Male and Female Athletes: Balance Performance Compared


Objective: To compare balanced performance between male and female athletes.

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Design: Cross-sectional study.

Background: Several studies conducted on athlete’s claim that female athletes cannot compete equally with their male counterparts due to the difference in balance performance. Male athletes are said to possess a stable postural control as compared to the female athletes hence decreasing their injury levels. Several factors have been attributed to this with most studies relying on measuring tools to measure the level of imbalance in female athletes.

Outcome measures: The Star Excursion Balance Test and Biodex Stability System are functioning instruments that are used for screening so as to increase the lower extremity stability, evaluate deficits as a result to injuries and further pick out high risk athletes with low extremity injuries. Also specific Neuromuscular Training Programs have been put in place to prevent the rise of injury risks and enhance interventions that help to stabilize the center mass control. The training ensures that excessive force is not applied to the lower extremity hence decreasing the risk injury levels.

Participants: The study was carried out on a group of 20 subjects (10 male and 10 female) whose ages range from 18-35. The subjects were all expected to meet the research’s criterion for inclusion of participation which was that one had to be without injuries.

Aim: Implementation of the training techniques used to test the balance performance of the athletes has been advocated as a mode to reduce and prevent injuries more rampant in female athletes. Most affected female athletes possess trunk proprioception and neuromuscular deficiency.

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Conclusion: Men have a higher balance performance than female.

Keywords: Balance performance, muscle strength, gender, SEBT, BSS


Balance performance in sports is an important aspect in both men and women in the sporting world (Druckman and Swets 1988). This is because every sports person requires the ability to have some kind of support demonstrating a solid dynamic balance (Druckman and Swets 1988). Tyldesley and Grieve (1989) argue that athletes with the ability to maintain good balance performance excel more in sports than those who do not. Studies conducted indicate that male athletes have more stable balance performances as compared to their female counterparts (National Strength and Conditioning Association 1985). This has been attributed to the fact that female athletes succumb more to injuries than the male athletes (Tyldesley and Grieve 1989). It has been reported that a higher percentage of female players are more likely to suffer a sports-related ACL injury than their male counterparts (Vickil, 2010). The reason attributed to this is the fact that the sports movements result in altered neuromuscular patterns which affect the lower limb joint in women.


The period before the 21st century experienced a sporting world dominated only by the males (Flintoff and Scraton 2002). The ancient Olympics, for example during that period had no female sport while the entire sports were male dominated. However, this took a turn in the Olympics held in 1928 which included sizeable female participants in the track and field competitions. It was after this first event that women began taking parts in other male dominated sports such as baseball (Flintoff and Scraton 2002). However, males continued to receive more fame and better monetary rewards than their female counterparts in sports, though they participated in similar competitions (Tyldesley and Grieve 1989).

As a result, there has developed reason that has prompted arguments as to who has better and solid balance performance between males and females. One such reason is a larger pelvis in females than male. “Sports medicine specialists have associated a “wider pelvis to a larger “Q” (Quadriceps) Angle – the angle at which the femur (upper leg bone) meets the tibia (lower leg bone).” (Flintoff and Scraton 2002). On a normal standard, this angle is degrees larger in female than in male, thus places more strain on the knee and also resulting to enlarged foot pronation in females. Most researches have been conducted on female athletes to prove their incapability to match up to their male counterparts (National Academy of Sports Medicine 2009). Some key differences have been reported to exist between male and female athletes, such as the amount of oxygen that each party can administer to produce energy differs with the male production surpassing that of the female anatomical assemblage. The current study is based on this background and to further establish the relationship between the measuring instruments and their ability to measure balance in athletes (Bressel et al 2007). Another key difference is the level of masculine strength that makes the male athletes have more endurance than the females. Male and female muscle tissues are basically identical, and respond in a similar way to strength training, though female usually have less muscle strength than male, the muscle adjusts to progressive resistance work out in the same way (Bressel et al 2007).

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A number of difficult sports tasks such as long jump pose a higher ACL injury risks to women (National Academy of Sports Medicine 2009). Past findings recommended several strategies for reducing these ACL female injuries, such as upgrading the neuromuscular training programs (Vickil 2010). The Neuromuscular training is a program used to “train” the body better habits for knees strength by training the knees to move in a particular manner, particularly when jigging, landing, and spinning around, so one can retain stability of the knee joints. These new programs are aimed at reducing the level of ACL injury suffered by female athletes and according to recent studies, an athlete is required to undergo some tests to determine his/her posture stability and level of injuries (Vickil 2010).

However, laboratory tests on athletes’ injuries and performance in female athletes indicate that even with the development of the new programs in place, female athletes continue to suffer more injuries than male athletes (National Academy of Sports Medicine 2009). Most of the studies conducted have come to a conclusion that female athletes succumb to injuries more than the male athletes. They base their arguments on the fact that female women get fatigued faster hence affecting their performance balance. This is especially in women who take part in high risk sports originally designed for the male athletes like basketball. However, the difference between the tests conducted and the actual injuries suffered by female athletes shows a missing link between the current studies conducted and the scientific laboratory results on the new neuromuscular training programs (National Academy of Sports Medicine 2009).

These key differences have been used to make performance balance comparisons between female and male athletes with the male athletes proving to have a more stable balance that leads to fewer injuries in various games. It is for this reason that measuring the performance balance in athletes became necessary by using various measuring tools such as SEBT and BSS (Flintoff and Scraton 2002) whereby these tests are used to measure changing or dynamic postures from static states of balance during pre-test and post-test. While the SEBT test is more reliable in measuring dynamic balance and determining deficits in performers who have unstable unilateral ankle that has an effect on balance control, the BSS test is effective in creating joint rehabilitation and further augments the proprioceptive mechanisms (National Academy of Sports Medicine 2009).

Purpose of the Study

Balance training and coaching approach accorded to both the female and male athletes takes into consideration the psychological differences between the different anatomical body configurations between the two genders. It is this psychological difference that brings about the imbalance between the genders (Flintoff and Scraton 2002). Also there are biomechanical differences between male and female, as well as the gender disparities among athletes in the incidence of ACL injuries, may be the effect of inexperience in appropriate performance balance rather than inherent gender aspects. The gender differences in Neuromuscular Performance are occasionally eclipsed by more evident gender differences; male athletes have an increase in Neuromuscular Performance after the teenager development spurt, nevertheless increase in muscle mass and other issues may mean that in some areas motor performance may in reality decrease in comparison to females (Flintoff and Scraton 2002).

The mode of training used by women was built out of a research that was conducted on males hence does not encompass the biological differences between the two sexes. The Neuromuscular Training Program which ensures that the athletes take a certain test using the measuring instruments (Kirk et al 2004). The test will therefore help to determine and establish several factors that have been considered to influence the dynamic balance in both male and female athletes. This study will therefore attempt to determine and discuss these factors and to further conduct a test to measure the balance of both parties and make comparisons.

Literature Review

Past studies have attempted to come up with a comparison of static and dynamic balance between male and female athletes. Bressel (2007) attempts to explain the performance variations exhibited during balance exercises basing their arguments on tests carried out using the SEBT test and the fact that trainers choose a particular exercise so as to enhance the postural control of the sports person so as to reduce injury risks. Some of these outstanding factors include strength and the manner that information is transferred from the somatosensory (Hill, 2001). Other factors that seem to affect balance are linked with the coordination that is affected by vestibular modes and visual responses. The study put forward in this literature gives a suggestion that greater balance performance is attained by motor responses which is higher in male athletes as compared to female athletes. This is due to the fact that men have the necessary strength to endure more than women during a game due to their great muscular strength (Harrel 2001). Women have close to twice as weaker muscular strength as men as a result of colossal fat loss; which influence their balance performance (Quin 2011). Harrel (2001) takes a different view by arguing that women have the ability to multitask more than their male counterparts. The sensory coordination in women is much stronger hence acquiring a superior balance performance than their male counterparts. Different balance performances are characterized by the specific type of sport. The gymnasts for example require strong muscular strength and balanced joint of motion (ROM). Basketball players require great joint speed for dribbling and shooting skills.

According to the SEBT and BSS tools used to measure and compare men and women athletes, performance balance can also be affected by the level of fitness in both male and female athletes. Hill (2001) argues that men are more fit than women due to the level of fat in the bodies. Women record a higher percentage of fat than men with the same athletic capabilities. This affects the performance balance of the two gender sexes. The body composition in the human body determines the weight and this in turn can affect the balance performance of an individual in different aspects. According to Quin (2011), women athletes are at higher risk of developing health issues due to massive fat loss compared to the male counterparts. This has been attributed to several factors such as eating disorders, amenorrhea and small bone mass which lead to their decreased performance in sports.

Researches conducted on the level of injuries sustained in the field indicate that knee and shoulder injuries are the most common musculoskeletal injuries suffered. Statistics given by James (2008) indicates that 60% of female athletes are prone to these injuries as compared to their male counterparts. Most training programs have been designed with the male athlete in mind hence fails to take into consideration the biological body balance of the female. A study conducted at the University of Michigan showed that the difference in the male structure between the two genders is also a contributing factor to determine the balance performance between the two. The research in particular studied the level of knee injury which seemed to be prevalent in female athletes. Women athletes have weaker muscle structure around the knee which affects their balance support. Knee stability is maintained and supported by the ligament placed behind the patella. Most athletes injure this particular anterior ligament which appears to have weaker support in women athletes. It is not yet clear whether different types of sports play a role in rotational knee stiffness. Some sports seem strenuous to women and require a lot of muscle application than they can handle leading to injury. They end up tearing up the anterior ligaments because of their inability to withhold the stiffness to the muscle around the knee joint. The studies become a puzzle in trying to solve the difference of the performance balance between the male and female athletes and to further come up with a solution to meet the training needs of the female athletes effectively (Kirk 2004).

Recent studies however, indicate that the prevalent knee injuries suffered by women athletes can be prevented by ensuring neuromuscular control. An example of the neuromuscular control that has been identified is the postural balance during a heavy landing and application of several muscle engagements. Fatigue is another factor that leads to performance imbalance between the male and female athletes hence should be determined during the test program. It has been argued that female athletes get fatigued faster than the male athletes in similar activities hence making them have less performance balance as compared to their male counterparts.



The research was carried out on 20 subjects divided into 10 male participants and 10 female participants aged between 18-35 years. There were no cases of exclusion of subjects since a criterion of participation in the study was that one had to be without injuries. The participants were split into two groups male and female. “Approval to conduct the study was granted by the Institutional Review Board and consent forms signed by the parents of legal guardians of the stakeholders” (Riemann and Guskiewicz 1999) The participants had to sign the assent form as acceptance to take part in the study. At the beginning of the study, the participants were given a questionnaire to fill which required them to fill in their personal details such as gender, age, injuries suffered in the past, extreme lower symptoms and their roles in conditioning training programs.


The participants were first allowed to watch an instructional video that gave them an illustration of the test procedure and what was expected of them. The participants were first tested using the SEBT measuring tool in which 8 equal lines had been used. The intersecting lines were extended at a 45° angle on a flat surface. The lines were labeled as posterior, medial, lateral, posteriomedial, posterolateral, anterolateral, anterolateral and anterior. The naming was based on the bearing of excursion comparative to the stance leg. The participants used the contra lateral leg to cover all the eight directions while at the same time maintaining a single leg stance. The participants then returned to the bilateral stance. Each participant took three trial tests and a gap of 15 seconds of SEBT executed among the subjects in each single direction. “The maximum distance that the participants reached in every direction was recorded in centimeters and the total score was the sum of the total distance covered in all the eight directions” ( Kirk 2004).

The participants were then tested using the Biodex Stability System (BSS) Shirley, USA, which is ideal for measuring balance. This is because it mainly targets the neuromuscular and somatosensory, which control balance in every athlete. The BSS only allows the individual’s support surface tilt to be maintained at a maximum of 20 degrees and the individual has to control and maintain their centre of gravity over their support base. The participants were asked to maintain a single leg stance on a movable balance platform. The platform was in a continuous tilting position of up 20° horizontally and in a 360° range of motion (ROM). The participants each took three trials at the difficulty level (level one) resting in between 10s for each participant. The participants had both of their legs tested randomly with most of the results discarded when a participant lifted or shifted the stance foot from the balance platform grid.


This research relies on two measurement tools to test balance; “the Star Excursion Balance Test (SEBT) and Biodex Stability System (BSS)” (Kirk 2004). These tests were used to measure changing or dynamic postures from dynamic states of balance. The preference of these tools is that the results derived from SEBT tests are more reliable especially when measuring dynamic balance, points out low performance due to musculoskeletal injuries and also view it as a rehabilitation measuring tool. According to Kirk (2004), SEBT is effective when it comes to determining deficits in performers with unstable unilateral ankle and is the same as measuring balance control. However, Maughan and Burke (2004) in their study to test SEBT effectiveness using twenty subjects refute Kirk et al arguing that SEBT was not a reliable tool and therefore not valid to give exact measurement. Phillip and Jay (2003) argue that the dynamical functional test cannot be fully validated by using SEBT measuring tool. It should be noted that using SEBT to measure balance creates a challenge to the player’s postural control with the player marinating balance on one leg.

The Biodex Stability System (BSS) was developed using a multi-axial dynamic to help in joint rehabilitation and to further augment the proprioceptive mechanisms. A study conducted by Gray (1990) using the Biodex Stability System, concluded that it was highly reliable as compared to other measuring devices. Tyldesley and Grieve (1989) argue that to get reliable results, the subjects should be subjected to two trial tests while using BSS. Nonetheless, other researchers criticize the BSS as an ineffective tool to measure dynamic balance. A recent study conducted by Fu and Cohen (2008) revealed that BSS was not a reliable measuring tool to test poor or stable balance. The study will therefore determine and test the reliability of SEBT and BSS as measuring tools and determine whether the female athletes recorded an improvement of their performance balance to surpass the male athletes.

Data Analyses

The average scores derived from the three trials taken by the subjects was calculated and recorded as the participant’s dynamic score. The average scores were based from the trials for each excursion so as to determine whether female athletes recorded an improvement of their performance balance to surpass the male athletes. The excursions used in our study were posterior, medial, lateral, posteromedial, posterolateral, anteromedial, anterolateral and anterior excursions. In addition, the data analysis further relied on the leg length of the participant’s dominant extremity to standardize their dynamic balance scores. The study also obtained the data from the three trial tests derived from the BSS. The average scores were calculated on the trial tests using balancing on the left leg and the right leg.

Statistical Analysis

The data derived in the dominant extremity was used to analyze each participant. The analysis was presented using the means and standards deviations mode for each participant’s demographics and the means and standard deviations for post and pre-test data for both BSS and SEBT. The analysis of variance was further conducted to point out effectiveness of Star Excursion Balance Test and Biodex Stability System. The reliability of the measuring tools was determined using the interclass correlation efficient by combining the post-test and pre-test data.


The study revealed no significant different between the limb excursions distances between both genders participants. Flintoff and Scraton (2002) notes “an important relation was found between height and leg length and excursion distances in all directions.” Stronger relations between the leg length and excursion distance in male athletes was greater than the female athletes. The male athletes were found to have much greater excursion distances than female athletes in 3 of the reaching directions. These are medial, Anterior and Anteromedial.

Differences in Excursion Distances For Male Athletes and Female Athletes

Raw Scores (cm)
Reaching Directions Male Female
Anterolateral 71.1±7.4 67.1±5.4
.Posteriomedial 66.4±8.0 65.1±6.5
Posterior 71.9±15.4 69.6±12.1
Medial 81.2±11.2 74.5±11.6

Note: Means of 3 test trials and standard deviation values in each reaching distance


The purpose of carrying out these tests was to determine if there were any factors that influenced performance balance between male and females and if there was a slight improvement of performance in females as compared to other conducted research. It was also meant to determine whether SEBT and BSS were effective enough to predict low extremity injury level in female athletes. One of the findings was the fact that the difference between the smaller standardized right composite reach distance and the increased anterior left or right reach distance predicted less extremity injuries in both gender sexes. The study shows a hypothesis that static and dynamic balance scores between male and female athlete is different. Female athletes showed a lower static balance and inferior dynamic balance as compared to the male athletes. Our static balance scores for the male and female athletes closely match the scores done in a study by Riemann and Guskiewicz (1999).

Although most researches have established that unstable balance is a risk factor that cause most injuries in women athletes, few have examined the connection of how they correlate with each other. However, there are conflicting findings in other studies where the researchers claim that good and stable balance can also be a risk factor to injuries. Other findings indicate that there is no connection between balance and the risks of injuries suffered. It can therefore be argued confidently that the relationship connecting the two have not been clearly established hence the need of this study. This study will adopt the use of two measuring tools to measure balance of both the female and male athletes and make a comparison on the results formulated. The Star Excursion Balance Test (SEBT) and Biodex Stability System (BSS) are reliable and inexpensive methods of measuring balance. It should however be noted that currently there are other state-of-art measuring devises that are used to point out the asymmetries in athletes, though they are very expensive. On the other hand, SEBT and BSS produce reliable results and they are relatively cheaper.

Our study indicated that many female athletes who participated in heavy engaging sports are energy deficient. The male athletes exhibited a higher level of resistance and are therefore energy efficient in the same sports participated by female athletes. Bressel (2007) argument that unstable postural posture can increase the level of injuries was one of the objectives that the tests aimed to examine. Though there was a significant decrease in the number of anterior cruciate ligament knee injuries due to imbalance among women, the study still gave an indication that the women were more affected than the male athletes. However, the data derived from the study negated the data released by the National Collegiate Athletic Association in 1990 which stated that the number of female athletes who suffered ACL injuries was five times more often than those of the male athletes participating in the same sport. The data released in this study indicates a fall in those statistics with fewer women suffering from the ACL injuries. It should however be noted that though the number had drastically dropped, they were still susceptible to ACL injuries more than the male athletes.

It is also important to note that before the training, the female athletes demonstrated a lower performance level on the SEBT and BSS variables. However, upon engaging in the neuromuscular training group, the SEBT and BSS composite score in female athletes improved drastically to almost match up with the composite score achieved by the male athletes. IDEA Health and Fitness (2002) explains the improvement in the composite score after the neuromuscular program as an increase in the posterolateral and posteromedial reach. However, the results in our study did not find any difference in reach towards the anterior direction as compared to the study conducted by IDEA Health and Fitness (2002).

Current studies have encouraged the use of Neuromuscular Training Program that adopts core stability as part of treatment programs aimed at preventing ankle and knee injury. It was obvious from the results that these programs reduced injuries such as knee injuries. The excluded controls who did not participate in the training program succumbed to more knee injuries than the participants. Further, the results indicated that a larger percentage of the women athletes who did not take part in the training program succumbed to more knee injuries than the male athletes. Other authors have also confirmed that players who suffered from chronic instabilities in the ankles developed a more stable postural control following the training programs. National Academy of Sports Medicine (2009) notes “the training athletes from both gender portrayed drastic improvements in the SEBT and BSS composite scores.” However, our study did not directly assess the effect of SEBT and BSS composite scores on the rate of knee or ankle injury. The SEBT and BSS measures indicated their capability of being a corollary outcome measure that can be used to determine the comparison of training programs that reduce injuries in both the male and female athletes. Studies that have been conducted in the past argue that isolated strength measures fail to have any effect in SEBT and BSS composite scores. Manske (2006) conducted a study which involved female soccer students as his subjects. The main aim of his study was to compare the isokinetic strength between the recreational and collegiate subjects and found that there was no difference in either. Their research further attempted to show a balancing correlation between SEBT performances and low extremity strength. Phillip and Jay (2003) cited improvements from using SEBT but argued that the improvement was not based on the strength but rather the flexibility of the hip and increased knee flexion based on the stance limb. Their research included twenty subjects from college who were not taken under any intervention program. They argued that the reach distance variance was comprised of 61.5% to 95% of the hip and knee flexion. However, the results by Phillip and Jay (2003) can be criticized due to various reasons. The most important thing to note was their failure to take measurements of the lower extremity strength. It can therefore be argued that the subjects who had the potential of portraying increased knee and hip flexion had a possibility of having lower extremity strength compared to those who had decreased angles in knee and hip flexions. Our study on the other hand supports this theory brought forward by Phillip and Jay. However, our study established that male athletes had increased knee and hip flexions hence having a higher performance balance as compared to the female athletes.

Our study was also aimed at establishing how the strength training program affected the male and female athletes based on their reactions to the forces of the ground, stability of the athletes with lower extremities using BSS and SEBT measuring tools and the overall sports performance between the male and female athletes. Our study found out that both the male and female athletes who had trained using SEBT and BSS had improved drastically. This was in contrast with the study conducted by Druckman and Swets (1988) that, after their six week strength training program came to a conclusion that there was no improvements in their subjects, especially the female athletes who used SEBT. They further argued that the improvement of the male athletes drastically improved. However, there can be several arguments that can be put forward in support of our study to disregard the claims that there was no improvement after using SEBT and BSS. One difference between our study and the previous conducted study was that Duckman and Swets (1988) lacked balanced training on one hand and the biomechanical response. They also adopted a different mechanism of what core stability training entailed and further failed to use the standard testing mechanism for the SEBT.

These studies have further developed various thresholds that can be used to determine the risk injuries by using BSS and SEBT. Bressel (2007) concluded that female athletes with more than 92% less composite reach when using measuring instruments such as BSS and SEBT were 7 times more likely to get an injury as compared to the male athletes. However, they claimed that the Neuromuscular Training Program relied more on the lower extremity strength and the stability during the training improved the SEBT and BSS composite score. Our current study was also aimed at evaluating the effects that training using SEBT and BSS could have on knee abduction load. It was clear from the results that the high-risk female athletes decreased their ACL injury risks as compared to the low-risk female athletes who seemed to show no change at all. On the other hand the male athletes showed a consistent performance and suffered less ACL injuries as compared to their counterparts.

Ligaments serve a very important function in joint kinematics by providing a solid base restraint to any unwarranted movement of the joint when stress has been exerted on the joint. When the tissue is injured, it leads to the instability of the individual which in turns leads to the aberrations to the normal kinematics. This is a common sports injury experienced by both male and female athletes. The ability to restore the joint stability ensures that the athletes resume their sporting activities thereby minimizing recurring injuries. The BSS and SEBT provided a platform to rehabilitate the tissue injury and to avoid further tissue injury in the joints. The study conducted by National Academy of Sports Medicine (2009) supported this finding and further added that the measuring instruments greatly reduce the risk of injuring the joint tissues especially in female athletes. This is because balance training with the use of stable platforms such as BSS and SEBT combines all the sensorimeters that are used to modulate the functioning of the muscles at a higher extremity. It should be noted that the study proved the Biodex Stability System to be more effective than the Star Excursion Balance Test to measure this type of stability. The results further indicated that though stability in female athletes had drastically improved from other studies, they were still lagging behind from the male athletes.

The study also came to a conclusion that the use of SEBT and BSS may turn out to be sensitive instruments especially for the athletes who have trained and can be used before the competition so as to assess other factors such as the neuromuscular determinants other than the strength and stability alone. Other studies have examined the BSS and SEBT measuring instruments to determine whether they have any relation with the injuries in the anterior cruciate ligaments that lacks postural control and have come to the conclusion that it had limitations to the patients who had less anterior cruciate ligament. These patients recorded a significant decline on their reach scores.

Bressel (2007) notes “following the Neuromuscular Training Program, the study recorded no similarity in the composite scores in the limbs between the control athlete group and the experimental group.” Several suggestions can be given to explain the reason behind the similarities with the most outstanding reason based on the design of the Neuromuscular Training Program used. The design adopted focused on how each limb equally performed during the exercise hence leading to the lack of limb effect. The study was important in establishing the symmetry of limb in both the male and female athletes as it can be used to compare their imbalance level performance which is one of the main risk factor for ACL injury. The main problem was to evaluate whether the results from the study indicated a decline of ACL injuries in female athletes as compared to other studies. A recent study conducted by National Academy of Sports Medicine (2009) conducted a retrospective epidemiological research for a period of one year to determine the trends in the anterior cruciate ligaments injuries rates between the male and female athletes playing soccer and basketball. At the end of the study, the author, in his report concluded that male athletes portrayed a very low ACL injury rate as compared to the female athletes who showed little or no change at all. Though this report can be relied on to determine the rate of ACL injury levels in both male and female athletes, it stand to be criticized as the study ignored to reflect the role of neuromuscular programs and its effect on the actual anterior cruciate ligament injuries incidence. Though the results in our study showed almost similar results with the above study by National Academy of Sports Medicine (2009), it further gave an indication that future prospective studies will likely portray a positive related effects of the neuromuscular training aimed at reducing injuries such as knee injuries in female athletes. This is because our study showed significant decline in the injuries after the training program using SEBT and BSS. SEBT and BSS has been used successfully as an indicator determining the lop-sided impairments in the functioning balance between injured involved athletes with serious ankle injuries or anterior cruciate ligaments injuries and the athletes controls who did not suffer any injuries.

According to Taylor and Francis (2009), postural instability was also related to chronic ankle instability and fatigue and the tests given to the twenty participants by using the SEBT and BSS measuring tools. The tests determined the effects of fatigue and chronic ankle instability relating to the performance balance measures between the male and female athletes. After the participants repeated each given tests three times as required, it was actually determined that the more involved side of the chronic ankle instability of the participants had a lower reach distance values and knee flexion angles. Most of these participants were women athletes who participated in the tests. This was in contrast with the larger percentage of the male athletes who recorded a higher value of reach distance and knee flexion angles as most of them were uninjured by the end of the exercise. The study concluded that the side effects of fatigue contributed to this factor and it was therefore evident that women athletes fatigued faster than the male athletes taking part in the same type of sport. Chronic ankle instability and fatigue therefore acted as a hindrance to the dynamic postural balance especially in female athletes.

Vickil (2010) notes “the study further examined the correlation between the foot type and postural control in both the male and female athlete.” However, our study took a different argument from the study conducted by Harrel (2001) by determining that the foot type was not directly related to the postural control as assessed by SEBT and BSS. The study also revealed no correlation between ROM measurements at the ankle and the performance of both the BSS and SEBT. Each participant took three trial test and it was established that there was no difference between the ROM based at the hip and ankle which did not affect their overall performance with the measuring instruments.

The study further was in agreement with the findings of Hill (2001) where he argues that male athletes possess more stabilized performance balance due to their less body fats. Our study came to the conclusion that weight in both the male and female athletes played a very big role in the balance performance. The female athletes’ weight records were either very low or extremely on the higher side as compared to their male athletes whose weights were standard. Hill (2001) attributes this to many factors. He argues that women underfeed themselves hence recording very low weight and this affects their performance in sports. Further, he argues that women are faced with biological problems such menstruation which can either affect their feeding habits and practice hence the reason why some women weigh on the extreme. It is therefore very difficult for female athletes to achieve and maintain standard weight balance as their male athlete’s counterparts. The study also demonstrated the ability of the male athlete to hold more oxygen than the female athlete for energy production. This ensures that male athletes have the ability to perform powerful activities without getting fatigued as opposed to the female athletes. Our study further showed a decline in the SEBT reach distance when the female athletes especially began getting fatigued hence portraying balance inability. The reach distance in SEBT of the male athletes showed little or less change throughout the test. It can therefore be concluded that fatigue plays a big role in balance performance between the male and female athletes hence declining the performance rate of the female athletes.


Any study conducted is faced by limitations that should be taken into consideration. Some subjects were excluded from the group that was being used for the experiment resulting to 30% drop-out range. Although the drop-out rate was slightly higher, the final analysis confirmed that the sample size used was enough. The other limitation was the small number of female athletes needed to be used for this experiment. Initially, the study was to use 30 participants to which 15 were female athletes and the other 15 were male athletes. The male turn-out was greater than the females, who come of them had to be excluded from the experiment due to various factors. Further, the training performed was done at the exclusion of the applicability of the random assignment.

The implications of future studies include making good use of SEBT and BSS as assessment and screening instruments especially for female athletes. This is because not only are they cheap tools but are also easy to use. They have also been established to be practical instruments that can be applied as a preseason tools for screening purposes so as to determine which of the athletes have the lowest level of risk injuries. The combination of the two tools to test the athletes ensures better results that can be used to compare and contrast the results.

Another limitation of our study was lack of counter balancing in the order of trials taken by the participants. “The order used for testing followed a dominant and non-dominant stance in the clockwise direction. Studies to be conducted should use random method of testing the participants so as to avoid factors such as getting fatigued and learning effects.” National Academy of Sports Medicine (2009)


The Neuromuscular testing of the athletes using SEBT and BSS is an essential way of determining the balance performance of the athletes. The study indicates that balanced performance in male athletes is more stable than the stability achieved by the female athletes. The Neuromuscular Training that concentrated more on the lower extremity strength had a higher impact on the SEBT and BSS composite score especially in female athletes. It can be concluded that the factors affecting performance balance between male and female athletes are connected to the level of instability between the two. Though it has been established that the female athletes have a lower balance performance than the male athletes, it can be argued from the study conducted that they are slowly catching up and are almost the same level with the male athletes in their reach level. This is in comparison with other previous concluded studies. The Star Excursion Balance Test and Biodex Stability System become the most recommended measuring tools that should be adapted to measure balance. They are cost effective and give almost accurate results needed to establish postural stability. They have been further been recommended clinically to measure the postural stability of the elderly and the stroke patients.


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