The modified Star Excursion Balance Test (mSEBT) is a valid, low-cost, and easily implemented screening tool in clinical practice recommended for assessing dynamic postural control in athletes. Previous studies evidenced that poorer performance on the mSEBT predicts an increased risk of injury in several sports. The performance of the mSEBT depends on the contribution of various body segments and constructs of physical function to reach maximum distance in the anterior, posteromedial, and posterolateral directions. Understanding the relationship between mSEBT performance, distal and proximal factors in the kinetic chain and other constructs of physical function in soccer athletes can contribute to a more assertive assessment in clinical practice, since soccer athletes with dynamic balance deficient are more likely to sustain a lower limb injury.

To verify if hip and foot/ankle musculoskeletal factors predicts the performance of the modified Star Excursion Balance Test (mSEBT) in male youth soccer athletes.

In this cross-sectional study, 108 athletes (18.04 ± 0.14 years, 72.86 ± 0.76 kg, 1.78 ± 0.7 m) in categories Under-17 and Under-20 from a professional soccer club in Brazil were assessed during the preseason assessment. The assessment included the following tests: shank-forefoot alignment (SFA), passive hip IR ROM, hamstring flexibility (HF), dorsiflexion range of motion (ROM), Single Leg Hamstring Bridge (SLHB), and the performance of the modified Star Excursion Balance Test (mSEBT). Multiple linear regression analysis was performed to identify if the foot/ankle musculoskeletal factors could explain the performance of the mSEBT.

Regression analyses revealed that shank-forefoot alignment and ankle dorsiflexion ROM predicted the performance of the mSEBT (P < 0.05). In model 1, SFA explained 9% of the mSEBT performance (F = 10.19; r = 0.3; r2 = 0.9; p = 0.002). The inclusion of the ankle dorsiflexion ROM in model 2 explained 16% of the total variance of the mSEBT (F = 8.54; r = 0.4; r2 = 0.16; p = 0.004).

The ankle dorsiflexion ROM and shank-forefoot alignment explained 16% of the performance of the mSEBT in male youth soccer athletes. These results suggest that the ankle dorsiflexion ROM and shank-forefoot alignment contribute to test performance and the physiotherapist must assess these factors.

The results of this study suggest that considering the influence of distal musculoskeletal factors of the kinetic chain on dynamic postural control and the association of the ankle dorsiflexion ROM and the shank-forefoot alignment with the performance of the mSEBT in youth soccer athletes. Athletes with a lower performance in the test should be assessed to verify the shank-forefoot alignment and the ankle dorsiflexion ROM. In addition, the improvement of the ankle mobility can be considered a good intervention in the implementation of prevention programs.