Plisky Phillip, Schwartkopf-Phifer Katherine, Huebner Bethany, Garner Mary Beth, Bullock Garrett
Physical Therapy, University of Evansville; ProRehab-PC.
Physical Therapy, University of Evansville; Rehabitlitation & Performance Institute.
Int J Sports Phys Ther. 2021 Oct 1;16(5):1190-1209. doi: 10.26603/001c.27634. eCollection 2021.
Deficits in dynamic neuromuscular control have been associated with post-injury sequelae and increased injury risk. The Y-Balance Test Lower Quarter (YBT-LQ) has emerged as a tool to identify these deficits.
To review the reliability of the YBT-LQ, determine if performance on the YBT-LQ varies among populations (i.e., sex, sport/activity, and competition level), and to determine the injury risk identification validity of the YBT-LQ based on asymmetry, individual reach direction performance, or composite score.
Systematic Review.
A comprehensive search was performed of 10 online databases from inception to October 30, 2019. Only studies that tested dynamic single leg balance using the YBT-LQ were included. Studies were excluded if the Y-Balance Test kit was not utilized during testing or if there was a major deviation from the Y-Balance test procedure. For methodological quality assessment, the modified Downs and Black scale and the Newcastle-Ottawa Scale were used.
Fifty-seven studies (four in multiple categories) were included with nine studies assessing reliability, 36 assessing population differences, and 16 assessing injury prediction were included. Intra-rater reliability ranged from 0.85-0.91. Sex differences were observed in the posteromedial direction (males: 109.6 [95%CI 107.4-111.8]; females: 102.3 [95%CI 97.2-107.4; p = 0.01]) and posterolateral direction (males: 107.0 [95%CI 105.0-109.1]; females: 102.0 [95%CI 97.8-106.2]). However, no difference was observed between sexes in the anterior reach direction (males: 71.9 [95%CI 69.5-74.5]; females: 70.8 [95%CI 65.7-75.9]; p=0.708). Differences in composite score were noted between soccer (97.6; 95%CI 95.9-99.3) and basketball (92.8; 95%CI 90.4-95.3; p <0.01), and baseball (97.4; 95%CI 94.6-100.2) and basketball (92.8; 95%CI 90.4-95.3; p=0.02). Given the heterogeneity of injury prediction studies, a meta-analysis of these data was not possible. Three of the 13 studies reported a relationship between anterior reach asymmetry reach and injury risk, three of 10 studies for posteromedial and posterolateral reach asymmetry, and one of 13 studies reported relationship with composite reach asymmetry.
There was moderate to high quality evidence demonstrating that the YBT-LQ is a reliable dynamic neuromuscular control test. Significant differences in sex and sport were observed. If general cut points (i.e., not population specific) are used, the YBT-LQ may not be predictive of injury. Clinical population specific requirements (e.g., age, sex, sport/activity) should be considered when interpreting YBT-LQ performance, particularly when used to identify risk factors for injury.
1b.
动态神经肌肉控制缺陷与损伤后后遗症及受伤风险增加有关。Y平衡测试下肢部分（YBT-LQ）已成为识别这些缺陷的一种工具。
回顾YBT-LQ的可靠性，确定YBT-LQ的表现是否因人群（即性别、运动/活动和竞赛水平）而异，并基于不对称性、个体伸展方向表现或综合评分确定YBT-LQ识别受伤风险的有效性。
系统评价。
对10个在线数据库从创建到2019年10月30日进行全面检索。仅纳入使用YBT-LQ测试动态单腿平衡的研究。如果测试期间未使用Y平衡测试套件或与Y平衡测试程序存在重大偏差，则排除相关研究。对于方法学质量评估，使用改良的唐斯和布莱克量表以及纽卡斯尔-渥太华量表。
纳入57项研究（4项属于多个类别），其中9项评估可靠性，36项评估人群差异，16项评估受伤预测。评分者内信度范围为0.85 - 0.91。在中后方向（男性：109.6[95%CI 107.4 - 111.8]；女性：102.3[95%CI 97.2 - 107.4；p = 0.01]）和后外方向（男性：107.0[95%CI 105.0 - 109.1]；女性：102.0[95%CI 97.8 - 106.2]）观察到性别差异。然而，在前伸方向两性之间未观察到差异（男性：71.9[95%CI 69.5 - 74.5]；女性：70.8[95%CI 65.7 - 75.9]；p = 0.708）。足球（97.6；95%CI 95.9 - 99.3）和篮球（92.8；95%CI 90.4 - 95.3；p <0.01）以及棒球（97.4；95%CI 94.6 - 100.2）和篮球（92.8；95%CI 90.4 - 95.3；p = 0.02）之间的综合评分存在差异。鉴于受伤预测研究的异质性，无法对这些数据进行荟萃分析。13项研究中有3项报告前伸不对称与受伤风险之间存在关联，10项研究中有3项报告中后和后外伸不对称与受伤风险之间存在关联，13项研究中有1项报告与综合伸不对称之间存在关联。
有中等到高质量的证据表明YBT-LQ是一种可靠的动态神经肌肉控制测试。观察到性别和运动方面存在显著差异。如果使用通用切点（即非特定人群的），YBT-LQ可能无法预测受伤情况。在解释YBT-LQ表现时，应考虑临床特定人群的要求（如年龄、性别、运动/活动），尤其是在用于识别受伤风险因素时。
1b。
