Star Excursion Balance Test – Why is it important to injury recovery?

The Star Excursion Balance Test (e.g., SEBT) is used to assess lower body mobility, proprioception, and strength.

To perform it, a series of eight lines in a “star” pattern is marked out on a floor using four 6 to 8-foot-long pieces of tape laid across one another in ‘X’ patterns to make a star with eight evenly-spaced points.


To perform the Star Excursion Balance Test (SEBT):

  1. Stand on one foot in the middle of the star.
  2. Without resting your free foot on the ground, you reach out and touch each point of the star at the furthest point you can reach.
  3. Do this one point at a time while returning your foot to the center each time before reaching out as far as you can to tap the ground on the next point on the star.


This measures your balance, mobility and motor control, which in itself is important for sports performance and resilience. But, most importantly, it also measures side-to-side asymmetries. If an athlete can stay balanced while reaching with much greater range of motion on one side than the other, they’re at a significantly increased risk of injury in their sport.

Tracking movement asymmetries in the lower body by using the SEBT is a reliable and valuable way to identify athletes with a high-risk of lower body injury, as well as a method to measure progress during rehabilitation.

An athlete recovering from a lower body injury will generally have less reach while standing on their injured limb. By tracking the changes in this deficit and comparing them to a more symmetrical, non-injured baseline, trainers and therapists are able to use objective progress indicators during their athlete’s return-to-play process. They can track meaningful data that allows them to know when an athlete is sufficiently recovered and functionally ready for the rigors of their sport.

Many studies have highlighted the validity of the star excursion balance test in screening athletes for participation in sports, as well as measuring functional symmetry during dynamic movements.

A drawback to the SEBT is that the therapist or trainer must keep track of A LOT of data. Each round of tests involve measuring and recording the reach-and-touch distance for each of eight points on the star. In the standard protocol, the test is repeated three times per leg and then the scores are averaged and compared.

This works out to 48 different numbers that have to be recorded and processed. For a busy trainer, this is a lot of data management and an inefficient use of time. The more time spent on processing data, the less time is allowed for direct patient treatment.

The Cipher Skin Knee BioSleeve changes this by automating the entire process. Rather than having a trainer scramble around on the ground on taking measurements of each distance 48 times, the BioSleeve auto-detects and records the reach distance for each touch on the star. This data is automatically collected, processed, and stored securely.

The physical therapist or trainer no longer has to plug numbers into a spreadsheet or track countless pieces of paper or software files. Instead, they simply use the Cipher Skin Digital Mirror to instantly see their patients' or athletes' data simultaneously as the test is performed and ready for review as immediately upon test completion. Data is captured with a the highest degree of accuracy, and is stored so progress and asymmetries can be easily tracked over time.

By automating the data capture and analysis process of the Star Excursion Balance Test, Cipher Skin enables the trainer to utilize this test more efficiently, with more accurate data and less wasted time. Trainers and physical therapists can now focus more on what matters – rehab and return-to-play progress, injury risk, and performance data.

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