Balance and Proprioception: Y-Balance Test

The Y-Balance Test (YBT) is a movement assessment tool used by healthcare professionals to evaluate an individual's dynamic balance, proprioception, and functional movement patterns. It involves performing a series of upper and lower extremity reach tests in three different directions, forming a Y-shape.

Materials needed:

• MAT or MegaMAT

Procedure:

Scoring:

The Y-Balance Test measures the distance in centimetres that an individual can reach in each direction. The test is scored by calculating the average of the three reach distances for each leg and dividing that by the leg length. The score is expressed as a percentage, with higher scores indicating better dynamic balance and neuromuscular control.

Interpretation:

The Y-Balance Test can be used to compare an individual's score to normative data for their age and gender or to monitor progress over time. It can also be used to identify individuals at risk for lower extremity injuries and to design injury prevention or rehabilitation programs.

Here are some examples of normative data for the YBT:

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 remove their shoes and socks.
3. Position the individual in the centre of the circle at one end of the MAT, with one foot on the centre point, with their second toe aligned to the middle intersection. 
4. With one foot raised, ensure the client holds their hands on their hips and maintains a stable position on one leg.
5. Instruct the client to reach with their raised foot as far as possible, three times in each of these directions: anterior, posteromedial and posterolateral.
6. The client should touch the MAT with the tips of their toes without losing their balance or moving their base foot.
7. Ask the individual to return to the starting position and repeat the reach test in the other two directions, forming a Y-shape.
8. After completing all three reach tests, mark the furthest distance reached in each direction on the MAT.
9. Record the results and repeat the same protocol on the opposite leg.

• In a study by Plisky et al. (2009), the mean composite YBT scores for healthy high school and collegiate athletes were as follows:
• Anterior reach: 92.4% of leg length
• Posteromedial reach: 92.9% of leg length
• Posterolateral reach: 94.0% of leg length
• Composite score: 93.1% of leg length
• In a study by Butler et al. (2013), the mean composite YBT scores for healthy adult recreational athletes were as follows:
• Anterior reach: 94.5% of leg length
• Posteromedial reach: 95.5% of leg length
• Posterolateral reach: 96.5% of leg length
• Composite score: 95.5% of leg length
• In a study by Gribble et al. (2012), the mean composite YBT scores for healthy adult non-athletes were as follows:
• Anterior reach: 80.4% of leg length
• Posteromedial reach: 78.2% of leg length
• Posterolateral reach: 83.2% of leg length
• Composite score: 80.6% of leg length

It's important to note that normative data can vary depending on the population being tested, the testing procedures, and the equipment used. Therefore, it's recommended to use normative data that closely matches the population being tested and to interpret the results with caution.

References:

1. Plisky, P. J., Rauh, M. J., Kaminski, T. W., & Underwood, F. B. (2006). The reliability and validity of an anterior reach test of dynamic stability. Journal of Orthopaedic & Sports Physical Therapy, 36(3), 126-136.
2. Plisky, P. J., Gorman, P. P., Butler, R. J., Kiesel, K. B., Underwood, F. B., & Elkins, B. (2009). The reliability of an instrumented device for measuring components of the star excursion balance test. North American Journal of Sports Physical Therapy, 4(2), 92-99.
3. Butler, R. J., Contreras, M., Burton, L. C., Plisky, P. J., Goode, A., & Kiesel, K. B. (2013). Modifiable risk factors predict injuries in firefighters during training academies. Work, 44(3), 289-298.
4. Gribble, P. A., Hertel, J., & Plisky, P. (2012). Using the Star Excursion Balance Test to assess dynamic postural-control deficits and outcomes in lower extremity injury: a literature and systematic review. Journal of athletic training, 47(3), 339-357.
5. Kiesel, K., Plisky, P. J., & Butler, R. J. (2011). Functional movement test scores improve following a standardized off-season intervention program in professional football players. Scandinavian Journal of Medicine & Science in Sports, 21(2), 287-292.