Patients Who Do Not Achieve 90% of the Nonoperative Side on the Anterior Reach Y-Balance Test at 3 Months After ACL Reconstruction Are More Likely to Have Persistent Knee Extension Strength Asymmetry at 6 Months Postoperatively.
Tomoko Kawasaki, Shunsuke Ohji, Kenji Hirohata and 7 others
PMID 41048417WHAT IT FOUND
Patients with an anterior reach Y-Balance test symmetry index below 90% at three months after ACL reconstruction were significantly more likely to have knee extensor strength asymmetry at six months.
However, a symmetry index above 90% at three months did not guarantee normal strength at six months.
Key findings
01An anterior reach Y-Balance test limb symmetry index of less than 90% at three months postoperatively was associated with an isokinetic knee extensor strength limb symmetry index of less than 90% at six months postoperatively.
02The 90% cutoff had high specificity (88.9%) but low sensitivity (38.1%), meaning it effectively identified those at risk for weakness but failed to detect most cases.
03Anterior reach distance improved earlier than knee extensor strength, with median limb symmetry index of 93.5% at three months compared to 83.2% for strength at six months.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was retrospective. Results apply only to patients with hamstring grafts, not those with patellar or quadriceps tendon grafts. Confounding factors such as age, gender, and ankle motion were not controlled for. The sensitivity of the 90% cutoff was low (38.1%), meaning many patients with normal reach scores still had significant strength deficits.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not use the Y-Balance Test anterior reach LSI at three months to clear patients for return to sport based on strength criteria. A score above 90% at three months does not guarantee adequate knee extensor strength at six months, as the test missed over 60% of those with strength deficits.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →