In athletes with chronic ankle instability, 2 studies report that fatigue decreases the reach distance on both sides(Gribble 2004, Gribble 2007). However, the unstable side is affected to a greater degree. So, performing a fatigue protocol prior to testing for return to sport might be a good idea. It will amplify those remaining neuromuscular control deficits. But remember, it will also decrease the composite score as well, so the results might not be as comparable to the age, gender, and sport specific injury risk cut points. But, I wouldn’t want anyone’s composite score so close to the risk cut point that fatigue tips them over the edge. Another
You should also consider fatigue with pre-participation physicals. Many places use the Y Balance Test not only for risk identification, but also as a baseline measure for return to sport after musculoskeletal injury or concussion. So if the athletes have a heavy workout prior to testing, their scores may be a little lower. I think that may be important to note, but would not cause me to postpone testing.
What do you think?
What research is there to support using the Upper Quarter Y Balance Test for return to sport testing?
Just like other return to sport tests, there is very little in the literature (really nothing). As far as the Upper Quarter Y Balance Test, there are 2 research studies (Gorman et al 2012, Westrick et al 2012). Both studies found the Y Balance Test – Upper Quarter to be reliable. In addition, both studies found there was no difference in YBT-UQ performance between dominant and non-dominant limbs. This indicates that YBT-UQ performance may serve as a good measure in return to sport testing when rehabilitating shoulder and arm injuries. Westrick et al state:
“Similarity on the UQYBT between dominant and non-dominant limbs indicates that performance on this test using a noninjured UE may serve as a reasonable measure for “normal” when testing an injured UE.”
We are also finding right/left symmetry on the YBT-UQ in professional and collegiate baseball players (including pitchers). So, I think if overhead athletes and healthy adults demonstrate symmetry on the YBT-UQ, that patients should demonstrate symmetry before return to sport/activity (or at least before discharge).
Other tests to consider are the Closed Kinetic Chain Upper Extremity Stability Test and the One Armed Hop test. But remember, these measure power (versus dynamic control near limit of stability) in a very limited dynamic range compared to the Y Balance Test. The YBT-UQ uniquely requires stability at the person’s limit of stability in a one-arm push up position unlike planks, side bridges, trunk flexor/extensor endurance tests and the CKCUEST. Westrick et al report:
“There was a significant fair to moderate association between performance on the UQYBT and the CKCUEST, LTET, and push-ups. These results suggest the tests are interrelated but do not necessarily assess equal components of UE CKC ability.”