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2007 The Impact of Single-Leg Dynamic Balance Training On Dynamic Stability PDF
2007 The Impact of Single-Leg Dynamic Balance Training On Dynamic Stability PDF
2007 The Impact of Single-Leg Dynamic Balance Training On Dynamic Stability PDF
Original research
Received 26 May 2006; received in revised form 22 May 2007; accepted 27 June 2007
Abstract
Objective: The aim of the study was to determine the effect of progressive one-leg dynamic balance training programme on dynamic
stability in healthy male athletes.
Design: Mixed design with repeated measures at baseline and after 2 and 4 weeks of progressive single-leg balance training.
Setting: Clinic and gymnasium.
Participants: Thirty healthy male athletes volunteered to participate in this study and were randomly assigned to a training or
control (CON) group.
Main outcome measures: Dynamic stability was assessed using the Star Excursion Balance Test (SEBT) in the trained (TRD) and
untrained (UTD) legs in the training group as well as in one leg of the CON group.
Results: SEBT scores did not change in the CON leg but signicantly increased at 2 and 4 weeks in the TRD leg for total combined
score and in all individual directions by ca. 1136%. For example, in the posterior direction reach increased from 9776 cm at
baseline to 11279 cm and 12177 cm (Po0.01) after 2 and 4 weeks, respectively. Performance in the UTD leg increased signicantly
in 4 out of 8 reach directions to a smaller extent than the TRD leg.
Conclusion: A progressive single-leg dynamic balance exercise programme can improve dynamic stability very rapidly. This has
practical implications for sporting scenarios such as pre-season training.
r 2007 Elsevier Ltd. All rights reserved.
Keywords: Proprioception; Functional reach; Postural stability; Injury prevention
1. Introduction
Inversion injuries of the lateral ligaments of the ankle
joint complex are among the most frequent injuries in
young physically active individuals (Bernier & Perrin,
1998; Holmer, Sondergaard, Konradsen, Nielsen, &
Jorgensen, 1994) and are believed to result from, and/or
lead to, diminished stability or balance ability (Cornwall
& Murrell, 1991; Lofvenberg, Karrholm, Sudelin, &
AhIgren, 1995). Balance training may be valuable in the
Corresponding author. Tel.: +44 151234088;
fax: +44 1512314353.
E-mail address: k.george@ljmu.ac.uk (K. George).
1466-853X/$ - see front matter r 2007 Elsevier Ltd. All rights reserved.
doi:10.1016/j.ptsp.2007.06.001
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2. Method
2.1. Subjects
Thirty healthy male athletes were recruited via posters
and word of mouth from the general athletic population
in Saudi Sport Clubs located in the Qatif and Dammam
area of the Eastern Province of Saudi Arabia. The
subjects were selected based on the following criteria:
Inclusion criteria: The subjects were young healthy male
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179
Fig. 1. Subject performing the posterior reach component of the Star Excursion Balance Test (SEBT).
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Table 1
Exemplar progression details for the dynamic single-leg balance training
Floor
Eyes
Exercise
Gymnasium oor
Open
Gymnasium oor
Soft gymnasium mat
Soft gymnasium mat
Gymnasium oor
Closed
Open
Closed
Open
Gymnasium oor
Soft gymnasium mat
Soft gymnasium mat
Gymnasium oor
Closed
Open
Closed
Open
Gymnasium oor
Soft gymnasium mat
Soft gymnasium mat
Closed
Open
Closed
60 s exercise trial in single-leg balance position. The contra-lateral leg was held in a
relaxed position with minor knee and hip exion by the side of the test leg. Five
trials with 30 s rest in between trials.
Same
Same
Same
60 s exercise trial in single-leg balance position. The contra-lateral leg held in a
comfortable relaxed position with minor knee and hip exion. The trunk was then
rotated smoothly to the end of range in both directions. Five trials with 30 s rest in
between trials.
Same
Same
Same
60 s exercise trial in single-leg balance position. The contra-lateral leg held in 901
hip and knee exion. The trunk is then rotated smoothly to the end of range in both
directions. Five trials with 30 s rest in between trials.
Same
Same
Same
3. Results
At baseline there were no differences in reach
distance, in any direction or for the total combined
score, between the TRD and CON legs as well as
between the TRD and UTD legs (P40.01; see Table 2).
Differences in SEBT scores were noted between directions due to the nature of the test.
Signicant interaction terms (Po0.01) were recorded
for all two-way ANOVAs comparing the TRD and
CON leg reach scores before and after 2 and 4 weeks of
training. The clear indication for total combined score
as well as all individual directions was that reach
distance increased signicantly in the TRD leg at 2
weeks and then either remained greater than pre-scores
(anterior, medial) or continued to signicantly increase
from 2 to 4 weeks of training (total combined,
anteromedial, posteromedial, posterior, posterolateral,
lateral, anterolateral). For total combined and all
individual directions, TRD leg reach scores were
signicantly greater than CON leg reach scores at both
2 and 4 weeks. The percentage change from baseline to 4
weeks of training ranged from 10.7% to 35.5% in the
anterior and anterolateral directions, respectively (see
Table 2) in the TRD leg but changes in the CON leg
over the same time period were always o4% and
sometimes negative.
The consistency of ANOVA interaction term outcomes was reduced for comparisons between the TRD
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Table 2
Reach performance data (cm; mean7S.D.) for all directions of the SEBT test in the CON, TRD and UTD legs
Direction
Leg
Total combined
CON
TRD
UTD
Anterior
Pre
2 week
4 week
% change
8674
8874
8974
8774
10077a,b,d
9679a
8774
10676a,b,c,d
9876a
+1.1
+20.4
+10.1
CON
TRD
UTD
8174
8476
8576
8275
9175a,b
8775
8376
9374a,b,d
8674
+2.5
+10.7
+1.1
Anteromedial
CON
TRD
UTD
8876
9076
9277
8975
9976a,b
9777
9075
10377a,b,c,d
9576
+2.3
+14.4
+3.2
Medial
CON
TRD
UTD
9477
9778
9877
9476
11378a,b
10678
9576
11575a,b
10876
+1.1
+18.6
+10.2
Posteromedial
CON
TRD
UTD
9577
102710
101710
9776
11778a,b
111711
9975
12276a,b,c
11478
+4.2
+19.6
+12.9
Posterior
CON
TRD
UTD
9478
9776
9979
9577
11279a,b
10778a
9776
12177a,b,c,d
10476a
+3.2
+25.8
+5.1
Posterolateral
CON
TRD
UTD
9174
9177
92710
8776
10179a,b
9878a
9074
11076a,b,c,d
10176a
1.1
+20.9
+9.8
Lateral
CON
TRD
UTD
8174
8079
79710
8074
9277a,b
86711a
7973
9976a,b,c,d
8776a
2.5
+23.8
+10.1
Anterolateral
CON
TRD
UTD
6778
62713
65711
6677
7678a,b,d
68713a
6279
8477a,b,c,d
7279a,d
7.5
+35.5
+10.8
SEBT, Star Excursion Balance Test; CON, control group leg; TRD, trained leg; and UTD, untrained leg.
a
Signicantly different from corresponding pre-score.
b
Signicantly different from corresponding CON score.
c
Signicantly different from corresponding 2 week score.
d
Signicantly different from corresponding UTD score.
4. Discussion
In summary, this study has demonstrated that
following as little as 2 and 4 weeks of progressive
single-leg dynamic balance training (TRD) signicant
improvements in dynamic balance performance occurred in all directions of the SEBT. In the UTD leg,
some small but signicant improvements in reach were
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Acknowledgements
This work was completed in partial fullment of an
M.Sc. in Science of Sports Injury at Manchester
Metropolitan University. The authors would like to
thank the physiotherapists in Saudi Arabia who
supported this study.
Conflict of interest statement: All authors have no
conicts of interest with respect to the data collected and
procedures used within this study.
Ethical statement: The authors conrm this study
meets the guidelines of the Declaration of Helsinki and
after local ethical approval all subjects provided written
informed consent.
183
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