Dynamic Balance Assessment

Question:

What can I use as a test for dynamic balance? 

Answer:

Assessing an individual’s balance is an important part of a functional assessment. For the athlete, dynamic balance assessment is a vital part of the screening process for athletic ability as well as return-to-play after an injury. Along with its associated secondary medical issues, falling is a major health concern for senior clients, necessitating a proper dynamic balance assessment.

While many tests are available to the trainer, multidirectional maximal single leg reaches were used to compare static and dynamic balance in female athletes. In other studies utilizing seniors, several tests including the modified step test and reaching test were utilized. A rather easy-to-implement and replicable dynamic balance assessment includes static single leg stance, single leg multi directional reach, single leg squat and a single leg hop. These tests are briefly described below. To improve inter- and intra-tester reliability, ensure consistency in assessing the following variables: the individual must perform each test without compensation, assess for bilateral comparisons where applicable. The greater the asymmetry, the greater the chance for potential injury, and there should be no pain when performing the following tests.

Static single leg stance (SSLS): With the eyes open, the average length of time to hold the SSLS is between 22 to 30 seconds for individuals ages 20 to 59 and approximately 15 to 22 seconds for those over the age 60. For those who easily pass this test, assess the individual with the eyes closed. Look for the individual to be able to hold that position for a minimum of 15 seconds.

Single leg multidirectional reaches (SLMR): For the SLMR test, have the individual stand on a single leg and reach in the sagittal, frontal and transverse planes with the non-weight bearing leg. Measure how far the individual can reach and return to a controlled upright position in each plane. Make bilateral comparisons.

Single leg squat (SLS): An individual should be able to hold a SLS for 15 seconds in proper alignment and be able to return to the upright posture without compensations. For clients or athletes involved in a plyometrics program, the hold time should be increased to 30 seconds.

Single leg hops (SLH): The SLH test is a great test for those participating in sports as well as for assessing return-to-play abilities in the rehabilitated athlete. Measure the number of controlled side-to-side and front-to-back SLH an individual can perform in 30 seconds (place a piece of tape on the floor as a marker). Ensure the individual has optimal eccentric control and produces an efficient concentric contraction to hop between legs.

The aforementioned tests are appropriate for the moderate to advanced skilled client. A modified version of this assessment consisting of the SSLS and substituting the modified step test (MST) and reaching test (RT) for the SLMR, SLS and SLH tests is appropriate for those individuals that exhibit diminished or beginner level motor skills and abilities. These tests are described below.

Modified step test (MST): The MST is performed by using a 7.5 cm (18-20 inches) step and measuring the maximum time to complete five steps, one foot on, then off, at either the front or side, as quickly as possible. Make comparisons from side-to-side in addition to evaluating movement quality.

Reach test (RT): In the RT, the individual stands with his feet together and maximally reaches to the front, overhead and to each side, on each occasion returning to the upright position. Measure the distance from the base of their feet to the maximum length of their reach in each direction.

Assessing an individual’s ability to balance is an important part of a functional assessment. It serves not only as an evaluation of an individual’s functional ability but also as an important predictor of potential problems or injuries. Please note: Avoid the trap of having the individual perform the above tests during your training program. It is relatively easy to demonstrate improvements in performance if the individual performs these tests during their training. However, this does not distinguish between whether or not the client's ability has improved or he has just become proficient at the tests. Follow a thorough, well rounded training program and re-test after a pre-determined length of time, generally eight to 12 weeks.

EDITOR'S NOTE: For more on functional assessments, please check out the latest educational offering from PTN, our MOVE Appraisal!