Date of Publication


Document Type


Degree Name

Doctor of Physical Therapy (DPT)


Health Science

Faculty Mentor

Dr. Hanz Tao, PT, DPT; Dr. Kory Zimney, PT, DPT, PhD


non-contact lower extremity injuries, perturbation training, sports injury prevention, single leg balance, dual task balance, injury prevention programs

Subject Categories

Physical Therapy | Rehabilitation and Therapy


Background: Previous systematic reviews have identified injury risk predictors of sport-related lower extremity (LE) injuries based on exercise programs. There are limited studies indicating the advantage of single-leg balance (SLB) training and its effectiveness in lowering injury rates. Research Question: Investigate which types of balance training were used in effective injury prevention programs. Methods: A systematic review utilizing the SPORTDiscus and PubMed databases. Inclusion criteria were randomized controlled trials from the last 10 years that included LE injury prevention, a balance training component and participants aged 10-30. Results: 5 studies were included in the qualitative synthesis, comprising 2,926 athletes. Three studies included SLB on firm surfaces, none significantly reduced injury. Two studies had SLB on alternating surfaces, one showed a significant reduction in injury risk. One article included SLB with psychomotor and attentional demands, which reduced injury risk. Two studies including SLB with dynamic movement showed reduced injury risk. Two studies including SLB with perturbations showed reduced injury risk and three studies showed that high adherence led to decreased injury risk. Clinical Significance: There is a dearth of research in this area, with only 5 studies within the last 10 years, so caution needs to be applied to make clinical judgments based on this systematic review. The current studies show a trend toward SLB training on firm surfaces not providing any protection against injury. However, SLB training that is incorporated with dual tasks, dynamic movement, or perturbations and that have high adherence, may give some benefit toward injury reduction.



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