Lower Quarter Y-Balance Test (2024)

Area of Assessment

Balance – Vestibular
Balance – Non-vestibular
Functional Mobility
Strength

Assessment Type

Performance Measure

Administration Mode

Computer

Cost

Not Free

Actual Cost

$319.95

Cost Description

$319.95-349.95 in US Dollars

• Start by having the subject’s barefoot in the center of the foot plate with toes just behind the red starting line.
• While maintaining a single leg stance, have the subject practice by reaching in each of the three directions - anterior, posteromedial, and posterolateral - with his/her free leg and then return to the starting position.
• When the practice trials are completed, have the subject start with his/her right foot in the center of the foot place and perform 3 trials of the direction being tested.
• Repeat with the subject’s left foot in the center of the foot plate. The testing order is:
  1) right anterior
  2) left anterior
  3) right posteromedial
  4) left posteromedial
  5) right posterolateral
  6) left posterolateral
• The maximal reach for each leg in each direction is often used, but some studies also report the average of 3 trials. The maximal reach is measured by reading the distance at the edge of the reach indicator closest to the subject to the nearest half centimeter. The limb being tested is the stance limb.
• The composite score is calculated by taking the sum of 3 reach directions divided by 3 times the limb length then multiplied by 100.
• Subject cannot touch down during the test or place his/her foot on top of the reach indicator.
• Subject also needs to maintain contract with the red target area on the reach indicator until the reach is finished.

Number of Items

6

• Y Balance Testing Kit

Required Training

Training Course

Body Part

Lower Extremity

ICF Domain

Body Function

Measurement Domain

Motor

• This study was only looking at sagittal plane motion when in reality the movements made during the YBT are multiplanar. There is also a difference in performance between genders that needs to be taken into account when analyzing data from the YBT.

• Use caution when making firm conclusions based on the results of a PPT alone. An observed change based on scoring may or may not be meaningful.

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Service Members(Shaffer et al, 2013; n = 64 adults 21-29 years of age)

Athletes(Plisky et al, 2006; n = 235 high school basketball players)

^aSEM Coefficient of Variation (CVME) is the percent of variation from the preseason to the postseason measurement, reflecting the difference between the 2 scores.

(Plisky et al, 2009; n = 15 male collegiate soccer players; mean age 19.7± 0.81)

Service Members(Shaffer et al, 2013; n = 64 adults 21-29 years of age)

Individuals with Chronic Ankle Instability(Hall et al, 2015; n = 39 college-aged individuals with chronic ankle instability)

• MDC = 7.7 for composite, normalized to limb length

Athletes(Chimera et al, 2015; n=190 Division I Collegiate Athletes; mean age = 20±1.5)

• MCID= 3.5%

Athletes(Butler et al, 2013; n = 59 male collegiate American football players; mean age 19.4±1.1 years of age)

• Cut-off score: Composite score of < 89% (100% sensitivity; 71.7% specificity) in collegiate American football players

• Composite scores were calculated by averaging the maximal reach distance for each reach direction after being normalized to limb length.

^aNormalized reach was calculated as reach distance/limb length (anterior superior iliac spine to medial malleolus X 100).

Healthy Adults(Kang et al, 2015; n = 30 adults; mean age 22.57±2.3 years of age)

(Coughlan et al, 2012; n = 20 healthy male participants; mean age 22.05 (3.05)

*The distance that participants reached on the SEBT in the anterior direction was significantly greater than on the YBT (Left: p = 0.0002; Right: p = 0.003). No other differences were found.

(Fullman et al, 2014; n = 29 healthy adults 19-25 years of age)

Athletes(Plisky et al, 2006; n = 235 high school basketball players)

^aSum of the 3 reach distances (anterior, posteromedial, posterolateral) in cm.

^bSum of the 3 reach distances, divided by 3 times limb length, multiplied by 100.

(Plisky et al, 2009; n = 15 male collegiate soccer players; mean age 19.7± 0.81)

*Normalized to limb length expressed as a percentage

(Smith et al, 2014; n = 184 Division I collegiate athletes 18-24 years of age)

* p < 0.05

^aAverage of right and left reach directions, normalized to leg length, and multiplied by 100.

(Chimera et al, 2015; n=190 Division I Collegiate Athletes; mean age = 20±1.5)

^aNormalized to % lower extremity length

Individuals with Chronic Ankle Instability(Hall et al, 2015; n = 39 college-aged individuals with chronic ankle instability)

Athletes(Plisky et al, 2006; n = 235 high school basketball players)

Service Members(Shaffer et al, 2013; n = 64 adults 21-29 years of age)

Healthy Adults(Gribble et al, 2013; n = 29 adults 18-50 years of age; mean age = 31.72)

Athletes(Plisky et al., 2006; n = 235 high school basketball players)

(Plisky et al., 2009; n = 15 male collegiate soccer players; mean age 19.7± 0.81)

Service Members:

(Shaffer et al, 2013; n = 64 adults 21-29 years of age; Service Members)

• 31.3% of the subjects had greater than 4cm differences in anterior limb reach differences suggesting a balance asymmetry and potential for increased risk of injury (p < 0.05).

Athletes:
(Plisky et al, 2006; n = 235 high school basketball players; Athletes)

^aReach distance is reach distance divided by limb length multiplied by 100. Right reach done by standing on left limb and reaching with right limb.

^bDifference between right and left anterior reach distances.

*Adjusted odds ratio for gender, grade, previous injury, and participation in a neuromuscular training program since initial measurement, and lower extremity tape/brace use.

• Players with an anterior reach distance difference of greater than or equal to 4cm were 2.7 times more likely to sustain a LE injury.
• Players with a decreased normalized composite right reach distance (≤ 94% of their limb length) 3 times more likely to sustain a LE injury, with the risk being 6.5 times more likely in girls.

(Smith et al, 2014; n = 184 Division I collegiate athletes 18-24 years of age; Athletes)

^aAverage of right and left reach directions, normalized to leg length, and multiplied by 100.

• Participants with anterior asymmetry greater than or equal to 4cm were at increased risk of injury compared to those without anterior asymmetry. No significant associations between noncontact injury and composite score or asymmetry in the posteromedial or posterolateral directions were found.

(Chimera et al, 2015; n=190 Division I Collegiate Athletes; mean age = 20±1.5; Athletes)

• Injury and surgery history did not influence performance on the YBT.
• The male athletes tested in this study had greater anterior reach asymmetry than the female athletes (t₁₈₈=-1.920; p=0.02).As the result, evaluating sex as a potential confounder may be necessary when testing performance on the YBT.

(Butler et al, 2013; n = 59 male collegiate American football players; mean age 19.4±1.1 years of age; Athletes)

• Using a composite score of <89% as the cut-off point, all athletes who developed a noncontact LE injury were identified, along with 15 athletes who did not get injured (positive likelihood ratio: 3.5, 95% CI, 2.4-5.3).
• In this study’s ROC analysis, reach asymmetry on the YBT and previous injury did not contribute to identifying athletes at risk for an injury during the season.

Healthy Adults:

(Kang et al, 2015; n = 30 adults; mean age 22.57±2.3 years of age; Healthy Adults)

• Linear regression between ankle dorsiflexion on the anterior reach portion of the LQYBT and the inclinometer and tape measurement of the weight bearing lunge test. Inclinometer: r²= 0.55; Tape measurement: r²= 0.40

(Coughlan et al, 2012; n = 20 healthy male participants; mean age 22.053.05; Healthy Adults)

(Fullman et al, 2014; n = 29 healthy adults 19-25 years of age; Healthy Adults)

• Participants reached farther on the anterior reach direction of the SEBT compared with the YBT (p < 0.017).
• No statistically significant relationship between sagittal-plane angular displacement at the hip, knee, and ankle joints and anterior reach distance were found. However, there was a negative correlation (r = –0.06, r²= 0.36, n = 29, P > .01) between hip joint flexion angle and anterior reach distance on the SEBT and a positive correlation (r = 0.43, r²= 18.49, n = 29, P > .01) between hip-joint flexion angle and anterior reach distance of the YBT.

Healthy Adults(Coughlan et al, 2012; n = 20 healthy male participants; mean age 22.05+3.05)

Individuals with Chronic Ankle Instability(Hall et al, 2015; n = 39 college-aged individuals with chronic ankle instability)

*No clinical significance from pre-test to post-test.