Research Report Abstracts - Gesundheit

WPT2011, Research Report Abstracts eS111
0.74 for range of motion and 0.66 for endurance. Significant
univariate correlations (p < 0.05) were obtained with GMFM
scores for balance (0.95), quality of movement (0.78), distribution
of involvement (−0.78), spasticity (−0.64), muscle
strength (0.84), range of motion (−0.69), endurance (0.67),
number of health problems (−0.56) and adaptive behaviour
(0.52).
Conclusions: Of the primary impairments, balance contributes
most (90%) and spasticity contributes least (41%) to
the variance in gross motor function. Among the secondary
impairments, muscle strength contributes most (71%) and
endurance contributes least (45%) to the variance in gross
motor function. Health problems and coping contribute more
modestly (31 and 27%, respectively).
Implications: Therapists are encouraged to classify determinants
into those that are amenable to change and those that
are not. Factors that are strongly associated with motor function
and are amenable to change (such as muscle strength) are
logical targets for intervention. Factors that are not amenable
to change (such as quality of movement) assist with realistic
goal setting. This evidence from a sample that is generalizable
to many parts of the world can enhance both the effectiveness
and efficiency of service delivery. Future analyses will
use multivariate methods to ascertain the contributions of the
constellation of these variables together.
Keywords: Cerebral palsy; Child factors; Gross motor function
Funding acknowledgements: The Move & PLAY study
was supported through funds from the Canadian Institutes
of Health Research (MOP 81107) and the US Department of
Education, National Institutes of Disability and Rehabilitation
Research (H133G060254).
Ethics approval: The University of Western Ontario Health
Sciences Research Ethics Board.
Research Report Poster Display
Number: RR-PO-304-1-Thu Thursday 23 June 13:00
RAI: Exhibit Halls 2&3
THE STAR EXCURSION BALANCE TEST (SEBT):
CONCOMITANT VALIDITY AND ASSOCIATION
WITH BIOMECHANICAL VARIABLES
Bastien M. 1 , Moffet H. 1 , Perron M. 1 , Bouyer L. 1 , Hébert
L. 2 , Lapointe I. 1 , Bedard J. 1
1Laval University, Faculty of Medicine and Center for
Interdisciplinary Research in Rehabilitation and Social
Integration (CIRRIS), Quebec, Canada, 2Laval University,
Faculty of Medicine and Canadian Forces, Quebec, Canada
Purpose: (1) To evaluate the concomitant validity between
the reach distance measured by visual estimations and by
the Optotrak probing system during the simplified SEBT and
(2) to measure the association between the reach distance
measured during the SEBT and biomechanical variables.
Relevance: Lack of dynamic control at the lower limb has
been observed following lateral ankle sprain. Among the tests
proposed to measure the residual functional deficits in this
population, the SEBT has been frequently used. However,
the validity of this test which is based on visual estimation
of the maximal distance reached in each tested direction has
never been studied although a good to very good reliability
has been documented (intraclass correlation coefficient
(ICC): 0.67–0.87). In addition, how some biomechanical
variables are associated with the performance (maximal distance
reached) is unknown.
Participants: Eight healthy males in the military population
(age: 25.3 ± 5.3 years) who had self-reported no symptoms
at the lumbar spine and lower limbs participated in the study.
Methods: Performance in the simplified SEBT was evaluated
during a single session. During the test, the subject had
to touch the floor as far as possible in three different directions
(anteromedial, medial and posteromedial) with the tip
of one foot while maintaining balance on the contralateral
leg. Biomechanical variables were collected using an Optotrak
3D system (45 markers: lower and upper limbs, spine and
head) and a force plate (AMTI-OR6-5). Maximal reach distances
were measured concomitantly by an evaluator (visual
estimation) and the Optotrak system. A practice session was
made before recording 3 trials per leg and in each direction.
The order of the recordings (legs and directions) was
systematically randomized between subjects.
Analysis: Concomitant validity of the maximal distance
reached, using the Optotrak measures as the gold standard,
was estimated using an ICC and its 95% confidence interval.
All trials recorded in the different directions and both
limbs (144 trials) were used for this analysis. Pearson correlation
coefficients were used to assess the relationship between
biomechanical variables and the reach distance for the posteromedial
direction, thought to be the most representative
component of performance.
Results: Concomitant validity is excellent (ICC = 0.99;
95%CI [0.98–0.99]). Significant correlations were found
between the maximal reach distances (posteromedial direction)
and the following variables: time to reach (r = 0.74,
p = 0.0001), vertical displacement of the center of the mass
of the trunk (COM) (r = −0.94, p = 0.0001), total excursion
of the center of pressure(COP) (r = 0.67, p = 0.0001).
Conclusions: This study demonstrates that visual estimation
of the distance reached during the SEBT is a highly valid
measure when performed in a standardized way. The best
performances in the SEBT are most likely related to the ability
to lower the COM of the trunk, to control the displacement of
the COP through a long trajectory, to maximize the distance
reached by taking enough time.
Implications: The demonstration that visual estimation of
the reach distance during the SEBT is highly valid supports
its use in clinical practice. Future studies are needed to better
understand the factors influencing the performance in the
SEBT especially in populations with physical impairments.
Keywords: Metrology; Motor control; Clinical tests