Is the upper quarter Y-Balance test a useful measure to determine upper limb loading response in female competitive gymnasts after upper extremity injury?


August 2023

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Gymnastics requires an athlete to weight-bear through each upper extremity (UE) in various positions. These unique sport requirements should be considered by clinicians when rehabilitating a gymnast after UE injury. There is currently no reliable and valid clinical test for female gymnasts, though the Upper Quarter Y-Balance test (YBT-UQ) may best recreate the sport’s demands. It requires an individual to maintain a plank position while one arm pushes a marker in three directions. The purpose of this project was to explore the YBT-UQ’s test–retest reliability, convergent validity, and predictive ability for female competitive gymnastics. Gymnasts were recruited using nonprobability sampling methods, and included if they participated in women’s competitive artistic gymnastics. Based on UE pain during gymnastics, participants were placed into either the Pain or No Pain group. All participants were asked to perform the YBT-UQ. For study one, follow-up testing was performed one week later. In the No Pain group, statistical analysis revealed good to excellent test–retest reliability of YBT-UQ composite scores. For the Pain group, test–retest reliability was acceptable to good. For studies two and three, the participants performed the YBT-UQ and a handstand on a portable pressure mat. As a handstand is a foundational gymnastics skill, it was chosen to identify a gymnast’s ability to weight-bear through each UE. The pressure mat system provided real-time data during the handstand. Limb symmetry index (LSI), a measure that compares performance between extremities, was calculated using YBT-UQ composite scores and two pressure measurements, peak pressure and time-to-peak pressure. Statistical analysis of the relationship between LSI of YBT-UQ and LSI of peak pressure revealed no significant correlation between the two variables for any group. Similar results were found for time-to-peak measurements. Analysis of the predictive ability of LSI of YBT-UQ scores indicated that this variable did not predict LSI for either peak pressure or time-to-peak pressure. The YBT-UQ, when used in isolation, does not appear to depict a female gymnast’s ability to perform sport tasks. Clinicians should consider implementing this test in combination with other outcome measures to determine a gymnast’s readiness to return to sport.



Competitive female gymnasts