Investigating the Association of Ankle Dorsiflexion Range With Y Balance Test, Single Leg Hop for Distance and Body Composition in Collegiate Athletes

Abstract

Ankle sprains are prevalent among athletes, and decreased ankle dorsiflexion range of motion (ADROM) can contribute to these injuries. Various tests like the Y Balance Test (YBT), Single Leg Hop for Distance (SLHD), Weight-Bearing Lunge Test (WBLT), and Body Mass Index (BMI) are used to evaluate ankle function. The primary purpose of this study was to find out the correlation between ADROM and SLHD, WBLT, YBT, and BMI. Fifty-two collegiate athletes were recruited after eliminating athletes with a history of injuries to the lower extremities. The study discovered strong positive correlations between YBT anterior reach, ADROM (r = 0.72, p<0.001), and WBLT (r = 0.64, p<0.001). ADROM and WBLT were found through regression analysis to be significant predictors of YBT performance, particularly in the anterior reach direction. While body composition measures like BMI and total fat did not significantly correlate with YBT scores, SLHD did show a moderate correlation with YBT performance. These results imply that improving weight-bearing lunge capacity and ankle dorsiflexion may help male collegiate athletes achieve better dynamic balance. Including specific exercises to and strengthen WBLT and ADROM capacities in training regimens may lower the possibility of lower extremity injuries.

Keywords

• Ankle joint
• Body composition
• Dorsiflexion
• Posture control
• Range of motion

References

1. Ageberg, E., & Cronström, A. (2018). Agreement between test procedures for the single-leg hop for distance and the single-leg mini squat as measures of lower extremity function. BMC Sports Science, Medicine and Rehabilitation, 10(1), 1–7. https://doi.org/10.1186/S13102-018-0104-6/TABLES/4
2. Basnett, C. R., Hanish, M. J., Wheeler, T. J., Miriovsky, D. J., Danielson, E. L., Barr, J. B., & Grindstaff, T. L. (2013). Ankle dorsiflexion range of motion influences dynamic balance in individuals with chronic ankle instability. International Journal of Sports Physical Therapy, 8(2), 121.
3. Bennell, K., Talbot, R., Wajswelner, H., Techovanich, W., & Kelly, D. (1998). Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Australian Journal of Physiotherapy, 44(3), 175–180. https://doi.org/10.1016/S0004-9514(14)60377-9
4. Booysen, M. J., Gradidge, P. J. L., & Watson, E. (2015). The relationships of eccentric strength and power with dynamic balance in male footballers. Journal of Sports Sciences, 33(20), 2157–2165. https://doi.org/10.1080/02640414.2015.1064152
5. Chimera, N. J., & Larson, M. (2020). Predicting Lower Quarter Y-Balance Test Performance From Foot Characteristics. Journal of Sport Rehabilitation, 30(1), 16–21. https://doi.org/10.1123/JSR.2019-0358
6. Daneshjoo, A., Rahnama, N., Mokhtar, A. H., & Yusof, A. (2013). Bilateral and unilateral asymmetries of isokinetic strength and flexibility in male young professional soccer players. Journal of Human Kinetics, 36(1), 45–53. https://doi.org/10.2478/HUKIN-2013-0005
7. Daniel, D. (1988). A measurement of lower limb function. The one leg hop for distance. Am J Knee Surg, 4, 212–214.
8. Doan, Q., Koehoorn, M., & Kissoon, N. (2010). Body mass index and the risk of acute injury in adolescents. Paediatrics & Child Health, 15(6), 351. https://doi.org/10.1093/PCH/15.6.351

9. Drewes, L. K., McKeon, P. O., Casey Kerrigan, D., & Hertel, J. (2009). Dorsiflexion deficit during jogging with chronic ankle instability. Journal of Science and Medicine in Sport, 12(6), 685–687. https://doi.org/10.1016/J.JSAMS.2008.07.003
10. Ewais, N. F., Abdel-Aziem, A. A., & Hassan, S. M. (2024). Effect of gender, leg dominancy, and body mass index on Y-balance performance among young, healthy adults. SPORT TK-Revista EuroAmericana de Ciencias Del Deporte, 13(2), 8–8. https://doi.org/10.6018/SPORTK.523751
11. Gabriner, M. L., Houston, M. N., Kirby, J. L., & Hoch, M. C. (2015). Contributing factors to star excursion balance test performance in individuals with chronic ankle instability. Gait & Posture, 41(4), 912–916. https://doi.org/10.1016/J.GAITPOST.2015.03.013
12. Ganesan, M., Koos, T., Kruse, B., & O’Dell, B. (2018). Dynamic Postural Instability in Individuals with High Body Mass Index. Journal of Novel Physiotherapies, 8(2), 1–5. https://doi.org/10.4172/2165-7025.1000387
13. Gribble, P. A., Terada, M., Beard, M. Q., Kosik, K. B., Lepley, A. S., McCann, R. S., Pietrosimone, B. G., & Thomas, A. C. (2016). Prediction of Lateral Ankle Sprains in Football Players Based on Clinical Tests and Body Mass Index. American Journal of Sports Medicine, 44(2), 460–467. https://doi.org/10.1177/0363546515614585
14. Hartley, E. M., Hoch, M. C., & Boling, M. C. (2018). Y-balance test performance and BMI are associated with ankle sprain injury in collegiate male athletes. Journal of Science and Medicine in Sport, 21(7), 676–680. https://doi.org/10.1016/J.JSAMS.2017.10.014
15. Hershkovich, O., Tenenbaum, S., Gordon, B., Bruck, N., Thein, R., Derazne, E., Tzur, D., Shamiss, A., & Afek, A. (2015). A large-scale study on epidemiology and risk factors for chronic ankle instability in young adults. The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons, 54(2), 183–187. https://doi.org/10.1053/J.JFAS.2014.06.001
16. Hoch, M. C., Staton, G. S., & McKeon, P. O. (2011). Dorsiflexion range of motion significantly influences dynamic balance. Journal of Science and Medicine in Sport, 14(1), 90–92. https://doi.org/10.1016/J.JSAMS.2010.08.001
17. Hodgkins, C. W., & Wessling, N. A. (2021). Epidemiology of sports-specific foot and ankle injuries. In Foot and Ankle Clinics (Vol. 26, Issue 1, pp. 173–185). W.B. Saunders. https://doi.org/10.1016/j.fcl.2020.10.001
18. Hootman, J. M., Dick, R., & Agel, J. (2007). Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. Journal of Athletic Training, 42(2), 311. /pmc/articles/PMC1941297/
19. Irving, D. B., Cook, J. L., & Menz, H. B. (2006). Factors associated with chronic plantar heel pain: a systematic review. Journal of Science and Medicine in Sport, 9(1–2), 11–22. https://doi.org/10.1016/J.JSAMS.2006.02.004
20. Jatmiko, Tinduh, D., Purwanto, B., & Desnantyo, A. T. (2023). Differences in ankle dorsiflexion deficit performance between male and female athletes with a history of lateral ankle sprain: The functional pre-participation evaluation. Natural and Life Sciences Communications, 22(2). https://doi.org/10.12982/NLSC.2023.017
21. Jespersen, E., Verhagen, E., Holst, R., Klakk, H., Heidemann, M., Rexen, C. T., Franz, C., & Wedderkopp, N. (2014). Total body fat percentage and body mass index and the association with lower extremity injuries in children: a 2.5-year longitudinal study. British Journal of Sports Medicine, 48(20), 1497–1501. https://doi.org/10.1136/BJSPORTS-2013-092790
22. Kang, M. H., Kim, G. M., Kwon, O. Y., Weon, J. H., Oh, J. S., & An, D. H. (2015). Relationship between the kinematics of the trunk and lower extremity and performance on the Y-balance test. PM & R : The Journal of Injury, Function, and Rehabilitation, 7(11), 1152–1158. https://doi.org/10.1016/J.PMRJ.2015.05.004
23. Kang, M. H., Lee, D. K., Park, K. H., & Oh, J. S. (2015). Association of ankle kinematics and performance on the Y-Balance test with inclinometer measurements on the weight-bearing-lunge test. Journal of Sport Rehabilitation, 24(1), 62–67. https://doi.org/10.1123/jsr.2013-0117
24. Knapik, J. J., Bauman, C. L., Jones, B. H., Harris, J. M., & Vaughan, L. (1991). Preseason strength and flexibility imbalances associated with athletic injuries in female collegiate athletes. The American Journal of Sports Medicine, 19(1), 76–81. https://doi.org/10.1177/036354659101900113
25. Myers, B. A., Jenkins, W. L., Killian, C., Rundquist, P., Myers, B., & Francis, S. (2014). Normatıve data for hop tests ın hıgh school and collegıate basketball and soccer players. International Journal of Sports Physical Therapy, 9(5), 596-603.
26. Nelson, S., Wilson, C. S., & Becker, J. (2021). Kinematic and Kinetic Predictors of Y-Balance Test Performance. International Journal of Sports Physical Therapy, 16(2), 371–380. https://doi.org/10.26603/001C.21492
27. Norkin, C. and W. D. (2016). Measurement of Joint Motion: A Guide to Goniometry (M. Biblis, M. Duffield, G. W. Lang, L. S. Horowitz, & C. O’Brien, Eds.; 5th ed.). F.A. Davis Company.
28. Olszewski, M., Zając, B., Mika, A., & Golec, J. (2024). Ankle dorsiflexion range of motion and hip abductor strength can predict Lower Quarter Y-Balance Test performance in healthy males. Journal of Bodywork and Movement Therapies, 38, 567–573. https://doi.org/10.1016/j.jbmt.2024.03.053
29. Overmoyer, G. V., & Reiser, R. F. (2013). Relationships between asymmetries in functional movements and the star excursion balance test. Journal of Strength and Conditioning Research, 27(7), 2013–2024. https://doi.org/10.1519/JSC.0B013E3182779962
30. Overmoyer, G. V., & Reiser, R. F. (2015). Relationships between lower-extremity flexibility, asymmetries, and the Y balance test. Journal of Strength and Conditioning Research, 29(5), 1240–1247. https://doi.org/10.1519/JSC.0000000000000693
31. Plisky, P. J., Rauh, M. J., Kaminski, T. W., & Underwood, F. B. (2006). Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players. The Journal of Orthopaedic and Sports Physical Therapy, 36(12), 911–919. https://doi.org/10.2519/JOSPT.2006.2244
32. Rafagnin, C. Z., Ferreira, A. de S., Telles, G. F., Lemos de Carvalho, T., Alexandre, D. J. de A., & Nogueira, L. A. C. (2023). Anterior component of Y-Balance test is correlated to ankle dorsiflexion range of motion in futsal players: A cross-sectional study. Physiotherapy Research International, 28(4), e2028. https://doi.org/10.1002/PRI.2028
33. Smith, C. A., Chimera, N. J., & Warren, M. (2015). Association of y balance test reach asymmetry and injury in division I athletes. Medicine and Science in Sports and Exercise, 47(1), 136–141. https://doi.org/10.1249/MSS.0000000000000380
34. Suvarna, T. P., Raj, J. O., & Prakash, N. (2021). Correlation between Balance and BMI in Collegiate students: A cross sectional study. International Journal of Physiotherapy and Research, 9(1), 3759–3764. https://doi.org/10.16965/IJPR.2021.103
35. Terada, M., Harkey, M. S., Wells, A. M., Pietrosimone, B. G., & Gribble, P. A. (2014). The influence of ankle dorsiflexion and self-reported patient outcomes on dynamic postural control in participants with chronic ankle instability. Gait & Posture, 40(1), 193–197. https://doi.org/10.1016/J.GAITPOST.2014.03.186
36. Tyler, T. F., McHugh, M. P., Mirabella, M. R., Mullaney, M. J., & Nicholas, S. J. (2006). Risk factors for noncontact ankle sprains in high school football players: the role of previous ankle sprains and body mass index. The American Journal of Sports Medicine, 34(3), 471–475. https://doi.org/10.1177/0363546505280429
37. van Melick, N., Meddeler, B. M., Hoogeboom, T. J., Nijhuis-van der Sanden, M. W. G., & van Cingel, R. E. H. (2017). How to determine leg dominance: The agreement between self-reported and observed performance in healthy adults. PLOS ONE, 12(12), e0189876. https://doi.org/10.1371/JOURNAL.PONE.0189876
38. Vicenzino, B., Branjerdporn, M., Teys, P., & Jordan, K. (2006). Initial changes in posterior talar glide and dorsiflexion of the ankle after mobilization with movement in individuals with recurrent ankle sprain. The Journal of Orthopaedic and Sports Physical Therapy, 36(7), 464–471. https://doi.org/10.2519/JOSPT.2006.2265
39. Wilczyński, B., Hinca, J., Ślęzak, D., & Zorena, K. (2021). The Relationship between Dynamic Balance and Jumping Tests among Adolescent Amateur Rugby Players. A Preliminary Study. International Journal of Environmental Research and Public Health 2021, Vol. 18, Page 312, 18(1), 312. https://doi.org/10.3390/IJERPH18010312
40. Worsley, P. R., Conington, C., Stuart, H., Patterson, A., & Bader, D. L. (2018). A randomised cross over study to evaluate the performance of a novel ankle dorsiflexion measurement device for novice users. Journal of Foot and Ankle Research, 11(1), 1–8. https://doi.org/10.1186/S13047-018-0286-X/FIGURES/4
41. Yard, E., & Comstock, D. (2011). Injury patterns by body mass index in US high school athletes. Journal of Physical Activity & Health, 8(2), 182–191. https://doi.org/10.1123/JPAH.8.2.182