participants with and without CAI. Twelve individuals with CAI and 12 healthy individuals walked on a treadmill at 1.5 m/s. Three-dimensional kinematics were analyzed using mean ensemble curves and independent t tests. Participants with CAI demonstrated less lower extremity flexion during the absorption phase of stance and the limb placement phase of swing, which may have implications for limb placement at initial contact.

Context:Following joint mobilizations, individuals with chronic ankle instability (CAI) have reported increased self-reported function as measured by the Foot and Ankle Ability Measure (FAAM).Objective:To examine the effect of a 2-week talocrural joint mobilization intervention on individual items of the FAAM in physically active adults with CAI.Participants:Twelve adults with CAI.Intervention:Self-reported function was documented with the FAAM-ADL and FAAM-Sport at preintervention and at 1-week postintervention. The joint mobilization intervention consisted of six treatments over 2 weeks. During each treatment, subjects received 4 minutes of talocrural traction and 8 minutes of Maitland Grade-III anterior-to-posterior talocrural joint mobilization.Main Outcome Measures:Participants completed the 21-item FAAM-ADL and 8-item FAAM-Sport.Results:Signifcant changes were detected between preintervention and 1-week follow-up measures for “Walking on even ground” (p = 0.06), “Going down stairs” (p = 0.07), “Walking on uneven ground” (p = 0.03), “Light to moderate work” (p = 0.06), “Heavy work” (p = 0.03), “Recreational activity” (p = 0.07), “Landing” (p = 0.03), “Low impact activities” (p = 0.07), and “Cutting” (p = 0.02). No signifcant changes were identifed in the other 20 items (p > 0.10).Conclusion:The fndings suggest talocrural joint mobilization may address specifc mechanical and functional impairments associated with the aforementioned tasks during physical activity.

Ankle sprains are the most frequently occurring orthopedic injury among the physically active. The number 1 risk factor for suffering an ankle sprain is a history of a previous sprain. Those with a history of ankle sprain often report recurrent bouts of ankle instability and decreased functional capacity. Several mechanical and functional deficits have been identified that may contribute to residual symptoms, sequelae, and functional loss. One is decreased dorsiflexion range of motion. This deficit could predispose the patient to alterations in the ankle axis of rotation, changes in alignment and tracking of bony surfaces, and disrupted proprioceptive input to the sensorimotor system resulting in future ankle sprains or ankle osteoarthritis. Therefore, improving accessory and physiological motion at the talocrural joint is a clinical consideration. Joint mobilizations could be an effective intervention for addressing these alterations during rehabilitation. A joint-mobilization technique known as mobilization with movement (MWM) is of particular interest because this method is the concurrent application of an accessory mobilization with active or passive physiological movement.

Context:Increased plantar cutaneous afferent information may improve postural control.Objective:To compare postural control measures between balance conditions with and without textured insoles.Design:crossover trial.Setting:Research Laboratory.Patients or Other Participants:33 healthy subjects (27.4 ± 9.1yrs, 172.6 ± 10.3 cm, 75.4 ± 16.4 kg).Intervention(s):Subjects performed 24, 10-second bipedal and unilateral stance balance trials with eyes opened and eyes closed, with and without a textured insole in subjects’ shoes.Main Outcome Measures:Average velocity and area of center of pressure (COP) excursions.Results:We observed an interaction among balance conditions during bilateral stance, but not during unilateral stance. On average, subjects exhibited greater area and velocity of COP excursions with eyes closed compared to eyes opened. Significant differences in area and velocity of COP excursions were observed during bilateral stance only when subjects were not wearing textured insoles. There were no significant differences while subjects balanced in bilateral stance with textured insoles.Conclusions:Increased afferent information from textured insoles improves postural control in bilateral stance.

based on the environmental cues received as the task is performed. If there are changes in the task or environment, the sensorimotor system can organize a new strategy to satisfy demands associated with the movement goal. More strategies translate to an enhanced ability to successfully accomplish the movement goal and cope with change. This has been referred to as invariant results through variant means, which is also referred to as functional variability.2 Injury can significantly hinder the sensorimotor system in its ability to UNCTIONAL REHABILITATION associated with physical activity has been touted to be the cornerstone of athletic training’s niche among health care professions. This rehabilitation paradigm has focused on restoring sensorimotor function related to sport/ activity-specific rehabilitation exercises and equipment. Advances in techniques associated with this paradigm have brought forth such things as jump training programs for the prevention of ACL injuries in female athletes and balance training for those with chronic ankle instability. As the utilization of these programs become more widespread, the need for a theoretic construct to aid in decisions associated with program design, evaluation, and progression has grown. The dynamical systems theory (DST) provides such a framework. A previous ATT report introduced DST as it relates to sports medicine research.1 According to DST, the behavior of the sensorimotor system is controlled by (a) the health of the person, (b) the task being performed, and (c) the environment in which a movement goal is executed (Table 1). Rather than having preprogrammed neural pathways to accomplish a movement goal (associated with traditional theories of sensorimotor system function), DST suggests that the sensorimotor system is free to develop and change strategies as it interacts with the environment. In this way, coordination within the sensorimotor system changes on the basis of demands imposed by the movement goal. Because of this spontaneous (goal-oriented) self-organization, a healthy sensorimotor system can accomplish a movement goal in a variety of ways, any one of which is John Parsons, MS, ATC, AT/L, Report Editor