***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Eisen , TC , Danoff , JV , Leone , JE , and Miller , TA . The effects of multiaxial and uniaxial unstable surface balance training in college athletes . J Strength Cond Res 24(7 ) : 1740 - 1745 , 2010-The purpose of this study was to compare the effects of 2 different types of unstable surface balance training ( uniaxial on a rocker board [ RB ] and multiaxial on a dynadisc [ DD ] ) on balance in division 1 collegiate athletes in sports that are at high risk for ankle sprains . Subjects ( n = 36 ) consisted of male soccer players and female volleyball and soccer players who were equally and r and omly assigned to 1 of 3 groups  ( CON ,  DD , and  RB ) . Balance training consisting of balancing on 1 leg on either the RB or DD , while repeatedly catching a 1-kg ball was performed 3 times per week for 4 weeks . Balance was tested with the Star Excursion Balance Test ( SEBT ) before , halfway through , and at the completion of the balance training . Control ( CON ) subjects also were given the balance test but did not participate in the training . A 3-way repeated analysis of variance revealed that no group individually changed SEBT scores from pre ( CON , 0.98 ± 0.086 ; DD , 0.98 ± 0.083 ; RB , 0.97 ± 0.085 ) to post ( CON , 1.00 ± 0.090 ; DD , 1.01 ± 0.088 ; RB , 1.02 ± 0.068 ) after balance training . When the 2 treatment groups were combined ( DD and RB ) , the p value decreased and came closer to significance ( p = 0.136 ) . When all 3 groups were combined , there was a significant difference in SEBT scores from pretraining ( CON + DD + RB ; 0.98 ± 0.085 ) to posttraining ( CON + DD + RB ; 1.01 ± 0.082 ) , which likely indicates low statistical power . The increase in physical activity the subjects experienced during the return to in-season activity , may have contributed to the significant differences in SEBT scores over time but not between DD or RB training . Therefore , a threshold level of physical activity may exist that is necessary to maintain balance during the off-season STUDY DESIGN Controlled cohort repeated- measures experimental design . OBJECTIVES To determine if a neuromuscular training program ( NMTP ) focused on core stability and lower extremity strength would affect performance on the star excursion balance test ( SEBT ) . We hypothesized that NMTP would improve SEBT performance in the experimental group and there would be no side-to-side differences in either group . BACKGROUND The SEBT is a functional screening tool that is used to assess dynamic stability , monitor rehabilitation progress , assess deficits following an injury , and identify athletes at high risk for lower extremity injury . The SEBT requires lower extremity coordination , balance , flexibility , and strength . METHODS Twenty uninjured female soccer players ( 13 experimental , 7 control ) participated . Players trained together as a team , so group allocation was not r and omized . The SEBT was administered prior to and following 8 weeks of NMTP in the experimental group and 8 weeks of no NMTP in the control group . A 3-way mixed-model ANOVA was used to determine the effect of group ( experimental versus control ) , training ( pretraining versus posttraining ) , and limb ( right versus left ) . RESULTS After participation in a NMTP , subjects demonstrated a significant improvement in the SEBT composite score ( mean ± SD ) on the right limb ( pretraining , 96.4 % ± 11.7 % ; posttraining , 104.6 % ± 6.1 % ; P = .03 ) and the left limb ( pretraining , 96.9 % ± 10.1 % ; posttraining , 103.4 % ± 8.0 % ; P = .04 ) . The control group had no change on the SEBT composite score for the right ( pretraining , 95.7 % ± 5.2 % ; posttraining , 94.4 % ± 5.2 % ; P = .15 ) or the left ( 97.4 % ± 7.2 % ; 93.6 % ± 5.0 % ; P = .09 ) limb . Further analysis identified significant improvement for the SEBT in the posterolateral direction on both the right ( P = .008 ) and left ( P = .040 ) limb and the posteromedial direction of the left limb ( P = .028 ) in the experimental group . CONCLUSION Female soccer players demonstrated an improved performance on the SEBT after NMTP that focused on core stability and lower extremity strength STUDY DESIGN Prospect i ve , r and omized controlled trial . OBJECTIVE To examine the effects of a 4-week rehabilitation program for chronic ankle instability ( CAI ) on postural control and lower extremity function . BACKGROUND CAI is associated with residual symptoms , performance deficits , and reinjury . Managing CAI is challenging and more evidence is needed to guide effective treatment . METHODS AND MEASURES Subjects with unilateral CAI were r and omly assigned to the rehabilitation ( CAI-rehab , n=16 ) or control ( CAI-control , n=13 ) group . Subjects without CAI were assigned to a healthy group ( n=19 ) . Baseline testing included the ( 1 ) center of pressure velocity ( COPV ) , ( 2 ) star excursion balance test ( SEBT ) , and ( 3 ) Foot and Ankle Disability index ( FADI ) and FADI-Sports Subscale ( FADI-Sport ) . The CAI-rehab group completed 4 weeks of rehabilitation that addressed range of motion , strength , neuromuscular control , and functional tasks . After 4 weeks , all subjects were retested . Nonparametric analyses for group differences and between-group comparisons were performed . RESULTS Subjects with CAI demonstrated deficits in postural control and SEBT reach tasks of the involved limb compared to the uninvolved limb and reported functional deficits of the involved limb compared to healthy subjects . Following rehabilitation , the CAI-rehab group had greater SEBT reach improvements on the involved limb than the other groups and greater improvements in FADi and FADI-Sport scores . CONCLUSIONS These results demonstrate postural control and functional limitations exist in individuals with CAl . In addition , rehabilitation appears to improve these functional limitations . Finally , there is evidence to suggest the SEBT may be a good functional measure to monitor change after rehabilitation for CAI PURPOSE Recurrence of ankle sprains is common among athletes . Although ankle taping reduces the risk of injury , the mechanism underlying its effectiveness remains unclear . Anecdotal reports suggest a role of the belief among athletes that taping will protect them from injury . That is , taping may have a placebo effect . The purpose of the present study was to determine whether there was a placebo effect with ankle taping in individuals with ankle instability . METHODS Thirty participants with ankle instability completed a hopping test and a modified star excursion balance test under three conditions : ( i ) real tape , ( ii ) placebo tape , and ( iii ) control ( no tape ) . Participants were blinded to the purpose of the study and were informed that the study aim ed to compare two methods of ankle taping referred to as mechanical ( real ) and proprioceptive ( placebo ) . The order of testing the three conditions and the two functional tests was r and omized . RESULTS There was no significant difference in performance among the three conditions for the hopping test ( P = 0.865 ) or the modified star excursion balance test ( P = 0.491 ) . However , a secondary exploratory analysis revealed that participants ' perceptions of stability , confidence , and reassurance increased with both real and placebo ankle taping when performing the functional tasks . CONCLUSION The role of the placebo effect of ankle taping in individuals with ankle instability remains unclear . Clinicians should , therefore , continue to use ankle-taping techniques of known efficacy . They should , however , focus on maximizing patients ' beliefs in the efficacy of ankle taping , because its application reassured participants and improved their perceived stability and confidence . The effect of ankle taping on participants ' perceptions may contribute to its effectiveness in preventing injury CONTEXT Interval cycle training could positively influence dynamic balance in middle-aged women . OBJECTIVE To compare training effects of a strength ergometer and a st and ard ergometer on 3 dynamic balance tests . DESIGN Repeated measures . SETTING Laboratory . PARTICIPANTS Seventeen women were r and omly assigned to st and ard  ( n = 10 ) or  strength cycle ergometry ( n = 7 ) . A control group consisted of 7 women . INTERVENTION Ergometry interval training ( 3 sessions/wk for 4 wk ) . MAIN OUTCOME MEASURES Three balance tests-the Star Excursion Balance Test ( SEBT ) , timed up- and -go ( TUG ) , and four-square step test (FSST)-were performed at pretraining and 4 wk posttraining . RESULTS Four SEBT directions improved and faster scores for FSST and TUG tests for the st and ard-cycle group were found , whereas the strength-cycle group only improved their TUG scores . No changes posttraining for the control group . CONCLUSIONS Stationary cycle training should be included in the dynamic balance-rehabilitation protocol for middle-aged women STUDY DESIGN Prospect i ve cohort . OBJECTIVE To determine if Star Excursion Balance Test ( SEBT ) reach distance was associated with risk of lower extremity injury among high school basketball players . BACKGROUND Although balance has been proposed as a risk factor for sports-related injury , few research ers have used a dynamic balance test to examine this relationship . METHODS AND MEASURES Prior to the 2004 basketball season , the anterior , posteromedial , and posterolateral SEBT reach distances and  limb lengths  of 235 high school basketball players were measured bilaterally . The Athletic Health Care System Daily Injury Report was used to document time loss injuries . After normalizing for lower limb length , each reach distance , right/left reach distance difference , and composite reach distance were examined using odds ratio and logistic regression analyses . RESULTS The reliability of the SEBT components ranged from 0.82 to 0.87 ( ICC3,1 ) and was 0.99 for the measurement of limb length . Logistic regression models indicated that players with an anterior right/left reach distance difference greater than 4 cm were 2.5 times more likely to sustain a lower extremity injury ( P<.05 ) . Girls with a composite reach distance less than 94.0 % of their limb length were 6.5 times more likely to have a lower extremity injury ( P<.05 ) . CONCLUSIONS We found components of the SEBT to be reliable and predictive measures of lower extremity injury in high school basketball players . Our results suggest that the SEBT can be incorporated into preparticipation physical examinations to identify basketball players who are at increased risk for injury PURPOSE The purpose of this r and omized controlled trial was to determine the effect of a 4-wk balance training program on static and dynamic postural control and self-reported functional outcomes in those with chronic ankle instability ( CAI ) . METHODS Thirty-one young adults with self-reported CAI were r and omly assigned to an intervention group ( six males and 10 females ) or a control group ( six males and nine females ) . The intervention consisted of a 4-wk supervised balance training program that emphasized dynamic stabilization in single-limb stance . Main outcome measures included the following : self-reported disability on the Foot and Ankle Disability Index ( FADI ) and the FADI Sport scales ; summary center of pressure ( COP ) excursion measures including area of a 95 % confidence ellipse , velocity , range , and SD ; time-to-boundary ( TTB ) measures of postural control in single-limb stance including the absolute minimum TTB , mean of TTB minima , and SD of TTB minima in the anteroposterior and mediolateral directions with eyes open and closed ; and reach distance in the anterior , posteromedial , and posterolateral directions of the Star Excursion Balance Test ( SEBT ) . RESULTS The balance training group had significant improvements in the FADI and the FADI Sport scores , in the magnitude and the variability of TTB measures with eyes closed , and in reach distances with the posteromedial and the posterolateral directions of the SEBT . Only one of the summary COP-based measures significantly changed after balance training . CONCLUSIONS Four weeks of balance training significantly improved self-reported function , static postural control as detected by TTB measures , and dynamic postural control as assessed with the SEBT . TTB measures were more sensitive at detecting improvements in static postural control compared with summary COP-based measures Quantification of dynamic balance is often necessary to assess a patient 's level of injury or ability to function in order to initiate an appropriate plan of care . Some therapists use the star-excursion test in an attempt to quantify dynamic balance . This test requires the patient to balance on one leg while reaching with the other leg . For the purpose of this study , the reach was performed in four directions . No previous research ers have attempted to evaluate the reliability of this test . Twenty healthy subjects between the ages of 18 and 35 years participated in this study . During two testing sessions , each subject was required to perform five reaching trials in four directions . Reliability estimates , calculated using the intraclass correlation coefficient ( 2 , 1 ) , ranged from 0.67 to 0.87 . Six duplicate practice sessions were suggested to increase this range above 0.86 . Task complexity may account for the moderate reliability estimates . Subjects should engage in a learning period before being evaluated on the star-excursion test STUDY DESIGN A double-blind r and omized crossover experimental study with repeated 
    Output:
    
The SEBT has been shown to be a reliable measure and has validity as a dynamic test to predict risk of lower extremity injury , to identify dynamic balance deficits in patients with a variety of lower extremity conditions , and to be responsive to training programs in both healthy people and people with injuries to the lower extremity .