Balance and Proprioception: Star Excursion Sitting Test (SEST)

The Star Excursion Sitting Test (SEST) is a novel test for examining trunk and postural control expressed as the maximum distance that participants can reach with their hands while in a sitting position. 

Research investigating this test found that there was little correlation between the SEST and the Star Excursion Balance Test (SEBT) indicating that the SEBT indicates that the lower limb may have more influence on test performance than trunk structures, especially in people with ankle chronic instability, leg extensor muscle weakness, or lower limb motion deficits. The SEST can be used to assess trunk and postural control in exclusion of the lower limb which may be advantageous to compare results to identify where deficiency may be, or to avoid an injured area during the testing process.

Preliminary findings in research by Lopez-Plaza et al 2018 found normative values of reaches as follows:

Anterior: 73cm

Lateral: 90cm

Posterior: 101cm

It is likely that more research needs to be conducted on this test however these are useful numbers to guide your assessment and analyze the people you work with.

Procedure:

1. Set up the MAT  on a flat surface with enough space for the client to move freely.
2. Ask the client to remove any bulky clothing or accessories and put on athletic shoes or sneakers.
3. Position the client in the centre of the circle at one end of the MAT, in a seated position with their ischial tuberosity aligned with the centre of the intersection.
4. Queue the client to lift their feet up in the air by placing one up underneath their knees. 
5. Instruct the client to reach with their opposite arm, gently touching as far as they can with their finger tips. Have them move around the circle on the MAT, reaching three times in each of these directions: anterior, anterolateral, lateral, posteromedial, posterior and posterolateral.
6. The client should touch the MAT with the tips of their fingers without losing stability in the seated position.
7. Ask the individual to return to the starting position and repeat the reach test in the other five directions, forming a Star-shape.
8. After completing all reach tests, mark the furthest distance reached in each direction on the MAT.
9. Record the results and repeat the same protocol using the opposite arm.