Y Balance Test

Star Excursion & Y Balance Test in Older Adults

Osteoporosis and Star Excursion Balance Test?

In order to stimulate bone growth, bone and joint loads during exercise need to exceed the osteogenic threshold. This study found that several activities did just that:

woman walking

“In the order of increasing bone load at the hip, and hence increasing bone growth stimulation, are the following: demi plié, star excursion balance test with maximum reach criterion, grande plié and star excursion balance test with maximum speed criterion.”

TAKE HOME: I would not necessarily use the Star Excursion Balance Test as a training exercise if I were also using it as a test for an individual (it is usually not a good idea to practice the same test over and over and assume you have improved). However, this study emphasizes the importance of using body weight testing and training particularly with our older adults. This also puts us one step closer to my life crusade of everyone receiving an annual musculoskeletal exam including movement and balance testing.

Shippen JM. The generation of loads in excess of the osteogenic threshold by physical movement. Proc Inst Mech Eng H. 2013 [Epub ahead of print]

Asymmetry in Star Excursion Balance Test Related to Asymmetry in Other Movements

Overmoyer GV, Reiser RF. Relationships between asymmetries in functional movements and the star excursion balance test. J Strength Cond Res. 2013 Jul;27(7):2013-24.

Balance Test - Post-Lat

“Correlations between reach directions in the SEBT improved in the subset comparisons but would not be considered strong. The results suggest that asymmetries are more likely to be expressed in multiple tasks as the bilateral difference increases, that intensity of effort plays a key role in the expression of asymmetries during bilateral tasks, tasks most relevant to the sport should be used when assessing athletes, and though not replacing functional tasks, the SEBT may serve an important role in the diagnosis of LEFA.”

TAKE HOME: While asymmetry in fundamental movements (squat and Star Excursion Balance Test-the reach directions of the Y Balance Test) has some relationship to asymmetry in higher load activities (counter-movement jump and single-leg drop landing), this is not always the case. Just because someone is symmetrical with higher level activities, it does not mean that they do not have underlying fundamental movement asymmetry related to risk of injury. Be sure to consider this in your pre-season and return to sport testing.

Y Balance Test Injury Prediction

Plisky PJ, Rauh MJ, Kaminski TW, Underwood, FB. Star Excursion Balance Test predicts lower extremity injury in high school basketball players. J Orthop Sports Phys Ther. 2006;36(12):911-9

  • “players with an anterior right/left reach distance difference greater than 4 cm were 2.5 times more likely to sustain a lower extremity injury (P<.05). Girls with a composite reach distance less than 94.0% of their limb length were 6.5 times more likely to have a lower extremity injury (P<.05).”
  • TAKE HOME MESSAGE: This was the first study demonstrating the Star Excursion Balance Test’s predictive ability. If you athletes have an asymmetry or low composite score, they may be at great risk of injury. Thus, one should consider using the SEBT for return to sport testing and in the pre-participation physical.

Why are there Age, Gender, Sport/Activity specific norms and risk cut points for the Y Balance Test?

I spend a lot of time discussing that the Functional Movement Screen (FMS) and Selective Functional Movement Assessment (SFMA) are not intended to be sport specific or even “Functional” measures. The FMS and SFMA are used to determine if a person has the underlying movement competency to serve as the foundation for his or her activity.
So why are there age, gender, and sport/activity specific norms and risk cut points for the Y Balance Test? Isn’t that a contradiction?

When it comes to higher level testing (such as dynamic balance), there can be an activity specific balance adaptation that occurs. To see how this plays out as different norms and injury risk cut points, check out this short video

Star Excursion & Y Balance Test Lower Quarter Systematic Review

Gribble PA, Hertel J, Plisky PJ. Using the Star Excursion Balance Test to Assess Dynamic Postural Control Deficits and Outcomes in Lower Extremity Injury – A Literature and Systematic Review. J Athl Train. 2012;47(3):339-57.

  • “The Star Excursion Balance Test is a reliable measure and a valid dynamic test to predict risk of lower extremity injury, to identify dynamic balance deficits in patients with lower extremity conditions, and to be responsive to training programs in healthy participants and those with lower extremity conditions.”
  • TAKE HOME MESSAGE: The Star Excursion & Y Balance Test should be used for return to sport testing, pre-participation physicals, and annual musculoskeletal exams.

Y Balance Test Reliability

Plisky PJ, Gorman P, Kiesel K, Butler R, Underwood F, Elkins B. The reliability of an instrumented device for measuring components of the Star Excursion Balance Test. NAJSPT. 2009;4(2):92-99.

  • “The Y Balance Test™ is a reliable test for measuring single limb stance excursion distances while performing dynamic balance testing in collegiate soccer players.”
  • TAKE HOME MESSAGE: If you follow the Y Balance Test Protocol, you can be confident of your results compared to another trained tester as well as consistent results over time. FULL FREE TEXT

Discriminant Validity

Butler RJ, SouthersC, Gorman PP, Kiesel KB, Plisky PJ.  Differences in Soccer Players’ Dynamic Balance Across Levels of Competition. Journal of Athletic Training. 2012;47(6):616-620.

  • “Dynamic balance performance varied with competition level. This may indicate that athletes’ movement strategies may be different depending on the competition level and that normative values may need to be established for each competition level”
  • TAKE HOME MESSAGE: Be sure to use the age, gender, and sport specific risk cut points

 

Gorman PP, Butler RJ, Rauh MJ, Kiesel K, Plisky PJ. Differences in dynamic balance scores in one sport versus multiple sport high school athletes. Int J Sports Phys Ther. 2012 Apr;7(2):148-53.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3325637/pdf/ijspt-07-148.pdf

“Male athletes exhibited significantly greater normalized reach values for the posteromedial, posterolateral, and composite reach while also exhibiting a larger anterior reach difference when compared to the females. Athletes who participated in multiple sports had similar performances on the YBT-LQ when compared to athletes who participated in a single sport.”

Take Home: There is no need to take into account the factor of multiple sport participation when developing return to sport standards for dynamic balance in high school athletes. FULL FREE TAKE

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Phil Plisky

I want to change peoples lives through dialogue about injury prevention research and return to activity testing.

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