Interrater and Test-Retest Reliability of the Y Balance Test in Healthy, Early Adolescent Female Athletes

Abstract

Background: Adolescence is the stage of development marked by peak rates of skeletal growth resulting in impaired dynamic postural control and increased injury risk, especially in female athletes. Reliable tests of dynamic postural control are needed to help identify athletes with balance deficits and assess changes in limb function after injury. Purpose: To estimate the interrater and test-retest (intrarater) reliability of the Y-Balance Test in a group of early adolescent females over a one-month period when administered by novice raters. Methods: Twenty-five early adolescent females (mean age 12.7 ± 0.6 years) participated. Two physical therapy student raters, randomly selected from a pool of five, simultaneously assessed each subject's performance on the Y-Balance Test and were blinded to each other's results. Twenty-one subjects returned for a second session (mean 32.3± 9.6 days) and were assessed by the same two raters, blinded to previous measurements. Maximum and normalized reach distances and composite scores of the right and left limbs were collected. Intraclass correlation coefficients (ICC) were calculated for between rater and between session agreement. Measurement error and minimal detectable change values were calculated for clinical interpretation. Results: Interrater reliability was excellent for all reach directions and composite scores of the right limb (ICC 0.973-0.998) and left limb (ICC 0.960-0.999) except for the day 1 left anterior reach which was good (ICC 0.811). Test-retest reliability were moderate to excellent for the right limb (ICC 0.681-0.908) and moderate to good for left limb (ICC 0.714-0.811). Minimal detectable change values for the right and left limbs ranged between 2.02-3.62% and 2.77-3.63%, respectively. Conclusions: The Y-Balance Test is a reliable tool to assess dynamic balance in early adolescent females and may be utilized in a clinical setting to monitor function over a one-month time interval. Between rater differences were mainly attributed to disparities in subjective test requirements and not quantitative measures of reach distance.

Comparison of the Effect of Resistance and Balance Training on Isokinetic Eversion Strength, Dynamic Balance, Hop Test, and Ankle Score in Ankle Sprain

“…The star excursion balance test measures balance in eight directions, whereas the YBT measures it in three directions and has the advantage of being a simple exercise [ 45 ]. Several studies have reported that YBT is useful for measuring dynamic balance and exercise function, not only for athletes but also for elderly individuals, with high validity and reliability [ 46 , 47 ]. When both sides are examined, if there is a difference of over 4 cm in the results, the test is considered abnormal.…”

Systematic Review and Meta-Analysis of the Y-Balance Test Lower Quarter: Reliability, Discriminant Validity, and Predictive Validity

“…Full text eligibility assessment of the remaining 411 articles resulted in 57 articles with 4 in multiple categories (Figure 1). 3,9,[12][13][14] Nine studies 9,25,33,40,46,[51][52][53][54] assessed reliability, 36 studies [12][13][14][23][24][25][26][27][28][29][30]32,35,37,38,[41][42][43][44][45]47,49,[54][55][56][57][58][59][60][61][62][63][64][65][66][67] examined differences in the performance on the YBT-LQ in different populations or reported mean performance on the YBT-LQ in a specific population, and 16 studies 3,3...…”

“…Nine studies 9,25,33,40,46,[51][52][53][54] assessed reliability of YBT-LQ (see Table 1). Intraclass correlation coefficients (ICCs) for intrarater reliability ranged from 0.57-0.82 in adolescent populations, 40 and 0.85-0.91 in adult populations.…”

“…9 Interrater reliability ICCs ranged from 0.81-1.00. 9,33,46,51 2). 12-14,24-30,32,37,38,42-44,55-57,59-66 However, there were significant differences based on sex, competition level, and sport throughout Figure 2.…”

Limb Dominance Does Not Affect Y-Balance Test Performance in Non-Athlete Adolescents

“…For adult populations, the YBT-LQ was found to have good-to-excellent inter-rater reliability (ICC 2,1 = 0.80 -1.00) and intra-rater reliability (ICC 3,1 = 0.85-0.91). 11, 26 For adolescents, the within-day inter-rater reliability was reported to be excellent (ICC 2,1 = 0.96 -0.99), 27 whereas the within-day and between-day intra-rater reliability was found only to be fairto-good (ICC 3,1 = 0.57-0.91). [27][28][29] Lastly, for pre-adolescent children, both the within-day (ICC 2,1 > 0.995) and betweenday (ICC 2,1 = 0.91-0.97) inter-rater reliability were excellent.…”