Lower Quarter Y-Balance Test

Last Updated

October 29, 2015

Purpose

The Y Balance Test is a portion of the Functional Movement Systems screen used to evaluate dynamic balance and functional symmetry in order to determine a person's risk for injury or return to sport readiness. This measure was developed from the Star Excursion Balance Test (SEBT) and assesses performance during single-leg balance with reaching in the 3 directions: anterior, posteromedial, and posterolateral. Though the Y Balance Test is often equated to the modified SEBT which tests only the 3 aforementioned directions, the Y Balance Test follows a specific protocol that uses standardized instrumentation and requires an online training certification.

Link to Instrument

Acronym LQYBT

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

Non-Specific Patient Population

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

Y Balance Testing Kit

10-15 minutes

Required Training

Training Course

Adolescent

13 - 17

years

Adult

18 - 64

years

Instrument Reviewers

Dak Adamson, SPT; Avi Bagley, SPT; Adam Dalbo, SPT; Anthony Evans, SPT; Hannah Josephson, SPT; Karla Martin, SPT; Amy Schepers, SPT; Rachel Shepherd, SPT; Taylor Stern, SPT; Lindsay Southam, SPT; Ashton Wedemeyer, SPT; Rachael Zdeb, SPT.

Body Part

Lower Extremity

ICF Domain

Body Function

Measurement Domain

Motor

Professional Association Recommendation

Recommendations for use based on acuity level of the patient: Not Established
Recommendations based on level of care in which the assessment is taken: Not Established
Recommendations based on SCI AIS Classification: Not Established
Recommendations based on EDSS Classification: Not Established
Recommendations for entry-level physical therapy education and use in research:

Further studies needed to address differences in construct and predictive validity of YBT and modified SEBT. 2. Establish the responsiveness of the YBT, including minimal detectable change, minimally clinical important difference, and population specific cut off points

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

The study showed significant reach differences in the anterior reach direction between the YBT and SEBT and claims that clinicians should not use these tests interchangeably.

Considerations

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

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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Standard Error of Measurement (SEM)

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

Type	Direction	YBT Interrater Reliability SEM (cm)
Maximal Reach	Anterior	3.1
	Posteromedial	3.7
	Posterolateral	4.2
	Composite	9
Average Reach of 3 Trials	Anterior	2.0
	Posteromedial	2.7
	Posterolateral	3.5
	Composite	7.0

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

Type	Measurement	Modiefied SEBT Intrarater Reliability SEM (cm)	SEM Coefficient of Variation^a (CVME, %)
Maximal Reach	Anterior	2.0	2.9
	Posteromedial	2.5	2.9
	Posterolateral	2.9	3.4
	Limb Length	0.2	0.2

^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)

Maximal Reach Direction	YBT Intrarater Reliability SEM (cm)
Anterior	2.01
Posteromedial	2.83
Posterolateral	3.11
Composite	5.84

Maximal Reach Direction

Limb

YBT Interrater Reliability SEM (cm)

Left

Right

0.69

0.71

Posteromedial

Left

Right

0.68

0.78

Posterolateral

Left

Right

0.73

0.85

Composite

Left

Right

3.31

2.08

Minimal Detectable Change (MDC)

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

YBT Measurement Type	Direction	MDC (cm)
Maximal Reach	Anterior	8.7
	Posteromedial	10.3
	Posterolateral	11.5
	Composite	24.8
Average Reach of 3 Trials	Anterior	5.5
	Posteromedial	7.5
	Posterolateral	9.7
	Composite	19.5

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

Minimally Clinically Important Difference (MCID)

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

MCID = 3.5%

Cut-Off Scores

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.

Normative Data

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

Type	Direction	Lower Extremity	Absolute Reach (cm) Mean ± SD (95% CI)	Normalized Reach^a (%) Mean ± SD (95% CI)
Maximal Reach	Anterior	Left Right	60.0&苍产蝉辫;±&苍产蝉辫;7.4&苍产蝉辫; 59.8&苍产蝉辫;±&苍产蝉辫;7.1	66.0&苍产蝉辫;±7.8 65.8&苍产蝉辫;±&苍产蝉辫;7.6
	Posteromedial	Left Right	95.7&苍产蝉辫;±&苍产蝉辫;8.3 95.0&苍产蝉辫;±&苍产蝉辫;8.7	105.3&苍产蝉辫;±&苍产蝉辫;8.3 104.6&苍产蝉辫;±&苍产蝉辫;8.9
	Posterolateral	Left Right	91.3&苍产蝉辫;±&苍产蝉辫;8.5 92.1&苍产蝉辫;±&苍产蝉辫;9.4	100.5&苍产蝉辫;±&苍产蝉辫;9.1&苍产蝉辫; 101.4&苍产蝉辫;±&苍产蝉辫;9.6
	Composite	Left Right	246.9&苍产蝉辫;±&苍产蝉辫;21.8 246.8&苍产蝉辫;±&苍产蝉辫;23.0	90.6&苍产蝉辫;±&苍产蝉辫;7.5 90.6&苍产蝉辫;±&苍产蝉辫;7.9
Average Reach of 3 Trials	Anterior	Left Right	57.8&苍产蝉辫;±&苍产蝉辫;6.8 57.6&苍产蝉辫;±&苍产蝉辫;7.1	63.6&苍产蝉辫;±7.2 63.5&苍产蝉辫;±7.7
	Posteromedial	Left Right	93.2&苍产蝉辫;±8.5 92.5&苍产蝉辫;±&苍产蝉辫;9.0	102.7&苍产蝉辫;±8.6 102.0&苍产蝉辫;±9.4
	Posterolateral	Left Right	88.3&苍产蝉辫;±8.5 89.1&苍产蝉辫;±&苍产蝉辫;9.4	97.2&苍产蝉辫;±&苍产蝉辫;9.4 98.2&苍产蝉辫;±&苍产蝉辫;10.0
	Composite	Left Right	239.3&苍产蝉辫;±&苍产蝉辫;21.5 239.4&苍产蝉辫;±&苍产蝉辫;23.5	87.8&苍产蝉辫;±&苍产蝉辫;7.6 87.9&苍产蝉辫;±&苍产蝉辫;8.3

^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)

YBT Normalized Reach Distance (%)	Mean ± SD	95% CI
Anterior	58.58 ± 5.26	57.61 - 61.54
Posteromedial	100.44 ± 7.98	97.46 - 103.42
Posterolateral	98.79 ± 10.00	95.06 - 102.53

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

Normalized Mean Maximal Reach Distances for SEBT and YBT

Direction

Limb

YBT Mean ± SD (%)

SEBT Mean ± SD (%)

Right

Left

64.90 ± 6.96*

64.84 ± 7.47*

69.49 ± 7.14*

69.92 ± 7.29*

Posteromedial

Right

Left

110.48 ± 7.31

110.58 ± 7.56

110.82 ± 7.23

111.51 ± 5.76

Posterolateral

Right

Left

104.79 ± 7.61

103.97 ± 6.42

104.03 ± 6.89

104.00 ± 6.42

Composite

Right

Left

89.74 ± 5.43

90.89 ± 4.91

90.72 ± 5.33

108.98 ± 5.54

*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)

Normalized Reach Distance Results for the YBT and SEBT
Direction	SEBT Mean ± SD (%)	YBT Mean ± SD (%)	P Value
Anterior	67.05 ± 4.97	59.74 ± 4.85	< 0.017
Posteromedial	99.71 ± 8.67	99.53 ± 9.81	> 0.05
Posterolateral	106.14 ± 7.94	102.87± 9.24	> 0.05

Joint Motion	Sagittal-Plane Angular Displacement Anterior Reach (in degrees)
Hip Flexion	28.32 ? 13.19
Knee Flexion	59.59 ? 13.05
Ankle Dorsiflexion	32.6 ? 6.20

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

Modified SEBT Reach Distance	Total Mean ± SD (cm)	Girls Mean ± SD (cm)	Boys Mean ± SD (cm)
Anterior	78.2 ± 8.2	73.1 ± 5.8	82.3&苍产蝉辫;±7.6
Posteromedial	107.0 ± 11.7	98.9 ± 9.3	113.6 ± 8.9
Posterolateral	100.4 ± 12.0	93.0 ± 9.7	106.4± 10.3
Composite^a	285.6 ± 30.0	265.0 ± 22.8	302.2 ± 24.3
Limb Length	94.3 ± 6.1	89.9 ± 3.9	97.9 ± 5.1
Modified SEBT Normalized Reach Distance	Total Mean ± SD (%)	Girls Mean ± SD (%)	Boys Mean ± SD (%)
Anterior	83.9 ± 7.1	81.4 ± 6.2	84.1 ± 7.6
Posteromedial	113.4 ± 9.7	110.1 ± 10.0	116.1 ± 8.5
Posterolateral	106.4 ± 10.8	103.6 ± 10.7	108.7 ± 10.3
Composite^b	100.9 ± 8.4	98.4 ± 8.2	103.0 ± 8.0

^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)

	Direction	Non-normalized Mean ± SD (cm)	Normalized* Mean ± SD (%)
Rater 1	Anterior	71.5 ± 6.9	76.7&苍产蝉辫;±4.4
	Posteromedial	114.0 ± 7.1	122.5 ± 4.3
	Posterolateral	110.2 ± 7.2	118.5&苍产蝉辫;±5.0
	Composite	295.1 ± 19.8	105.7 ± 3.4
Rater 2	Anterior	71.7 ± 7.1	76.9 ± 4.4
	Posteromedial	114.0 ± 7.1	122.5&苍产蝉辫;±4.3
	Posterolateral	110.3 ± 7.2	118.5 ± 4.9
	Composite	296.7 ± 20.3	106.2 ± 3.8
Repeated Measurement	Anterior	72.9 ± 5.8	78.3 ± 3.9
	Posteromedial	114.9 ± 7.3	123.5 ± 5.0
	Posterolateral	112.3 ± 6.5	120.8 ± 5.3
	Composite^b	300.1 ± 17.7	107.5 ± 3.5

*Normalized to limb length expressed as a percentage

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

Demographic Data and YBT Anterior, Posteromedial, and Posterolateral Reach Asymmetry and Composite Scores for Injured and Uninjured Athletes
Variable	Injured (n = 81) Mean ± SD	Uninjured (n = 103) Mean ± SD
Age (yr)	20.6 ± 1.6	20.0 ± 1.4*
Height (cm)	174.0 ± 0.1	180.3 ± 0.1*
Weight (kg)	73.6 ± 19.6	85.3 ± 20.8*
Anterior Asymmetry (cm)	3.6 ± 3.9	3.2 ± 3.3
Posteromedial Asymmetry (cm)	3.9 ± 3.5	3.1&苍产蝉辫;±2.7
Posterolateral Asymmetry (cm)	3.5 ± 2.7	3.7 ± 2.8
Composite Score^a (%)	101.3 ± 7.8	101.2 ± 7.1

* 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)

YBT Composite Scores^a Classified by Sport and Sex
	Women		Men
Sport	No.	Mean ± SD	No.	Mean ± SD
Basketball	2	98 ± 0	9	98 ± 6
Cheer and Dance	4	97 ± 8	N/A	N/A
Cross Country	17	99 ± 5	13	101 ± 12
Football	N/A	N/A	69	102 ± 7
Golf	3	97 ± 3	N/A	N/A
Soccer	28	102 ± 6	N/A	N/A
Swimming and Diving	17	102 ± 7	N/A	N/A
Tennis	5	99 ± 6	5	107 ± 5
Track and Field	3	92 ± 14	7	106 ± 6
Volleyball	8	99 ± 8	N/A	N/A
Total	87		103

^aNormalized to % lower extremity length

YBT Performance Classified by Injury History
Composite Score (Mean ± SD, cm, 95% CI)
	Ankle	Knee	Hip	Trunk
Previous Injury	101 ± 8	101 ± 7	100 ± 10	102 ± 10
No Previous Injury	101 ± 8	101 ± 8	101 ± 8	101 ± 7
P Value	0.68	0.49	0.53	0.37
t Value	0.416	0.695	-0.635	0.902
Anterior Reach Asymmetry (Mean ± SD, cm, 95% CI)
	Ankle	Knee	Hip	Trunk
Previous Injury	4.5&苍产蝉辫;±8.9	5.1 ± 11.6	3.1 ± 2.3	6.3 ± 14.3
No Previous Injury	4.2 ± 8.5	4.0 ± 6.9	4.5 ± 9.1	3.9 ± 6.9
P Value	0.78	0.40	0.51	0.34
t Value	0.274	0.841	-0.616	0.976
Posteromedial Reach Asymmetry (Mean ± SD, cm, 95% CI)
	Ankle	Knee	Hip	Trunk
Previous Injury	4.4 ± 9.6	3.1 ± 2.6	4.3 ± 2.9	5.8 ± 15.6
No Previous Injury	3.5 ± 3.2	4.4 ± 8.7	3.9 ± 7.6	3.5 ± 3.2
P Value	0.39	0.24	0.83	0.40
t Value	0.857	-1.171	0.211	0.864
Posterolateral Reach Asymmetry (Mean ± SD, cm, 95% CI)
	Ankle	Knee	Hip	Trunk
Previous Injury	3.6 ± 2.8	3.9 ± 3.1	3.9 ± 3.9	3.5 ± 2.7
No Previous Injury	3.7 ± 2.7	3.5 ± 2.6	3.6 ± 2.6	3.7 ± 2.8
P Value	0.91	0.4	0.78	0.74
t Value	-0.116	0.851	0.290	-0.335

YBT Performance Classified by Surgery History
Composite Score (Mean ± SD, cm, 95% CI)
	Ankle	Knee	Hip
Previous Injury	96 ± 4	100 ± 8	95 ± 3
No Previous Injury	101 ± 8	101 ± 8	101 ± 1
P Value	0.20	0.56	0.20
t Value	-1.286	-0.586	-1.285
Anterior Reach Asymmetry (Mean ± SD, cm, 95% CI)
	Ankle	Knee	Hip
Previous Injury	2.1 ± 1.4	6.7 ± 15.8	2.5 ± 3.5
No Previous Injury	4.4 ± 8.8	4.3 ± 7.4	4.4 ± 8.8
P Value	0.61	0.44	0.71
t Value	-0.512	0.790	-0.368
Posteromedial Reach Asymmetry (Mean ± SD, cm, 95% CI)
	Ankle	Knee	Hip
Previous Injury	1.6 ± 0.5	3.2 ± 2.6	3.0 ± 1.3
No Previous Injury	4.0 ± 7.3	4.1 ± 7.7	4.0 ± 7.3
P Value	0.52	0.61	0.82
t Value	-0.648	-0.517	-0.230
Posterolateral Reach Asymmetry (Mean ± SD, cm, 95% CI)
	Ankle	Knee	Hip
Previous Injury	2.4 ± 1.9	3.1 ± 3.0	2.8 ± 1.8
No Previous Injury	3.4 ± 2.8	3.7 ± 2.7	3.7 ± 2.8
P Value	0.36	0.34	0.61
t Value	-0.925	-0.952	-0.509

YBT Performance Classified by Sex

Women

Men

P Value

Composite Score

(Mean ± SD, cm, 95% CI)

100 ± 6

102 ± 8

0.052

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

ntervention Group	YBT Pre-Test Normalized Composite Score (%)	YBT Post-Test Normalized Composite Score (%)
Resistance Band	97.4 ± 7.2	102.0 ± 7.2
PNF	96.9 ± 7.0	101.5 ± 7.2
Control	99.6 ± 7.7	99.9 ± 4.6

Test/Retest Reliability

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

Measurement Type	Modified SEBT Test- Retest Reliability (ICC, 95% CI)
Maximal Reach (n = 40)	Excellent (0.89-0.93)

Interrater/Intrarater Reliability

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

Measurement Type	YBT Interrater Reliability (ICC, 95% CI)
Maximal Reach	Excellent (0.80-0.85)
Average Reach of 3 Trials	Excellent (0.85-0.93)

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

Measurement Type	Modified SEBT Interrater Reliability (ICC, 95% CI)
Maximal Reach	Excellent (0.86-0.94)
Average Reach of 3 Trials	Excellent (0.88-0.92)
Limb Length	Excellent (0.92)

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

Measurement Type	Modified SEBT Intrarater Reliability (ICC, 95% CI)
Maximal Reach	Excellent (0.82-0.87)
Limb Length	Excellent (0.92)

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

Measurement Type	YBT Intrarater Reliability (ICC, 95% CI)	YBT Interrater Reliability (ICC, 95% CI)
Maximal Reach	Excellent (0.85-0.89)	Excellent (0.97-1.0)

Criterion Validity (Predictive/Concurrent)

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)

Adjusted Odds Ratios for Potential Lower Extremity Injury Risk Factors Among High School Basketball Players From Performance on the Modified SEBT
Population	Risk Factor	Category	LE Injury Adjusted Odds Ratio* (95% CI)
All Players	Normalized Composite Right Reach Distance^a	≤ 94%	3.0 (1.5, 6.1)
	Anterior Reach Distance Difference^b	≥ 4cm	2.7 (1.4, 5.3)
Girls	Normalized Composite Right Reach Distance^a	≤ 94%	6.5 (2.4, 17.5)
Boys	Anterior Reach Distance Difference^b	≥ 4cm	3.0 (1.1, 7.7)

^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)

Association between Composite Scores and Asymmetry and Injury in Collegiate Athletes During Competitive Season
YBT Variable	Odds Ratio, 95% CI	P Value
Anterior Asymmetry (≥4cm)	2.20	0.03
Posteromedial Asymmetry (≥ 4cm)	1.15	0.69
Posterolateral Asymmetry (≥ 4cm)	0.57	0.11
Composite Score^a (%)	1.00	0.69

^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)

YBT Cut-off Point and Noncontract LE Injury Occurrence
Composite Reach Cut-Off Score	Noncontact LE Injury Present (+)	Noncontact LE Injury Absent (-)
(+) YBT (<89%)	6 (true positive)	15 (false positive)
(-) YBT (≥89%)	0 (false negative)	38 (true negative)

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.

Construct Validity

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)

SEBT and YBT Paired-Samples Correlations (n=20)
Direction	Limb	Correlation	P Value
Anterior	Right Left	0.638 0.781	0.002 0.000
Posteromedial	Right Left	0.781 0.572	0.000 0.008
Posterolateral	Right Left	0.651 0.624	0.002 0.003

(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.

Responsiveness

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

SEBT and YBT Effect Size
Reach Direction	Right Leg	Left Leg
Anterior	Moderate, 0.76	Strong, 1.04
Posteromedial	Weak, 0.07	Weak, 0.15
Posterolateral	Weak, -0.13	Weak, 0.00
Composite	Moderate, 0.3	Strong, 2.55

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

Intervention Group	YBT Effect Size (95% CI)*
Resistance Band	Moderate, 0.6 (-0.2, 1.4)
PNF	Moderate, 0.6 (-0.2, 1.4)
Control	Weak, 0.1 (-0.7, 0.8)

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

Bibliography

Shaffer S.W., Teyhen D.S., et al. (2013). “Y-Balance Test: A Reliability Study Involving Multiple Raters.” Military Med 178(11): 1264-1270.

Gribble P.A., Kelly S.E., et al. (2013). “Interrater Reliability of the Star Excursion Balance Test.” J Athl Train 48(5): 621-626

Kang M-H., Lee D-K., et al. (2015). “Association of Ankle Kinematics and Performance on the Y-Balance Test With Inclinometer Measurements on the Weight-Bearing-Lunge Test.” J Sport Rehab 24: 62-67.

Plisky P.J., Rauh M. J., et al. (2006). “Star Excursion Balance Test as a Predictor of Lower Extremity Injury in High School Basketball Players.” J Orthop Sports Phys Ther 36(12): 911-919.

Plisky P.J., Gorman P. P., et al. (2009). “The Reliability of an Instrument Device for Measuring Components of the Star Excursion Balance Test.” N Am J Sports Phys Ther 4(2): 92-99.

Coughlan G.F., Fullam K., et al. (2012). “A Comparison Between Performance on Selected Directions of the Star Excursion Balance Test and Y Balance Test.” J Athl Train 47(4): 366-371.

Smith C.A., Chimera N.J., et al. (2014). “Association of Y Balance Test Reach Asymmetry and Injury in Division I Athletes. Med Sci Sports Exerc 47(1): 136-141.

Hall E.A., Docherty C.L., et al. (2015). “Strength-Training Protocols to Improve Deficits in Participants with Chronic Ankle Instability: A Randomized Controlled Trial. J Athl Train 50(1): 36-44.

Chimera N.J., Smith C.A., & Warren M. (2015). “Injury History, Sex, and Performance on the Functional Movement Screen and Y Balance Test.” J Athl Train 50(5): 475-485.

Fullman K., Caulfied B, et al. (2014). “Kinematic Analysis of Selected Reach Directions of the Star Excursion Balance Test Compared with the Y Balance Test.” J Sports Rehab 23: 27-35.

Butler R.J., Lehr M.E., et al. (2013). “Dynamic Balance Performance and Noncontact Lowe Extremity Injury in College Football Players: An Initial Study.” Sports Health 5(5): 417-422.

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