Journal of Athletic Training 2013;48(3):000000
doi: 10.4085/1062-6050-48.3.03
by the National Athletic Trainers Association, Inc
www.nata.org/journal-of-athletic-training
Interrater Reliability of the Star Excursion Balance Test
Phillip A. Gribble, PhD, ATC, FNATA*; Sarah E. Kelly, BAppSci;
Kathryn M. Refshauge, PhD; Claire E. Hiller, PhD
*University of Toledo, OH; University of Sydney, Australia
Context: Dynamic postural control has gained popularity as
a more useful assessment of function than static postural
control. One measurement of dynamic postural control that has
increased in frequency of use is the Star Excursion Balance Test
(SEBT). Although the intrarater reliability of the SEBT is
excellent, few authors have determined interrater reliability.
Preliminary evidence has shown poor reliability between
assessors.
Objective: To determine interrater reliability using a group
of investigators at 2 testing sites. A corollary purpose was to
examine the interrater reliability when using normalized and
nonnormalized performance scores on the SEBT. eF
Design: Descriptive laboratory study.
Setting: University research laboratory.
Patients or Other Participants: A total of 29 healthy
participants between 18 and 50 years of age.
Intervention(s): Participants were evaluated by 5 raters at 2
testing sites. After participants performed 4 practice trials, each
rater assessed 3 test trials in the anterior, posteromedial, and
in
posterolateral reaching directions of the SEBT.
Key Points
nl
 When multiple raters in different settings were trained by an experienced rater, the Star Excursion Balance Test had
excellent reliability.
 Whether the chosen outcome was average or maximum scored and used raw or normalized data, the anterior,
posteromedial, and posterolateral directions had excellent reliability.
O
C
linicians often use postural-control assessments to
evaluate the risk of injury, initial decits resulting
from injury, and the level of improvement after
intervention for an injury. Dynamic postural control has
gained popularity in clinical and research settings as an
assessment of function. One measurement of dynamic
postural control that has increased in frequency of use is the
Star Excursion Balance Test (SEBT). The measure of
dynamic postural control is inferred from how far a
participant can reach while maintaining a base of support.
Widespread use of the SEBT in the clinical and research
settings has demonstrated its strong capability to differen-
tiate patients with lower extremity conditions such as ankle
instability,18 anterior cruciate ligament reconstruction,9
and patellofemoral pain.10 Additionally, the SEBT can
assess improvements in dynamic postural control after
exercise interventions.4,11,12
The limited literature available suggests that when a
single investigator performs the assessments and the
participant has had an adequate number of practice trials,
the conventional categorization of reliability13 is consis-
tently moderate or better, even across multiple days of
original research
Main Outcome Measure(s): Normalized and nonnormal-
ized (leg-length) reaching distances were analyzed. Additionally,
the mean and maximum values from the 3 test trials were
analyzed, producing a total of 16 variables.
Results: For all 16 measures, the interrater reliability was
st
excellent. For the normalized maximum excursion distances, the
intraclass correlation coefficients (1,1) ranged from 0.86 to 0.92.
Reliability for the nonnormalized measurements was stronger,
ir
ranging from 0.89 to 0.94.
Conclusions: When the raters have been trained by an
experienced rater, the SEBT is a test with excellent reliability
when used across multiple raters in different settings. This
information adds to the body of knowledge that exists regarding
the usefulness of the SEBT as an assessment tool in clinical and
research practice. Establishing excellent interrater reliability with
normalized and nonnormalized scores strengthens the evidence
for using the SEBT, especially at multiple sites.
Key Words: dynamic postural control, clinical balance tests,
functional balance
testing.9,1416 Kinzey and Armstrong15 were the rst to
examine the reliability of the SEBT. A single investigator
conducted trials on 20 healthy participants, who performed
reaches in 4 directions of the SEBT during 2 sessions, with
moderate to strong intraclass correlation coefcient (ICC)
scores ranging from 0.67 to 0.87.15 Hertel et al14 recruited
16 healthy women who performed all 8 directions of SEBT
over 2 testing sessions, with 2 investigators evaluating each
participant on each day. The range of interrater reliability
for the 8 directions was wide (ICC 0.350.93), whereas
the range of intrarater reliability was more narrow with
stronger reliability scores (ICC 0.780.96). The authors
attributed the wide range in interrater reliability to lower
scores that occurred on the rst day of testing and were a
potential artefact of a learning effect. They recommended 6
practice trials to overcome the learning effect and
consequently improve reliability of the measure. More
recently, Robinson and Gribble17 found that 4 practice trials
were sufcient to overcome the learning effect, with better
consistency in subsequent test trials. Similarly, Munro and
Herrington16 noted that reliability between test trials
improved after a fourth consecutive trial, with excellent
Journal of Athletic Training 0
reliability (ICC 0.840.92) in the subsequent 3 trials.
Thus, repeated testing using the SEBT is reliable after 4
trials are implemented to effectively account for the
learning effect associated with the test.
Although the intrarater reliability of the SEBT is
excellent, few investigators have determined interrater
reliability; preliminary evidence is for poor reliability
between assessors.14 Plisky et al18 showed that the SEBT
may be a useful, inexpensive tool to screen athletes for risk
of lower extremity musculoskeletal injury and reported
strong intrarater reliability (ICC 0.840.87) and test-retest
reliability (ICC 0.890.93). Their work demonstrates a
likely underused purpose for the SEBT: assessment of
dynamic postural control in the clinical and research
settings. This could lead to large-scale, collaborative efforts
to establish appropriate screening methods for injury
prevention.
However, we rst need to determine whether multiple
assessors at different sites can provide strong consistency in
SEBT measures. To date, no authors have had more than 2
assessors examine interrater reliability; a larger number of
assessors is paramount to strengthening interrater reliability
and expanding the use of this inexpensive tool to multi-site
applications in which a number of individuals may be
sharing information about patient screening. Interrater
eF
reliability is also essential to underpin the development of
prevention and intervention strategies for lower extremity
injury. Additionally, since the rst reliability studies were
performed, the now-accepted practice is to use normalized
reach distances (reach distance / leg length).19 Therefore,
we must revisit the reliability of the SEBT using
in
normalized, rather than absolute, reach distances.
The primary purpose of our study was to determine
interrater reliability using a group of investigators at 2
testing sites. The raters were all trained by the same
nl
instructor. This approach to determining reliability was
used to establish whether the SEBT can be applied in large-
scale assessments of dynamic postural control.
A corollary purpose was to examine the interrater
O
reliability when using normalized and nonnormalized
scores of SEBT performance. Until now, the reliability of
normalized scores has not been examined. We also wished
to examine the intertester reliability when using average
and maximum performance scores on the SEBT. Tradi-
tionally, average scores are used, but when the SEBT is
conducted in clinical and research practices, the largest
distance from a series of test trials may be more
appropriate; however, reliability has not yet been estab-
lished for this approach. A tertiary purpose was to establish
the interrater reliability of measures of leg length. These
measures are essential when normalizing the SEBT
performance, so it was necessary to examine this measure
as we examined the reliability of normalized SEBT values.
Methods
Participants
A total of 29 participants (19 women, 10 men, age
31.72 6 10.8 years, height 169.52 6 8.8 cm, mass
65.58 6 12.3 kg) from the University of Toledo (Ohio) and
the University of Sydney (Australia) volunteered for the
study. Each participant completed an injury-history ques-
0 Volume 48  Number 3  June 2013
tionnaire and was free of any known musculoskeletal injury
or other condition that would preclude completion of the
test. Before the study, all participants read and signed an
informed consent form approved by the Human Research
Ethics Committee at each university.
Protocol
Before the test sessions at each laboratory, an investigator
with more than 11 years of experience (P.A.G.) with the
SEBT instructed the raters at the test site using a script and
a standardized demonstration. This investigator then served
as the practice model for the other raters at each site and
established that the raters were properly instructed and
could take measures independently. Participants were
scheduled for the day after the raters were trained. On
testing days, 3 raters (the supervising investigator and 2
trained raters) each assessed the SEBT performance of each
participant.
st
A total of 29 individuals volunteered to participate in the
trial: 19 at 1 test site and 10 at the other site. At each site,
participants reported to the laboratory for a single testing
ir
session. The stance leg was determined by randomization.
The length of the stance leg was measured from the
anterior-superior iliac spine to the most distal point of the
ipsilateral medial malleolus, using a standard tape measure
while participants lay supine on a plinth.
Each participants performance on the SEBT was rated
by all 3 raters in the manner described in the Performance
of the SEBT section, with the order of raters being
randomized. A verbal and visual demonstration of the
SEBT was given to participants by the rst rater, and the
constraints of the test were explained. The participants then
underwent the same protocol, and their SEBT performance
was measured by the 3 raters. Participants performed 4
practice trials of the SEBT, in any order in each direction,
with the rater with whom they were initially randomly
assigned to minimize any learning effects.17 The participant
then performed 3 test trials in each direction for each of the
3 raters, sitting in a chair to rest for 5 minutes between
raters. The 3 reach directions tested were anterior (ANT),
posteromedial (PM), and posterolateral (PL). The order of
the reach directions was randomized for each participant
and kept constant across all 3 raters.
Performance of the SEBT
Participants performed the SEBT by standing in the
middle of a testing grid with strips of tape placed at 458
angles, reaching with 1 foot as far as possible along the
different grid lines, and then returning to the starting
position.20,21 The goal was to have the individual establish a
stable base of support on the stance limb at the apex of the
testing grid and maintain support through a maximal reach
excursion in multiple directions.20,21 While standing
barefoot or in socks on a single limb and keeping the
hands on the hips, the participant made an effort to reach as
far as possible with the reaching limb along each tape
measure; touch lightly on the tape measure with the most
distal portion of the reaching foot, without shifting weight
to or coming to rest on the foot of the reaching limb; and
return the reaching limb to the start position at the apex of
the grid, resuming a stable bilateral stance. Standardized
oral instructions were given to every participant (Table 1).
Table 1. Oral Instructions Given for Star Excursion Balance Test
Performance
1. Keep your stance foot flat on the floor with your hands on your
hips.
2. Make a reach with your other leg as far as possible and make a
light tap on the measuring tape.
3. Without pushing off the ground with your reaching leg, return it
back to the center of the testing grid and place this foot on the
ground next to the foot of the stance leg.
4. You may make any movements you wish to reach as far as
possible, as long as you keep your stance foot planted, your hands
on your hips.
5. If you tap more than once or slide the reaching foot during the
reach, miss the tape measure with your tap, push off the floor with
the reaching foot, lift your heel or your hands from the testing
position, or are unable to return the reaching foot back to the
starting position, we will repeat that trial.
A trial was not considered complete if the participant
touched heavily or came to rest at the touchdown point, had
to make contact with the ground with the reaching foot to
maintain balance, or lifted or shifted any part of the foot of
the stance limb during the trial.19,21
Although the SEBT consists of 8 directions, conventional
testing procedures have adopted a condensed version of the
test, using the ANT (Figure 1), PM (Figure 2), and PL
eF
(Figure 3) reaching directions.11,18,22 For the ANT reach,
the stance-foot position is to place the toes at the 0 mark
position of the anterior reach direction line. For the PM and
PL reaches, the heel is placed at the 0 mark position of the
anterior reach direction line. At the rst testing station, 4
in
practice trials were required in each direction.17 Participants
were afforded 5 minutes rest between the practice and test
trials.
nl
Data Reduction
From each reaching direction (ANT, PM, and PL), the
excursion distances were recorded (cm) and considered the
O
nonnormalized data. Additionally, the results from the 3
directions were averaged to create a composite non-
normalized score.
For the 4 dependent variables (ANT, PM, PL, and
composite), the nonnormalized scores (cm) were recorded
and analyzed. Additionally, the excursion distances in each
direction (cm) were normalized by dividing by a partici-
pants leg length (cm) and multiplying by 100 (normalized
maximum excursion distance) for the percentage score.19
Finally, using the nonnormalized and normalized scores
from the 4 dependent variables, we determined 2 measures:
the average and the maximum score. For the average score
of each direction, the means and standard deviations from
the 3 trials were used. For the maximum score, the
maximum reach distance of the 3 trials was used.
In addition to the SEBT analyses, the interrater reliability
of the single trial of leg-length measures needed to be
established because this value is used in the normalized
version of SEBT performance reporting. Therefore, this
measure was included as a separate variable for analysis.
Thus, in total, 16 SEBT variables and 1 leg-length
variable were available for our analyses. All variables were
analyzed for 1 randomly selected limb from each
participant.
Statistical Analysis
Interrater reliability refers to variation between 2 or
more assessors who measure the same group of partici-
pants.13,23 We used a conservative interpretation of
interrater reliability by pooling data from 2 testing sites
to determine whether consistent SEBT assessments could
be achieved by multiple raters, all instructed by the same
source. Using an ICC (1,1) model, we examined the
reliability of a single assessment by a rater, wherein
different sets of raters assessed different groups of
participants.13,23,24 The interrater reliability of the SEBT
was determined by calculating ICCs (1,1) with 95%
condence intervals for each of the 4 primary variables
(ANT, PM, PL, and composite) for both normalized and
nonnormalized measurements. Within the groupings of
normalized and nonnormalized measurements, an ICC (1,1)
was calculated for the average and maximum score from
the 3 trials for each of the 4 primary variables.
st
Additionally, this model was applied to the leg-length
measure. The data from the 2 sites were pooled, and an ICC
(1,1) was used because participants were rated by different
ir
sets of 3 raters. An ICC (1,1) of ,0.4 represents poor
reliability; 0.4 to 0.75, fair to good reliability; and .0.75,
excellent reliability.25
Results
For all 16 measures, the interrater reliability was
excellent. For the normalized maximum excursion distanc-
es, the ICC (1,1) ranged from 0.86 to 0.92 (Table 2).
Reliability for the nonnormalized measurements was
stronger, ranging from 0.89 to 0.94 (Table 3). The interrater
reliability of the leg-length measurement was excellent
(ICC [1,1] 0.92, 95% condence interval 0.86, 0.96).
The ICC (1,1) and 95% condence interval for the average,
maximum, and composite scores in each direction, for both
normalized and nonnormalized measurements, are shown in
Tables 2 and 3, respectively.
Discussion
Assessment of dynamic postural control with the SEBT
had excellent interrater reliability, as per the classication
of Fleiss.25 For each type of measure (average and
maximum) and for both normalized and nonnormalized
data, our results demonstrate strong consistency of
measurements by multiple investigators for the ANT, PM,
PL, and composite scores. This information adds to the
body of knowledge regarding the usefulness of the SEBT as
an assessment tool in clinical and research practice.
Establishing excellent interrater reliability with normalized
and nonnormalized scores supports the use of the SEBT,
especially at multiple sites.
This is the rst study in which more than 2 raters
evaluated the interrater reliability of the SEBT. Five
investigators measured the participants overall; however,
each participant was assessed by 3 investigators, and testing
took place at 2 sites. Experience varied among the
investigators, but each was trained by the same SEBT
expert before testing. Despite the varied experience of the
investigators, the interrater reliability results were excel-
lent. This allows us to conclude that the SEBT can be used
with condence across raters of different experience levels
Journal of Athletic Training 0
Table 2. Interrater Reliability for Normalized Reach Distances on the Star Excursion Balance Test
Reach Distance, Intraclass Correlation Coefficient (1,1) (95% Confidence Interval)
Distance Anterior Posteromedial Posterolateral Composite
Average 0.88 (0.80, 0.94) 0.91 (0.83, 0.95) 0.88 (0.80, 0.94) 0.92 (0.85, 0.96)
Maximum 0.86 (0.77, 0.93) 0.88 (0.79, 0.94) 0.90 (0.83, 0.95) 0.91 (0.84, 0.95)

without compromising the reliability of results, provided
each rater is initially trained in the measurement of the
SEBT by an experienced rater. This nding has promising
clinical and research implications: consistent, reliable data
can be collected when multiple investigators at multiple
sites are trained and then assess participants performing the
SEBT. A limitation to the application of our ndings is that
an expert provided the training and was involved in rating
the participants. The next needed step is to determine
whether similar levels of reliability can be obtained with
the nonnormalized data seemed to be slightly higher, all
values had excellent reliability with small 95% condence
intervals. Therefore, it is logical that SEBT performance
should continue to include normalized reaching distances as
previously established,19 and we can be condent that the
associated reliability will be excellent.
A secondary purpose of this study was to establish
interrater reliability of the leg-length measurements.
Because this measurement is critical to the normalization
of the SEBT reaches, it was imperative that this be reliable

st
the use of written or video instructions (or both) that could across our group of investigators. We demonstrated
be distributed to clinicians and researchers. excellent interrater reliability using the selected leg-length
In the only previous report of interrater reliability of the measurement technique. This technique was chosen based

SEBT, Hertel et al14 reported ICCs between 0.35 and 0.93
when 16 healthy females performed all 8 directions of the
SEBT over 2 testing sessions and 2 investigators evaluated
each participant on each day. Lower estimates of
reliability were found on day 1 of testing: ICCs were
0.76, 0.58, and 0.80 for the ANT, PL, and PM directions,
eF
respectively, less than demonstrated in our study. Hertel et
al14 included the initial published recommendation for a
specic number of requisite practice trials before SEBT
assessment because of higher ICC values on a second day
in
of testing. The interrater reliability scores in our study
might be higher because we included 4 practice trials in
each direction before the test was performed, based on a
nl
ir
on the original article19 describing normalizing SEBT reach
distances. It should be noted that all the investigators were
either credentialed clinicians or students in clinician
preparation programs, and all had experience using this
technique. Therefore, we must conclude that this result
would be applicable to similar populations of individuals
with clinical backgrounds.
An additional secondary purpose of the study was to
compare the reliability of the SEBT assessments when
using the average of 3 trials versus the maximum reach
distance among 3 trials. In more than half of the
assessments, the average normalized value had higher
associated ICC values than the maximum values. However,

more recent study17 examining the learning effect during
SEBT performance.
Furthermore, although it is not stated in their testing
protocol, Figure 1 in the investigation of Hertel et al14
O
for all the assessments, the ICC values were strong (.0.81).
Common practice is to use an average of 3 or more trials on
the SEBT. These data could be interpreted to show that if
reliability is strong when maximum trials are used, perhaps

shows a participant performing the test wearing footwear.
Our participants performed the test barefoot, potentially
allowing for a more accurate measurement of excursion
distance along the tape measure. Additionally, Hertel et al14
did not normalize reaching distances. One purpose of our
investigation was to establish the interrater reliability using
the normalized procedures that are now standard for the
SEBT.19 Both normalized and nonnormalized reaching
distances were associated with stronger interrater reliability
than previously reported.14 Again, this is likely because we
afforded participants a specic number of practice trials,
which was a recommendation from the initial reliability
study by Hertel et al.14
Little difference was observable in the strength of the
reliability between the normalized and nonnormalized
reaching data. Although the ICC values associated with
greater time efciency could be gained from only recording
the maximum trial. When working with large sample sizes,
this reduction may be advantageous. Additional investiga-
tion will be needed to determine how much time is saved
when using only the maximum of 3 trials.
Each investigator in our study was trained in the
measurement of the SEBT before the testing sessions. An
investigator with more than 11 years of experience in SEBT
performance and measurement provided instruction to the
raters at each site before deeming them competent to take
measures independently. The Hertel et al14 reliability study
was conducted early in the initial development of the
SEBT. Since this time, the evidence base surrounding the
SEBT has been well established, and the test has become
widely used in both clinical and research settings. The
pretesting training of raters in the current study by an

Table 3. Interrater Reliability for Nonnormalized Reach Distances on the Star Excursion Balance Test
Reach Distance, Intraclass Correlation Coefficient (1,1) (95% Confidence Interval)
Distance Anterior Posteromedial Posterolateral Composite
Average 0.92 (0.86, 0.96) 0.92 (0.85, 0.96) 0.92 (0.86, 0.96) 0.91 (0.85, 0.96)
Maximum 0.89 (0.82, 0.94) 0.90 (0.82, 0.95) 0.93 (0.88, 0.96) 0.94 (0.88, 0.97)

0 Volume 48  Number 3  June 2013

individual with expertise using the SEBT may have been
responsible for greater consistency of measurement among
raters and may provide an explanation for the higher
interrater reliability we obtained. We cannot conclude from
our study exactly how much experience is needed to
adequately train other individuals to ensure excellent
interrater reliability. Future authors should investigate this
factor to further strengthen the use of the SEBT in multi-
site testing designs.
It is commonly accepted that in order to obtain accurate
estimates of reliability in research, data should be collected
from a wide range of participants. Where previous trials
may have been limited in participant characteristics of
either sex16 or age,17 the participants in our study ranged
widely in age, height, and mass: women predominated, the
age range was 21 to 57 years, the height range was 152 to
190 cm, and the mass range was 42 to 112 kg. Despite the
demographic variability, interrater reliability results were
excellent. This nding further veries the strength of the
current results, improves the external validity of the study,
and allows for greater generalizabilty of results.
The main limitation of our study is that only 3 reach
directions were evaluated. Therefore, we can conclude only
that interrater reliability is excellent for the ANT, PM, and
PL reach directions, as well as the composite score of these
eF
3 reaching directions. However, previous researchers5 have
demonstrated considerable redundancy in performance of
the different reach directions of the SEBT in participants
with and without chronic ankle instability. It is now
common practice to include only 3 reach directions to
assess dynamic postural control with the SEBT, and the 3
in
reach directions in our trial are those most often used in
both clinical and research settings.
Additionally, we had a relatively small total sample size,
with unbalanced numbers of participants at the testing sites.
nl
Our sample sizes were based on convenience and were
restricted by time and availability due to the nature of the
multi-site design and the international collaboration. We
believe that our study provides interesting and useful
O
information, but future researchers could consider replicat-
ing our methods with larger and equal sample sizes at each
testing site.
All participants performed the procedures without shoes,
but we did not control whether the participants wore socks
during the performances. Although this could pose a
limitation, a recent investigation,26 using the same 3
reaching directions as those in our study, demonstrated no
differences in SEBT performance between a bare foot and
wearing a regular sock.
Finally, a potential limitation is that the verbal instruc-
tions and practice trials were only provided to the
participant at the rst testing station by the rst randomly
assigned rater, followed by performing test trials for each of
the 3 raters. This protocol was implemented because our
interpretation of the previous reliability studies14,17 sug-
gested that during a single testing session, after a specic
number of practice trials are allowed, no signicant
improvement in performance follows. This protocol is
useful for studying reliability, but we do not believe that
having 3 raters is practical. Instead, a single rater would
provide the verbal instructions and observe the prescribed
practice trials for a single patient. This is a small
discrepancy between our study protocol and practical
implementation, yet our results support the strong reliabil-
ity in using the SEBT, as we have discussed in previous
sections.
ConclusionS
The SEBT is a reliable test when used across multiple
raters in different settings when raters are trained by an
experienced rater. Reaching in the ANT, PM, and PL
directions has excellent reliability, whether the chosen
outcome is the average or maximum score using raw or
normalized data. Therefore, researchers, especially with
clinical backgrounds, should be able to use this tool for
assessing dynamic postural control after receiving instruc-
tion and practice, making it a suitable and inexpensive tool
in clinical and research settings.
References
st
1. Akbari M, Karimi H, Farahini H, Faghihzadeh S. Balance problems
after unilateral lateral ankle sprains. J Rehabil Res Dev. 2006;43(7):
819824.
ir
2. Gribble PA, Hertel J, Denegar CR. Chronic ankle instability and
fatigue create proximal joint alterations during performance of the
Star Excursion Balance Test. Int J Sports Med. 2007;28(3):236242.
3. Gribble PA, Hertel J, Denegar CR, Buckley WE. The effects of
fatigue and chronic ankle instability on dynamic postural control. J
Athl Train. 2004;39(4):321329.
4. Hale SA, Hertel J, Olmsted-Kramer LC. The effect of a 4-week
comprehensive rehabilitation program on postural control and lower
extremity function in individuals with chronic ankle instability. J
Orthop Sport Phys Ther. 2007;37(6):303311.
5. Hertel J, Braham RA, Hale SA, Olmsted-Kramer LC. Simplifying the
Star Excursion Balance Test: analyses of subjects with and without
chronic ankle instability. J Orthop Sport Phys Ther. 2006;36(3):131
137.
6. Martinez-Ramirez A, Lecumberri P, Gomez M, Izquierdo M.
Wavelet analysis based on time-frequency information discriminate
chronic ankle instability. Clin Biomech (Bristol, Avon). 2010;25(3):
256264.
7. Nakagawa L, Hoffman M. Performance in static, dynamic, and
clinical tests of postural control in individuals with recurrent ankle
sprains. J Sport Rehabil. 2004;13(3):255268.
8. Olmsted LC, Carcia CR, Hertel J, Shultz SJ. Efcacy of the Star
Excursion Balance Tests in detecting reach decits in subjects with
chronic ankle instability. J Athl Train. 2002;37(4):501506.
9. Herrington L, Hatcher J, Hatcher A, McNicholas M. A comparison of
Star Excursion Balance Test reach distances between ACL decient
patients and asymptomatic controls. Knee. 2009;16(2):149152.
10. Aminaka N, Gribble PA. Patellar taping, patellofemoral pain
syndrome, lower extremity kinematics, and dynamic postural control.
J Athl Train. 2008;43(1):2128.
11. McKeon PO, Ingersoll CD, Kerrigan DC, Saliba E, Bennett BC,
Hertel J. Balance training improves function and postural control in
those with chronic ankle instability. Med Sci Sports Exerc. 2008;
40(10):18101819.
12. McLeod TC, Armstrong T, Miller M, Sauers JL. Balance
improvements in female high school basketball players after a 6-
week neuromuscular-training program. J Sport Rehabil. 2009;18(4):
465481.
13. Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater
reliability. Psychol Bull. 1979;86(2):420428.
14. Hertel J, Miller SJ, Denegar CR. Intratester and intertester reliability
during the Star Excursion Balance Test. J Sport Rehabil. 2000;9(2):
104116.
Journal of Athletic Training 0
15. Kinzey SJ, Armstrong CW. The reliability of the Star-Excursion test
in assessing dynamic balance. J Orthop Sport Phys Ther. 1998;27(5):
356360.
16. Munro AG, Herrington LC. Between-session reliability of the Star
Excursion Balance Test. Phys Ther Sport. 2010;11(4):128132.
17. Robinson RH, Gribble PA. Support for a reduction in the number of
trials needed for the Star Excursion Balance Test. Arch Phys Med
Rehabil. 2008;89(2):364370.
18. Plisky PJ, Rauh MJ, Kaminski TW, Underwood FB. Star Excursion
Balance Test as a predictor of lower extremity injury in high school
basketball players. J Orthop Sport Phys Ther. 2006;36(12):911919.
19. Gribble PA, Hertel J. Considerations for normalizing measures of the
Star Excursion Balance Test. Meas Phys Educ Exerc Sci. 2003;7(2):
89100.
20. Gray GW. Lower Extremity Functional Prole. Adrian, MI: Wynn
Marketing Inc; 1995.
Address correspondence to Phillip A. Gribble, PhD, ATC, FNATA, 2801 W Bancroft, University of Toledo, Mailstop #119, Toledo, OH
43606. Address e-mail to phillip.gribble@utoledo.edu.
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21. Gribble PA. The Star Excursion Balance Test as a measurement tool.
Athl Ther Today. 2003;8(2):4647.
22. Delahunt E, McGrath A, Doran N, Coughlan GF. Effect of taping on
actual and perceived dynamic postural control stability in persons
with chronic ankle instability. Arch Phys Med Rehabil. 2010;91(9):
13831389.
23. Portney L, Watkins M. Statistical measures of reliability. Founda-
tions of Clinical Research. 3rd ed. Upper Saddle River, NJ: Pearson/
Prentice Hall; 2009:585600.
24. Maher CG, Sherrington C, Herbert RD, Moseley AM, Elkins M.
Reliability of the PEDro scale for rating quality of randomized
controlled trials. Phys Ther. 2003;83(8):713721.
25. Fleiss J. The Design and Analysis of Clinical Experiments. New
York, NY: Wiley and Son; 1986.
26. Shinohara J, Gribble P. Five-toed socks with grippers on the foot sole
improve dynamic postural control in healthy individuals [abstract].
Med Sci Sport Exerc. 2010;42(suppl 5):496.
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