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Inter- and intrarater reliability of the Hand Reach Star Excursion Balance Test
Ola Eriksrud1, Peter Federolf2 and Jan Cabri1
1 Department of Physical Performance, Norwegian School of Sport Sciences, N-0806 Oslo, NORWAY
2 Department of Sport Science, University of Innsbruck, A-6020 Innsbruck, AUSTRIA
Introduction
Several test batteries have been developed to evaluate
dynamic postural control, balance, and mobility through
functional excursion tasks. One example is the star excursion
balance test (SEBT)(1), which has been found to be reliable (2).
However, the SEBT is neither designed to nor does it elicit
general hip, spine or upper extremity joint movements. To target
these joint movements and to complement the SEBT in the
assessment of dynamic postural control, balance and mobility
we developed the hand reach star excursion balance test
(HSEBT).
Methods
In an experimental study, with a within subjects repeated
measures design, 29 male subjects (25.4 ± 6.4 years; 180.0 ±
9.3 cm) were included.
The HSEBT consists of 8 horizontal and 2 rotational hand reach
tests executed separately standing on the right and the left foot.
Similar to the SEBT, the horizontal HSEBT reaches are
performed along 8 reaching directions at 45 degree intervals,
measured in centimeters (cm), while the two rotational reach
tests are measured in degrees (°). The individual hand reach
tests are defined/named based on the anatomical neutral
position as follows: direction (anterior (A); posterior (P)), side of
body (left (L); right (R)), angle at 45° increments from anterior
(0°) to posterior (180°) and movement (rotation (ROT)) (Figure
1-4). Specifically, diagonal reaches (R45, L45, R135 and L135)
are unilateral hand reaches, while all the other reaches are
bilateral hand reaches. Rotational reaches are conducted with
both shoulders flexed to 90°. For description of reaches see
Figure 1-4 and Table 1.
All subjects were tested on four different occasions by one of
three testers. One tester tested each subjects twice, while two
testers tested each subjects once. The order of testers was
randomized, while the order of HSEBT tests were not. Testers
were blinded to the results. Coefficient of variation (CV) and
Interclass correlation coefficient (ICC3,1) was calculated. The
ICC was evaluated according to the following criteria:
high≥0.90, 0.80-0.89 moderate and below 0.80 questionable.
Conclusions
HSEBT shows moderate to high inter- and intrarater reliability.
Aim
To determine the inter- and intrarater reliability of the HSEBT.
References
1. 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: 47: 339-357
2. Hyong IH, Kim JH. Test intrarater and interrater reliability for the star excursion
balance test. J Phys Ther Sci 2014: 26: 1139-1141
Descriptive statistics for all reaches are presented in Figure 1-4.
Interrater reliability ICC and CV values, ranged from 0.88-0.97
and 2.22-13.42% respectively while intrarater reliability ICC
values and CV values ranged from 0.82-0.98 and 2.12-12.15%
respectively (Table 1).
Results
Figure 1. Horizontal reaches left leg (photographs) with center graph
showing average (black line) and standard deviation (grey area)
Table 1. Inter and intrarater reliability of HSEBT
Figure 3. Horizontal reaches right leg (photographs) with center
graph showing average (black line) and standard deviation (grey
area)
Interrater reliability Intrarater reliability
Test Foot Hand(s) ICC (3,1) 95 CI CV(%) ICC (3,1) 95 CI CV(%)
A0 L B 0.97 0.95, 0.99 2.9 0.98 0.96, 0.99 2.1
A0 R B 0.97 0.94, 0.98 2.2 0.95 0.89, 0.98 3.3
R45 L L 0.95 0.90, 0.97 3.6 0.92 0.83, 0.96 3.4
L45 R R 0.95 0.90, 0.97 3.4 0.93 0.85, 0.97 3.1
R90 L B 0.95 0.91, 0.98 5.5 0.90 0.79, 0.95 6.6
L90 R B 0.96 0.92, 0.98 5.8 0.93 0.84, 0.97 5.7
R135 L L 0.91 0.84, 0.96 13.2 0.88 0.73, 0.94 12.2
L135 R R 0.91 0.82, 0.95 13.4 0.89 0.74, 0.95 11.8
P180 L B 0.96 0.92, 0.98 5.6 0.93 0.85, 0.97 6.3
P180 R B 0.94 0.88, 0.97 7.2 0.89 0.76, 0.95 7.7
L135 L R 0.93 0.87, 0.96 6.3 0.93 0.86, 0.97 5.3
R135 R L 0.94 0.90, 0.97 6.4 0.94 0.88, 0.97 5.4
L90 L B 0.91 0.84, 0.96 6.8 0.82 0.61, 0.92 7.9
R90 R B 0.92 0.86, 0.96 6.4 0.87 0.73, 0.94 6.7
L45 L R 0.96 0.92, 0.98 4.9 0.97 0.93, 0.99 3.4
R45 R L 0.95 0.91, 0.97 5.1 0.95 0.90, 0.98 3.9
RROT L B 0.92 0.85, 0.96 5.0 0.93 0.84, 0.96 3.7
LROT R B 0.88 0.75, 0.94 5.1 0.93 0.84, 0.96 3.8
LROT L B 0.92 0.84, 0.96 5.3 0.91 0.81, 0.96 4.6
RROT R B 0.93 0.87, 0.97 5.5 0.90 0.79, 0.95 5.1
!!!!L!Foot
72#
79#
68#
50#
68#
81#
73#
66#
A0
R45
R90
R135
P180
L135
L90
L45
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!R!Foot
73#
66#
73#
80#
67#
50#
68#
80#
A0
R45
R90
R135
P180
L135
L90
L45
Figure 2. Rotational reaches left leg (photographs) with average (±SD)
reach (°)
Figure 4. Rotational reaches right leg (photographs) with average
(±SD) reach (°)
128±13
121±15
RROT
LROT
118±15
131±13
RROT
LROT
Abbreviations: LROT=Left rotation; RROT=Right rotation
Abbreviations: R=Right; L=Left; A0=Anterior; 45=Anterolateral; 90=Lateral;
135=posterolateral; P180=Posterior
Abbreviations: R=Right; L=Left; A0=Anterior; 45=Anterolateral; 90=Lateral;
135=posterolateral; P180=Posterior
Abbreviations: LROT=Left rotation; RROT=Right rotation