A bench mark in the field of physiotherapy for diagnostics and intervention is through on-invasive methods. The Y Balance test(YBT) the one of the essential tool to check if the person is having Balance Issue as well as can add a treatment tool to improve balance in both the upper and lower extremities as well as to improve the strength of the Core Muscles.
The Y Balance Test was developed through years of research in injury prevention and the identification of motor control changes that occur after injury. The YBT is a simple way to measure a person’s motor control and demonstrate functional symmetry. The result? A map that identifies roadblocks to a person’s functional performance both in the rehabilitation and performance worlds.
How do we measure and quantify a person’s motor control and functional symmetry? The Y Balance Test (YBT). YBT allows us to quarter the body – left versus right and upper versus lower body - to test how the core and each extremity function under bodyweight loads
Purpose:
It has been established that the YBT for the UQ (UQYBT) is a valid test for evaluating unilateral UE function in a closed chain situation. The UQYBT also requires the patient to lift themselves up and reach with one UE in three different directions. To evaluate whether the UQYBT is applicable, more study is required.
The Y Balance Test (YBT) is a tool used to test a person’s risk for injury. It can be used for both the upper quarter and lower quarter. The YBT for the lower quarter (LQYBT) has been thoroughly researched as its protocol is based on research done on the Star Excursion Balance Test. The Star Excursion Balance Test demonstrated reliable results on its ability to predict LE injury in high school basketball players, and the LQYBT has identified athletes at increased risk for injury.
Technique:
The YBT for the UQ (UQYBT) has been shown to be a reliable test to assess unilateral UE function in a closed chain position. The UQYBT also has the patient reach in 3 different directions with one UE while in a push-up position. Further research is needed to determine the applicability of the UQYBT.
The LQYBT has the patient stand on one leg while reaching out in 3 different directions with the other lower extremity. They are anterior, posteromedial and posterolateral. When using the Y-Balance test kit, the 3 reaches yield a “composite reach distance” or composite score used to predict injury. Research shows that collegiate football players with a composite score below 89% had an increased probability of injury from 37.7% to 68.1. Therefore, a cut point of 89% composite reach on the YBT was established (with a sensitivity of 100% and a +LR of 3.5). For high school basketball players, the cut point was 94%. These studies demonstrate that every sport and group has a unique risk cut-off.
Reliability:
The LQYBT showed good interrater test-retest reliability with an acceptable level of measurement error among multiple raters screening active duty service members, and a second study shows excellent reliability (ICC = 0.88- 0.99)
Resources:
The Y-Balance, along with the Functional Movement Screen (FMS), is used in the “Move2Perform Algorithm” software to predict the risk for injury. The components used are:
Previous injury
Y-Balance test composite score based on sex, sport, and competition level
Y-Balance Test asymmetry
Functional Movement Screen (FMS) total score
Functional Movement Screen Asymmetry
Pain with testing
Based on the algorithm, patients are then categorized according to risk level (normal, slightly increased risk, moderately increased risk, and substantially increased risk).
Benefits:
Evidence based care
The clear decision for return to sport/work/activity
Increase referrals to your practice with valuable reports
Prevent sports injuries using a validated injury prediction algorithm
Clear documentation for the medical necessity of rehabilitation
Decrease injury rates and promote your practice through pre-participation physicals, wellness, and occupational screens
The Y Balance Test was developed through years of research in injury prevention and the identification of motor control changes that occur after injury. The YBT is a simple way to measure a person’s motor control and demonstrate functional symmetry. The result? A map that identifies roadblocks to a person’s functional performance both in the rehabilitation and performance worlds.
How do we measure and quantify a person’s motor control and functional symmetry? The Y Balance Test (YBT). YBT allows us to quarter the body – left versus right and upper versus lower body - to test how the core and each extremity function under bodyweight loads
Purpose:
It has been established that the YBT for the UQ (UQYBT) is a valid test for evaluating unilateral UE function in a closed chain situation. The UQYBT also requires the patient to lift themselves up and reach with one UE in three different directions. To evaluate whether the UQYBT is applicable, more study is required.
The Y Balance Test (YBT) is a tool used to test a person’s risk for injury. It can be used for both the upper quarter and lower quarter. The YBT for the lower quarter (LQYBT) has been thoroughly researched as its protocol is based on research done on the Star Excursion Balance Test. The Star Excursion Balance Test demonstrated reliable results on its ability to predict LE injury in high school basketball players, and the LQYBT has identified athletes at increased risk for injury.
Technique:
The YBT for the UQ (UQYBT) has been shown to be a reliable test to assess unilateral UE function in a closed chain position. The UQYBT also has the patient reach in 3 different directions with one UE while in a push-up position. Further research is needed to determine the applicability of the UQYBT.
The LQYBT has the patient stand on one leg while reaching out in 3 different directions with the other lower extremity. They are anterior, posteromedial and posterolateral. When using the Y-Balance test kit, the 3 reaches yield a “composite reach distance” or composite score used to predict injury. Research shows that collegiate football players with a composite score below 89% had an increased probability of injury from 37.7% to 68.1. Therefore, a cut point of 89% composite reach on the YBT was established (with a sensitivity of 100% and a +LR of 3.5). For high school basketball players, the cut point was 94%. These studies demonstrate that every sport and group has a unique risk cut-off.
 |
| YBT Left Upper Limb |
 |
| YBT Right Upper Limb |
The LQYBT showed good interrater test-retest reliability with an acceptable level of measurement error among multiple raters screening active duty service members, and a second study shows excellent reliability (ICC = 0.88- 0.99)
Resources:
The Y-Balance, along with the Functional Movement Screen (FMS), is used in the “Move2Perform Algorithm” software to predict the risk for injury. The components used are:
Previous injury
Y-Balance test composite score based on sex, sport, and competition level
Y-Balance Test asymmetry
Functional Movement Screen (FMS) total score
Functional Movement Screen Asymmetry
Pain with testing
Based on the algorithm, patients are then categorized according to risk level (normal, slightly increased risk, moderately increased risk, and substantially increased risk).
Benefits:
Evidence based care
The clear decision for return to sport/work/activity
Increase referrals to your practice with valuable reports
Prevent sports injuries using a validated injury prediction algorithm
Clear documentation for the medical necessity of rehabilitation
Decrease injury rates and promote your practice through pre-participation physicals, wellness, and occupational screens
Words by
Manikandan Rengasamy
Lecturer in Physiotherapy
MAHSA University
Lecturer in Physiotherapy
MAHSA University
If you're a physiotherapist or aspiring to be one, MAHSA offers programmes from Diploma right up to Master's Degree with the pathway towards Doctorate in Science by Research. Connect with us via www.mahsa.edu.my to embark on a rewarding career in this field of science.
References:
· Chimera, N. J., Smith, C. A., & Warren, M. (2015). Injury history, sex, and performance on the functional movement screen and Y balance test. Journal of Athletic Training, 50(5), 475–485. https://doi.org/10.4085/1062-6050-49.6.02
· Lee, D.-K., Kang, M.-H., Lee, T.-S., & Oh, J.-S. (2015). Relationships among the y balance test, Berg balance scale, and lower limb strength in middle-aged and older females. Brazilian Journal of Physical Therapy, 19(3), 227–234. https://doi.org/10.1590/bjpt-rbf.2014.0096
· Plisky, P. J., Rauh, M. J., Kaminski, T. W., & Underwood, F. B. (2006). Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players. Journal of Orthopaedic & Sports Physical Therapy, 36(12), 911–919. https://doi.org/10.2519/jospt.2006.2244
· Butler, R. J., Lehr, M. E., Fink, M. L., Kiesel, K. B., & Plisky, P. J. (2013). Dynamic balance performance and noncontact lower extremity injury in college football players. Sports Health: A Multidisciplinary Approach, 5(5), 417–422. https://doi.org/10.1177/1941738113498703
References:
· Chimera, N. J., Smith, C. A., & Warren, M. (2015). Injury history, sex, and performance on the functional movement screen and Y balance test. Journal of Athletic Training, 50(5), 475–485. https://doi.org/10.4085/1062-6050-49.6.02
· Lee, D.-K., Kang, M.-H., Lee, T.-S., & Oh, J.-S. (2015). Relationships among the y balance test, Berg balance scale, and lower limb strength in middle-aged and older females. Brazilian Journal of Physical Therapy, 19(3), 227–234. https://doi.org/10.1590/bjpt-rbf.2014.0096
· Plisky, P. J., Rauh, M. J., Kaminski, T. W., & Underwood, F. B. (2006). Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players. Journal of Orthopaedic & Sports Physical Therapy, 36(12), 911–919. https://doi.org/10.2519/jospt.2006.2244
· Butler, R. J., Lehr, M. E., Fink, M. L., Kiesel, K. B., & Plisky, P. J. (2013). Dynamic balance performance and noncontact lower extremity injury in college football players. Sports Health: A Multidisciplinary Approach, 5(5), 417–422. https://doi.org/10.1177/1941738113498703