Reliability and Validity of the Y-balance Test in Young Adults with Chronic Low Back Pain

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Abstract

Background

Individuals with chronic low back pain (CLBP) may demonstrate reduced ability to perform dynamic tasks due to fear of additional pain and injury in response to the movement. The Y-balance test (YBT) is a functional and inexpensive test used with various populations. However, the reliability and validity of the YBT used for assessing dynamic balance in young adults with CLBP have not yet been examined.

Purpose

To determine the inter-rater reliability of the YBT and to compare dynamic balance between young adults with CLBP and an asymptomatic group.

Study Design

Reliability and validity study.

Methods

Fifteen individuals with CLBP (≥ 12 weeks) and 15 age- and gender-matched asymptomatic adults completed the study. Each group consisted of 6 males and 9 females who were 21-38 years of age (27.47 ± 5.0 years). The YBT was used to measure participant’s dynamic balance in the anterior (ANT), posteromedial (PM) and posterolateral (PL) reach directions. The scores for each participant were independently determined and recorded to the nearest centimeter by two raters. Both the YBT reach distances and composite scores were collected from the dominant leg of asymptomatic individuals and the involved side of participants with CLBP and were used for statistical analysis.

Results

The YBT demonstrated excellent inter-rater reliability, with intraclass correlation coefficients ranging from 0.99 to 1.0 for the YBT scores of both asymptomatic and CLBP groups. The CLBP group had lower scores than those of the asymptomatic group in the reach distances of the ANT ( p = 0.023), PM ( p < 0.001), and PL ( p = 0.001) directions, and the composite scores ( p < 0.001).

Conclusions

The results demonstrated excellent inter-rater reliability and validity of the YBT for assessing dynamic balance in the CLBP population. The YBT may be a useful tool for clinicians to assess dynamic balance deficits in patients with CLBP.

Level of Evidence

2b.

Related collections

Most cited references 29

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Effect size estimates: current use, calculations, and interpretation.

Catherine O Fritz, Peter Morris, Jennifer J. Richler (2012)

The Publication Manual of the American Psychological Association (American Psychological Association, 2001, American Psychological Association, 2010) calls for the reporting of effect sizes and their confidence intervals. Estimates of effect size are useful for determining the practical or theoretical importance of an effect, the relative contributions of factors, and the power of an analysis. We surveyed articles published in 2009 and 2010 in the Journal of Experimental Psychology: General, noting the statistical analyses reported and the associated reporting of effect size estimates. Effect sizes were reported for fewer than half of the analyses; no article reported a confidence interval for an effect size. The most often reported analysis was analysis of variance, and almost half of these reports were not accompanied by effect sizes. Partial η2 was the most commonly reported effect size estimate for analysis of variance. For t tests, 2/3 of the articles did not report an associated effect size estimate; Cohen's d was the most often reported. We provide a straightforward guide to understanding, selecting, calculating, and interpreting effect sizes for many types of data and to methods for calculating effect size confidence intervals and power analysis.

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Responsiveness of the numeric pain rating scale in patients with low back pain.

John Childs, Sara Piva, Julie M Fritz (2005)

Cohort study of patients with low back pain (LBP) receiving physical therapy. To examine the responsiveness characteristics of the numerical pain rating scale (NPRS) in patients with LBP using a variety of methods. Although several studies have assessed the reliability and validity of the NPRS, few studies have characterized its responsiveness in patients with LBP. Determination of change on the NPRS during 1 and 4 weeks was examined by calculating mean change, standardized effect size, Guyatt Responsiveness Index, area under a receiver operating characteristic curve, minimum clinically important difference, and minimum detectable change. Change in the NPRS from baseline to the 1 and 4-week follow-up was compared to the average of the patient and therapist's perceived improvement using the 15-point Global Rating of Change scale. The majority of patients had clinically meaningful improvement after both 1 and 4 weeks of rehabilitation. The standard error of measure was equal to 1.02, corresponding to a minimum detectable change of 2 points. The area under the curve at the 1 and 4-week follow-up was 0.72 (0.62, 0.81) and 0.92 (0.86, 0.97), respectively. The minimum clinically important difference at the 1 and 4-week follow-up corresponded to a change of 2.2 and 1.5 points, respectively. Clinicians can be confident that a 2-point change on the NPRS represents clinically meaningful change that exceeds the bounds of measurement error.

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Using the Star Excursion Balance Test to assess dynamic postural-control deficits and outcomes in lower extremity injury: a literature and systematic review.

Phillip A Gribble, Jay Hertel, Phil Plisky (2016)

A dynamic postural-control task that has gained notoriety in the clinical and research settings is the Star Excursion Balance Test (SEBT). Researchers have suggested that, with appropriate instruction and practice by the individual and normalization of the reaching distances, the SEBT can be used to provide objective measures to differentiate deficits and improvements in dynamic postural-control related to lower extremity injury and induced fatigue, and it has the potential to predict lower extremity injury. However, no one has reviewed this body of literature to determine the usefulness of the SEBT in clinical applications. To provide a narrative review of the SEBT and its implementation and the known contributions to task performance and to systematically review the associated literature to address the SEBT's usefulness as a clinical tool for the quantification of dynamic postural-control deficits from lower extremity impairment. Databases used to locate peer-reviewed articles published from 1980 and 2010 included Derwent Innovations Index, BIOSIS Previews, Journal Citation Reports, and MEDLINE. The criteria for article selection were (1) The study was original research. (2) The study was written in English. (3) The SEBT was used as a measurement tool. Specific data extracted from the articles included the ability of the SEBT to differentiate pathologic conditions of the lower extremity, the effects of external influences and interventions, and outcomes from exercise intervention and to predict lower extremity injury. More than a decade of research findings has established a comprehensive portfolio of validity for the SEBT, and it should be considered a highly representative, noninstrumented dynamic balance test for physically active individuals. The SEBT has been shown to be a reliable measure and has validity as a dynamic test to predict risk of lower extremity injury, to identify dynamic balance deficits in patients with a variety of lower extremity conditions, and to be responsive to training programs in both healthy people and people with injuries to the lower extremity. Clinicians and researchers should be confident in employing the SEBT as a lower extremity functional test.

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Author and article information

Journal

Journal ID (nlm-ta): Int J Sports Phys Ther

Journal ID (iso-abbrev): Int J Sports Phys Ther

Journal ID (publisher-id): 2159

Title: International Journal of Sports Physical Therapy

Publisher: NASMI

ISSN (Electronic): 2159-2896

Publication date (Electronic, pub): 1 June 2021

Publication date (Electronic, collection): 2021

Volume: 16

Issue: 3

Pages: 628-635

Affiliations

[1 ] University of Tabuk

[2 ] Shaqra University

[3 ] Texas Woman’s University

Author notes

Corresponding author: Yousef Alshehre PT, M.S., PhD, Assistant Professor Physical Therapy Department, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia. 71491 University of Tabuk, Tabuk, Saudi Arabia 47713. E-mail: yalshehre@ut.edu.sa Phone: +9665000956

Article

Publisher ID: 23430

DOI: 10.26603/001c.23430

PMC ID: 8169036

PubMed ID: 34123515

SO-VID: 0177b4c6-a39c-4449-8b49-c9facb670977

License:

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (4.0) which permits non-commercial use and sharing in any medium or format, provided the original author and source are credited. If you remix, transform, or build upon this work, you may not distribute the modified material.

Reliability and Validity of the Y-balance Test in Young Adults with Chronic Low Back Pain

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Abstract

Background

Purpose

Study Design

Methods

Results

Conclusions

Level of Evidence

Related collections

Politics of the Low Countries

Most cited references 29

Effect size estimates: current use, calculations, and interpretation.

Responsiveness of the numeric pain rating scale in patients with low back pain.

Using the Star Excursion Balance Test to assess dynamic postural-control deficits and outcomes in lower extremity injury: a literature and systematic review.

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