p The Y Balance Test

Transcription

1 The Y Balance Test

2 Star Excursion Balance Test First described by Gary Gray 1995 Requires measurement in 8 directions (each leg) 6 practice trials in each direction 3 measurements 144 reaches to test one

3 Measurement Error Touch down? (support?) How far off the ground? (1 inch 6 inches?) Capture movement instantaneously? (marking error?)

4 Which Direction Matters? Hertel et al PosterolateralPosteromedial JOSPT 2006 Plisky et al JOSPT 2006 Anterior

5 A Solution? Quick/Efficient Portable Consistent Objective Multiple Surface Applications

6 Anterior Reach Quad dominant activity Management of center of mass in forward direction Single limb stance

7 Posteromedial Reach Hamstring dominant activity Management of center of mass in right to left diagonal

8 Posterolateral Reach Hamstring dominant activity Management of center of mass in left to right diagonal

9 Practicality Pre-participation Physicals Injury Prevention Screens Pre/Post Measures for Functional Rehabilitation Multi-sport Application Return to Sport Testing

10 Application Greater than 4 cm right/left difference in anterior direction > 2.5 times more likely to be injured Decreased overall performance (lowest 1/3 of individual scores) on test (total of all three directions) Women over 6 times more likely to be

11 Return to Sport Testing Greater than 4 cm right/left difference in anterior direction Identifies Chronic Ankle Instability Can be used to demonstrate functional symmetry

12 Reliability of The Y Plisky et al 2007 (In Review) Balance Test Intertester ALL directions Excellent 0.99, p 0.01

13 Reliability of The Y Balance Test Intratester Good Anterior direction 0.91, p 0.01 Posterormedial direction 0.86, p 0.01 Posterolateral direction 0.90, p 0.01 Plisky et al

14 Identifies Chronic Ankle Instability Gribble 2004 (SEBT) Fatigue amplified side to side difference Altered neuromuscular control at knee at hip Olmstead 2002 (SEBT) cm side to side difference

15 Identifies Chronic Ankle Instability Hubbard 2007 (SEBT) Anterior, posteromedial, & posterolateral reach distance predicted CAI Hertel 2006 (SEBT) 2-4% side to side difference

16 Identifies Athletes at ncreased Risk of LE Injury 4cm right/left anterior reach difference Bottom 1/3 of peers Athletes with previous injury WERE included in analysis

17 Improves After Training Chaiwanichsiri 2005 SLST improved after SEBT training Hale 2007 English 2007 Improves after Pilates exercise program

18 References Chaiwanichsiri D., Lorprayoon E., Noomanoch L. Star excursion balance training: effects on ankle functional stability after ankle sprain. J Med Assoc Thai. Sep 2005;88 Suppl 4:S Cote K. P., Brunet M. E., Gansneder B. M., Shultz S. J. Effects of Pronated and Supinated Foot Postures on Static and Dynamic Postural Stability. J Athl Train. Mar 2005;40(1): Earl JE, Hertel J. Lower-extremity muscle activation during the Star Excursion Balance Tests. J Sport Rehabil. 2001;10:

19 References English T., Howe K. The effect of Pilates exercise on trunk and postural stability and throwing velocity in college baseball pitchers: single subject design. NAJSPT. 2007;2(1):8-19. Gribble P. A., Hertel J., Denegar C. R., Buckley W. E. The Effects of Fatigue and Chronic Ankle Instability on Dynamic Postural Control. J Athl Train. Dec 2004;39(4): Gray G. Lower Extremity Functional Profile. Adrian, Mi: Wynn Marketing Inc.; 1995.

20 References Gribble PA, Hertel J. Considerations for normalizing measures of the Star Excursion Balance Test. Measurement in Physical Education and Exercise Science. 2003;7(2): Hale SA, Hertel J, Olmsted-Kramer LC. The effect of a 4- week comprehensive rehabilitation program on postural control and lower extremity function in individuals with chronic ankle instability. J Orthop Sports Phys Ther. 2007;37(6): Hertel J, Braham RA, Hale SA, Olmsted LC. Simplifying the Star Excursion Balance Test: analyses of subjects with and without ankle instability. J Orthop Sports Phys Ther. 2006;36:

21 References Hertel J, Miller SJ, Denegar CR. Intratester and intertester reliability during the Star Excursion Balance Tests. J Sport Rehabil. 2000;9: Hubbard T. J., Kramer L. C., Denegar C. R., Hertel J. Contributing factors to chronic ankle instability. Foot Ankle Int. Mar 2007;28(3): Kinzey SJ, Armstrong CW. The reliability of the starexcursion test in assessing dynamic balance. J Orthop Sports Phys Ther. 1998;27(5):

22 References Lanning C. L., Uhl T. L., Ingram C. L., Mattacola C. G., English T., Newsom S. Baseline values of trunk endurance and hip strength in collegiate athletes. J Athl Train. Oct-Nov 2006;41(4): Olmsted LC, Carcia CR, Hertel J, Shultz S. Efficacy of the Star Excursion Balance Tests in detecting reach deficits in subjects with chronic ankle instability. J Athl Train. 2002;37(4): Plisky PJ, Rauh MJ, Kaminski TW, Underwood FB. Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players. J Orthop Sports Phys Ther. 2006;36(12):