Systematic Review and Meta-Analysis of the Y-Balance Test Lower Quarter: Reliability, Discriminant Validity, and Predictive Validity.
Phillip Plisky, Katherine Schwartkopf-Phifer, Bethany Huebner and 2 others
PMID 34631241WHAT IT FOUND
The Y-Balance Test is reliable for measuring dynamic control, but performance varies significantly by sex and sport.
Injury prediction remains unclear because studies used different cut points. Do not use a single universal score to flag risk; interpret results against population-specific norms.
Key findings
01The Y-Balance Test Lower Quarter demonstrates high reliability, with intrarater ICCs ranging from 0.57-0.82 in adolescents and 0.85-0.91 in adults.
02Performance differs significantly by sex and sport, with males reaching farther in posterior directions and soccer players outperforming basketball players in all reach directions.
03Evidence for using the test to predict future injury is inconsistent and cannot be pooled due to varying definitions of asymmetry and cut points across studies.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
High heterogeneity in injury prediction studies prevented a meta-analysis, making it impossible to draw definitive conclusions about the test's predictive validity. The review included only athletic and active populations, so findings cannot be generalized to inactive adults or geriatric populations. The YBT-LQ is a controlled, low-velocity test, which may not mimic the high-force mechanisms of many sports injuries. Some included studies had low methodological quality, and there was variability in testing protocols (e.g., hand placement, number of trials).
Declared interests
Funding for a graduate research assistant was provided by the Ridgeway 488 Student Research Award from the University of Evansville. One author, Dr. Phillip Plisky, developed the YBT-LQ protocol and receives royalties from the sale of the test kit.
The easy way to misread this
Do not use the YBT-LQ composite score or reach asymmetry as a standalone tool to clear athletes for return to sport or to predict injury risk. The evidence for its predictive validity is inconsistent and hampered by varying cut points across studies. Use it as part of a multifactorial assessment, interpreting results against population-specific norms rather than universal thresholds.