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Purpose <p>Functional asymmetry is a potential risk factor for injury, yet its prospective association with pain development in volleyball players remains under-investigated. This preliminary prospective study aimed to determine whether preseason inter-limb asymmetry in lower extremity performance predicts the onset of pain during the season.</p> Methods <p>19 collegiate volleyball players were assessed for hip range of motion, Star Excursion Balance Test (SEBT), and hop tests during the preseason. Participants were monitored for pain occurrence over a 3-month season. Due to the exploratory nature of the study, analysis focused on Effect Sizes (Cohen’s d) and 95% Confidence Intervals (CIs) to identify potential risk signals.</p> Results <p>Nine players (47.4%) experienced pain. While hop tests showed no significant group differences, SEBT asymmetry was significantly greater in the pain group (asymmetry index: 0.29 ± 0.25 vs. 0.04 ± 0.03, <i>p</i> = 0.04). Notably, this asymmetry exhibited a large effect size (Cohen’s <i>d</i> = 1.42). Univariate logistic regression indicated that increased SEBT asymmetry was associated with higher odds of developing pain (OR: 2.42 per 0.1 increase; 95% CI: 1.02–7.41).</p> Conclusion <p>Despite the small sample size, substantial inter-limb asymmetry in dynamic balance (SEBT) emerged as a notable precursor to pain. These findings serve as a critical pilot for larger validations, suggesting that screening for SEBT asymmetry may help identify at-risk athletes.</p> Trial Registration <p> UMIN000054720.</p>

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Comparison of inter-limb functional asymmetry in collegiate volleyball players with and without lower extremity pain: a preliminary prospective study

  • 期刊论文

  • 发表日期：

    2026年1月5日

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  • Ryota Imai,
  • Aya Kusumoto,
  • Takanari Kubo,
  • Daisuke Bai

摘要

Purpose

Functional asymmetry is a potential risk factor for injury, yet its prospective association with pain development in volleyball players remains under-investigated. This preliminary prospective study aimed to determine whether preseason inter-limb asymmetry in lower extremity performance predicts the onset of pain during the season.

Methods

19 collegiate volleyball players were assessed for hip range of motion, Star Excursion Balance Test (SEBT), and hop tests during the preseason. Participants were monitored for pain occurrence over a 3-month season. Due to the exploratory nature of the study, analysis focused on Effect Sizes (Cohen’s d) and 95% Confidence Intervals (CIs) to identify potential risk signals.

Results

Nine players (47.4%) experienced pain. While hop tests showed no significant group differences, SEBT asymmetry was significantly greater in the pain group (asymmetry index: 0.29 ± 0.25 vs. 0.04 ± 0.03, p = 0.04). Notably, this asymmetry exhibited a large effect size (Cohen’s d = 1.42). Univariate logistic regression indicated that increased SEBT asymmetry was associated with higher odds of developing pain (OR: 2.42 per 0.1 increase; 95% CI: 1.02–7.41).

Conclusion

Despite the small sample size, substantial inter-limb asymmetry in dynamic balance (SEBT) emerged as a notable precursor to pain. These findings serve as a critical pilot for larger validations, suggesting that screening for SEBT asymmetry may help identify at-risk athletes.

Trial Registration

UMIN000054720.