Upper Quarter Y-Balance Test

Last Updated

October 31, 2024

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Purpose

The purpose of the UQYBT is to provide an assessment of UE mobility and stability.

Link to Instrument

Instrument Details

Acronym UQYBT

Area of Assessment

Balance �C Non-vestibular
Functional Mobility
Range of Motion
Strength
Upper Extremity Function

Assessment Type

Performance Measure

Cost

Not Free

Actual Cost

$349.95

Cost Description

$319.95 (for standard Test Kit) $349.95 (for the Professional Test Kit)
Only available through www.ybalancetest.com

Healthy Adults

Non-Specific Patient Population

The UQYBT places a patient in a closed chain (Push Up) position and tests their ability to maintain that position while reaching with one hand in 3 test directions (Medial Reach, Inferolateral Reach, Superolateral Reach) as far as possible during the entirety of the movements.

Number of Items

Y-Balance Test Kit

6-30 minutes

Required Training

Training Course

Adolescent

13 - 17

years

Adult

18 - 64

years

Instrument Reviewers

Initially reviewed in October 2015 by Sara Regan, SPT; Hannah Jasurda, SPT; Aram Simonian, SPT; Lisa Delmedico, SPT; Taylor Chapman, SPT; Kirstin McCoy, SPT; Madison Haller, SPT; Elizabeth Charney, SPT; Justin Losciale, SPT, CSCS; Evan Vasilauskas, SPT; Rachel Cesario, SPT; Melissa Gunner, SPT; Jeffrey Wimsatt, SPT; Elizabeth Roscoe, SPT; Breanne Mitcham, SPT. Updated in October 2024 by Daniel Aliberto, Student PT; Sara Baumgartner, Student PT; Anthony Cappuccio, Student PT; Eric Loughren, Student PT; & Paige Yaggins, Student PT under the direction of Irene Ward, PT, DPT, NCS.

Body Part

Upper Extremity

ICF Domain

Body Structure
Body Function
Activity

Measurement Domain

Motor

Professional Association Recommendation

Recommendations for sports professionals in identifying movement limitations and asymmetries in athletes before implementation of training and conditioning programs.

Coaches and sports medicine professionals may consider incorporating the YBT-UQ as part of their pre-program testing to identify movement limitations and asymmetries in athletes and thereby may reduce injury. Recommendation for future studies to determine whether asymmetries and poor performance in upper extremity movement testing are predictive of future injury
Recommendations for use based on acuity level of the patient: N/A
Recommendations based on level of care in which the assessment is taken: N/A
Recommendations based on SCI AIS Classification: N/A
Recommendations based on EDSS Classification: N/A
Recommendations for entry-level physical therapy education and use in research: Research is necessary to establish the responsiveness of the UQYBT to wrist, elbow, and shoulder pathology and to determine which muscles or muscle groups are recruited during performance on the UQYBT.

Considerations

Patients/subjects may watch the instructional video prior to performing the UQYBT.

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Standard Error of Measurement (SEM)

Recreational Fitness Subjects (Gorman, 2010)

Medial direction: SEM= 2.9 cm
Superolateral direction: SEM= 2.3 cm
Inferolateral direction: SEM=2.2 cm

General Population (Westrick, 2012)

Dominant Composite: SEM= 2.5
Non-Dominant Composite: SEM= 2.3

Adolescents between the ages of 12 to 17: (Schwiertz et al., 2019; n = 111; Single year age groups from age 12 thru age 17)

SEM (%) by Arm, Age, and Reach Direction

Left Arm:

12 y/o (n = 14):
- MD (% AL): 3.3%
- IL (% AL): 4.0%
- SL (% AL): 5.4%
- CS (% AL): 2.9%
13 y/o (n = 20):
- MD (% AL): 4.6%
- IL (% AL): 7.4%
- SL (% AL): 4.9%
- CS (% AL): 3.8%
14 y/o (n = 24):
- MD (% AL): 5.2%
- IL (% AL): 4.1%
- SL (% AL): 5.3%
- CS (% AL): 3.2%
15 y/o (n = 20):
- MD (% AL): 4.6%
- IL (% AL): 7.3%
- SL (% AL): 4.7%
- CS (% AL): 3.4%
16 y/o (n = 18):
- MD (% AL): 5.5%
- IL (% AL): 6.0%
- SL (% AL): 4.4%
- CS (% AL): 3.3%
17 y/o (n = 15):
- MD (% AL): 2.9%
- IL (% AL): 2.5%
- SL (% AL): 2.5%
- CS (% AL): 1.8%

Right Arm:

12 y/o (n = 14):
- MD (% AL): 4.8%
- IL (% AL): 6.1%
- SL (% AL): 3.5%
- CS (% AL): 3.3%
13 y/o (n = 20)
- MD (% AL): 5.2%
- IL (% AL): 6.2%
- SL (% AL): 5.3%
- CS (% AL): 3.5%
14 y/o (n = 24):
- MD (% AL): 4.4%
- IL (% AL): 3.5%
- SL (% AL): 3.7%
- CS (% AL): 1.9%
15 y/o (n = 20)
- MD (% AL): 4.5%
- IL (% AL): 7.6%
- SL (% AL): 4.5%
- CS (% AL): 3.5%
16 y/o (n = 18)
- MD (% AL): 4.6%
- IL (% AL): 4.3%
- SL (% AL): 4.3%
- CS (% AL): 2.7%
17 y/o (n = 15)
- MD (% AL): 3.5%
- IL (% AL): 4.3%
- SL (% AL): 2.8%
- CS (% AL): 2.3%

Note: AL = arm length; CS = composite score; IL = inferolateral; MD = medial; SL = superolateral

Minimal Detectable Change (MDC)

Recreational Fitness Subjects (Gorman, 2010)

Medial direction: MDC= 8.1 cm
Superolateral direction: MDC= 6.4 cm
Inferolateral direction: MDC= 6.1 cm

General Population (Westrick, 2012)

Dominant Composite: MDC= 6.9
Non-Dominant Composite: MDC= 6.5

Adolescents between the ages of 12 to 17: (Schwiertz et al., 2019)

MDC by Arm, Age, and Reach Direction

Left Arm:

12 y/o (n = 14):
- MD (%AL): 9.1%
- IL (%AL): 11.2%
- SL (%AL): 15.0%
- CS (%AL): 8.1%
13 y/o (n = 20):
- MD (%AL): 12.8%
- IL (%AL): 20.4%
- SL (%AL): 13.5%
- CS (%AL): 10.5%
14 y/o (n = 24):
- MD (%AL): 14.5%
- IL (%AL): 11.4%
- SL (%AL): 14.8%
- CS (%AL): 8.9%
15 y/o (n = 20):
- MD (%AL): 12.3%
- IL (%AL): 20.2%
- SL (%AL): 13.1%
- CS (%AL): 9.5%
16 y/o (n = 18):
- MD (%AL): 15.2%
- IL (%AL): 16.5%
- SL (%AL): 12.3%
- CS (%AL): 9.2%
17 y/o (n = 15):
- MD (%AL): 8.0%
- IL (%AL): 7.1%
- SL (%AL): 6.8%
- CS (%AL): 4.8%

Right Arm:

12 y/o (n = 14):
- MD (%AL): 13.3%
- IL (%AL): 16.9%
- SL (%AL): 9.8%
- CS (%AL): 9.2%
13 y/o (n = 20):
- MD (%AL): 14.5%
- IL (%AL): 17.1%
- SL (%AL): 14.7%
- CS (%AL): 9.7%
14 y/o (n = 24):
- MD (%AL): 12.3%
- IL (%AL): 9.6%
- SL (%AL): 10.1%
- CS (%AL): 5.4%
15 y/o (n = 20):
- MD (%AL): 12.6%
- IL (%AL): 21.1%
- SL (%AL): 12.3%
- CS (%AL): 9.6%
16 y/o (n = 18):
- MD (%AL): 12.7%
- IL (%AL): 11.9%
- SL (%AL): 12.0%
- CS (%AL): 7.6%
17 y/o (n = 15):
- MD (%AL): 9.6%
- IL (%AL): 11.9%
- SL (%AL): 7.8%
- CS (%AL): 6.4%

Note: AL = arm length; CS = composite score; IL = inferolateral; MD = medial; SL = superolateral

Normative Data

Recreational Fitness Subjects (Gorman, 2012) Average Upper Quarter Y Balance Test scores, reported as a percentage of limb length (%LL) for all reach directions and the composite.

Medial Direction: Mean= 97.2%, SD 9.6 cm (males)
Medial Direction: Mean= 95.2%, SD 10.6 cm (females)
Superolateral Direction: Mean= 70.9%, SD 9.6 cm (males)
Superolateral Direction: Mean= 70.4%, SD 9.3 cm (females).
Inferolateral Direction: Mean= 84.2%, SD 9.1 cm (males)
Inferolateral Direction: Mean= 82.7%, SD 10.1 cm (females).

Teyhen, 2014 - No Age effect. Total Composite Score of all 3 reach directions reported as percentage of Limb Length (%LL):

89.5 +/-9.6 (males)
84.9+/-9.1 (females)

General Population (Westrick, 2012; n=33, mean ages= 19.5 men and 18.8 women)

Dominant Composite: Mean= 86.5%, SD 8.1 cm (males)
Dominant Composite: Mean= 82.9%, SD 9.2 cm (females)
Non-dominant: Mean= 88.1%, SD 7.4 cm (males)
Non-dominant: Mean= 85.2%, SD 11.7 cm (females)

Female Infantry Soldiers: (Gottlieb et al., 2018; n = 167; mean age = 18.6 (0.5) years; Israel sample)

Composite Score: Mean (SD)
- All (n = 167): 36.9 (5.9)
- Attrited (n = 53): 36.4 (6.6)
- Not Attrited (n = 114): 37.2 (5.6)

High School Athletes: (Myers et al., 2017; n = 48 (n = 24 wrestlers, mean age = 16.12 (1.24) years and n = 24 baseball players, mean age = 15.79 (1.25) years)

Average normalized reach distances and composite scores (% of limb length)

Wrestlers:

Left Upper Extremity:
- Medial: 107.59 (11.04)
- Superolateral: 71.93 (12.08)
- Inferolateral: 96.89 (13.08)
- Composite: 92.14 (9.60)
Right Upper Extremity:
- Medial: 106.99 (10.54)
- Superolateral: 73.92 (15.14)
- Inferolateral: 93.98 (11.68)
- Composite: 91.63 (9.70)

Baseball players:

Left Upper Extremity:
- Medial: 97.05 (5.89)
- Superolateral: 70.90 (8.26)
- Inferolateral: 85.59 (7.45)
- Composite: 85.14 (6.30)
Right Upper Extremity:
- Medial: 97.04 (7.10)
- Superolateral: 73.08 (8.76)
- Inferolateral: 85.29 (8.39)
- Composite: 84.51 (5.40)

Adolescents between the ages of 10 to 17 (Schwiertz et al., 2021; n = 665 (325 females, 340 males); 10�C11-year-olds (n = 56), 12�C13-year-olds (n = 175), 14�C15-year-olds (n = 218), 16�C17-year-olds (n = 216))

Right Arm Reach by % Arm Length; (Mean (SD))

10-11 y/o females (n = 35)
- Medial: 100.7 (10.9)
- Inferolateral: 98.4 (17.4)
- Superolateral: 73.0 (15.2)
- Composite: 90.7 (12.9)
10-11 y/0 males (n = 21)
- Medial: 100.1 (7.9)
- Inferolateral: 95.4 (14.5)
- Superolateral: 69.7 (17.1)
- Composite: 88.4 (11.9)
12-13 y/o females (n = 91)
- Medial: 95.7 (11.7)
- Inferolateral: 88.4 (13.7)
- Superolateral: 69.0 (12.5)
- Composite: 84.5 (11.1)
12-13 y/o males (n = 84)
- Medial: 92.9 (10.3)
- Inferolateral: 86.0 (16.3)
- Superolateral: 63.0 (12.9)
- Composite: 80.5 (10.9)
14-15 y/o females (n = 88)
- Medial: 98.3 (10.3)
- Inferolateral: 84.1 (13.1)
- Superolateral: 70.7 (14.4)
- Composite: 84.3 (10.8)
14-15 y/o males (n = 130)
- Medial: 104.1 (12.3)
- Inferolateral: 97.7 (15.8)
- Superolateral: 76.2 (13.5)
- Composite: 92.6 (11.9)
16-17 y/o females (n = 111)
- Medial: 96.6 (14.5)
- Inferolateral: 85.2 (15.8)
- Superolateral: 72.1 (15.5)
- Composite: 84.6 (12.3)
16-17 y/o males (n = 105)
- Medial: 96.5 (15.6)
- Inferolateral: 92.0 (20.6)
- Superolateral: 76.8 (16.0)
- Composite: 88.4 (12.8)

Left Arm Reach by % Arm Length; (Mean (SD))

10-11 y/o females (n = 35)
- Medial: 98.2 (9.3)
- Inferolateral: 96.6 (14.6)
- Superolateral: 71.4 (12.8)
- Composite: 88.7 (11.0)
10-11 y/0 males (n = 21)
- Medial: 99.5 (9.0)
- Inferolateral: 97.0 (14.4)
- Superolateral: 70.7 (15.9)
- Composite: 89.1 (11.9)
12-13 y/o females (n = 91)
- Medial: 95.8 (11.0)
- Inferolateral: 88.8 (14.7)
- Superolateral: 67.3 (12.0)
- Composite:84.0 (11.1)
12-13 y/o males (n = 84)
- Medial: 93.1 (11.1)
- Inferolateral: 85.9 (14.5)
- Superolateral: 60.9 (13.0)
- Composite:80.1 (11.4)
14-15 y/o females (n = 88)
- Medial: 96.9 (9.3)
- Inferolateral: 83.1 (12.5)
- Superolateral: 69.2 (14.2)
- Composite:83.1 (10.1)
14-15 y/o males (n = 130)
- Medial: 103.7 (11.8)
- Inferolateral: 95.7 (15.8)
- Superolateral: 73.7 (14.0)
- Composite:91.1 (11.9)
16-17 y/o females (n = 111)
- Medial: 94.9 (13.0)
- Inferolateral: 84.9 (15.6)
- Superolateral: 70.4 (15.4)
- Composite:83.4 (11.9)
16-17 y/o males (n = 105)
- Medial: 95.8 (15.5)
- Inferolateral: 91.1 (21.0)
- Superolateral: 74.6 (16.4)
- Composite: 87.2 (13.0)

Adolescents between the ages of 12 to 17: (Schwiertz et al., 2019)

Left Arm Range (% AL):
- MD: 85.4- 99.9%
- IL: 72.8-92.7%
- SL: 58.8-66.3%
- CS: 74.4%-83.8%
Right Arm Range (% AL):
- MD: 84.3-98.3%
- IL: 72.3-91.0%
- SL: 56.7-63.0%
- CS: 72.7%-82.8%

Note: AL = arm length; CS = composite score; IL = inferolateral; MD = medial; SL = superolateral

Test/Retest Reliability

Recreational Fitness Subjects (Gorman, 2012)

Excellent: ranged from ICC=0.80 (inferolateral direction)to ICC= 0.99 (superolateral direction)

General Population (Westrick, 2012; n=33, mean ages= 19.5 men and 18.8 women)

Excellent: ICC of 0.91 and 0.92 for dominant and nondominant UE measurements, respectively.

Female Infantry Soldiers: (Gottlieb et al., 2018)

Acceptable test-retest reliability for all side and direction combinations of the UQYBT

Side and direction	ICC value	95% CI
Left medial	0.829	0.785-0.866
Left inferolateral	0.817	0.771-0.856
Left superolateral	0.837	0.795-0.872
Right medial	0.889	0.859-0.914
Right inferolateral	0.802	0.754-0.844
Right superolateral	0.850	0.811-0.883

Interrater/Intrarater Reliability

Recreational Fitness Subjects (Gorman, 2012)

Inter-rater reliability was excellent(ICC= 1.00 for all tests).
All testing was observed and scored by 2 raters simultaneously who were blinded to each other��s scoring. The raters independently determined whether a successful trial was completed. To reduce bias, the raters recorded the reach distance regardless of whether each rater through the trial was successful.

General Population (Westrick, 2012; n=33, mean ages= 19.5 men and 18.8 women)

Excellent: Intra-rater reliability values ranged from ICC = 0.86 left shoulder IR, to ICC = 0.98 right shoulder flexion.
SMRT intrarater reliability was same for both sides ICC = 0.99

Internal Consistency

Recreational Fitness Subjects (Gorman, 2012)

The YBT-UQ evaluates joint mobility and stability simultaneously, by requiring the patient to use balance, proprioception, strength, and greater range of motion. Some limitations causing potential error would be fatigue, practice effect, lack of control for training level, training cycle, nutrition or hydration. The YBT-UQ has shown good reliability with standardized equipment and methods.

Criterion Validity (Predictive/Concurrent)

Female Infantry Soldiers: (Gottlieb et al., 2018)

Poor predictive validity of the UQYBT as it did not significantly predict attrition rates.

Construct Validity

Convergent validity:

General Population (Westrick, 2012; n=33, mean ages= 19.5 men and 18.8 women)

There was a significant convergent relationship observed between the UQYBT and core stability measures (Dominant side LTET; p=0.04, r=.38; non-dominant; p=0.01, r=.45) and UE CKC performance measures (CKCUEST p=0.01, r=0.49 and APFT pushups p=0.02, r=.41).

There was not a significant relationship observed between the UQYBT and measures of trunk rotation, trunk flexor and extensor endurance tests, APFT sit-ups, shoulder AROM, or shoulder isometric strength.

Discriminant validity:

High School Athletes: (Myers et al., 2017)

Significant ability of the UQYBT to detect greater reach distance of wrestlers over baseball players in the medial and inferolateral directions as well as the overall composite score (p < 0.01)

Standard Error of Measurement (SEM)

Healthy College Students: (Williamson et al., 2019; total n = 12; Male Students n = 6, mean age = 32.9 (4.0) years; Female Students n = 6, mean age = 29.7 (2.4) years)

SEM for entire group (n = 12)
Limb Length Measurement SEM
- Rater 1: 0.066
- Rater 2: 0.053
- Rater 3: 0.054
Limb Length Measurement: C7 spinous process to the distal end of the third digit of the right hand (SEM):
- All 3 raters: 0.039

Normative Data

College Athletes: (Taylor et al., 2016; n = 257 (n = 118 males, mean age = 19.3 (1.2) years; n = 139 females, mean age = 19.2 (1.2) years); men��s baseball (37), basketball (10), lacrosse (36), cross country/track and field (35), and women��s basketball (15), lacrosse (42), soccer (28), cross-country/track and field (35), and volleyball (19)

Average reach distances and composite scores (cm) (Mean (SD))

Men dominant arm
- Lateral: 111.4 (9.4)
- Overhead: 82.8 (11.9)
- Underbody: 110.1 (13.1)
- Composite: 101.4 (9.1)
Men nondominant arm
- Lateral: 110.5 (9.0)
- Overhead: 84.2 (12.1)
- Underbody: 110.7 (13.8)
- Composite: 101.8 (8.7)
Women dominant arm
- Lateral: 99.1 (10.5)
- Overhead: 78.1 (13.0)
- Underbody: 97.9 (16.2)
- Composite: 91.7 (10.8)
Women nondominant arm
- Lateral:100.4 (10.9)
- Overhead: 77.5 (12.9)
- Underbody: 98.5 (14.6)
- Composite: 92.1 (9.7)

Test/Retest Reliability

Healthy College Students: (Williamson et al., 2019)

Limb length measurement:
- Excellent test-retest reliability (ICC = 0.990, p < 0.001), 95% CI (0.981, 0.995))

Interrater/Intrarater Reliability

Healthy College Students: (Williamson et al., 2019)

Limb Length Measurements: Intra-rater ICC, 95% CI:
- Excellent intra-rater reliability
  - Rater 1: 0.986, (0.953-0.996)
  - Rater 2: 0.987, (0.941-0.997)
  - Rater 3: 0.990, (0.964-0.997)
Limb Length Measurements: Inter-rater ICC, 95% CI:
- Excellent inter-rater reliability
  - All 3 Raters: 0.990 (p < 0.001), 95% CI (0.981-0.995)

Construct Validity

Discriminant validity:

College Athletes: (Taylor et al., 2016)

Excellent correlations between the UQYBT and the Closed Kinetic Chain Upper-Extremity Stability Test (r = 0.04-0.18 with UQYBT composite or specific directional test scores in men or women)

Bibliography

Butler, R. J., Myers, H. S., Black, D. et al. (2014). Bilateral Differences in Upper Quarter Function of High School Aged Baseball and Softball Players. The International Journal of Sports Physical Therapy, 9(4). 518-524.

Garrigues, G., Gorman, P., Plisky, P., Kiesel, K., Myers, H., Black, D. Queen, R., Butler, R. (2012). Differences on the Upper Quarter Y Balance Test Between High School and College Baseball Players. Medicine and Science in Sports and Exercise, 44(5S), 408.

Gottlieb, U., Kelman D, Springer S. (2018). Evaluation of two simple functional tests to predict attrition from combat service in female light infantry soldiers. Med Sci Monit. 24, 9334-9341. .

Gorman, P. P., Butler, R. J., Plisky, P. J., & Kiesel, K. B. (2012). Upper quarter y balance test:reliability and performance comparison between genders in active adults. Journal of Strength and Conditioning Research, 26(11), 3043-3048.

Hazar, Z., Ulug, N., Yuksel, I. (2014). Upper Quarter Y Balance Test score of patients with shoulder impingement syndrome. Orthopaedic Journal of Sports Medicine, 2(11_suppl3), 2325967114S00275.

Myers, H., Poletti, M., Butler, R.J. (2017). Difference in functional performance on the Upper-Quarter Y-Balance test between high school baseball players and wrestlers. J Sport Rehabil. 26(3),253-259. .

Schwiertz, G., Brueckner, D., Schedler, S., Kiss, R., Muehlbauer, T. (2019). Reliability and minimal detectable change of the Upper-Quarter Y Balance test in healthy adolescents aged 12 to 17 years. Int J Sports Phys Ther. 14(6),927-934.

Schwiertz, G., Bauer, J., Muehlbauer, T. (2021). Upper Quarter Y Balance test performance: Normative values for healthy youth aged 10 to 17 years. PLoS One. 16(6), e0253144. .

Taylor, J.B., Wright, A.A., Smoliga, J.M., DePew, J.T., Hegedus, E.J. (2016) Upper-extremity physical-performance tests in college athletes. J Sport Rehabil. 25(2), 146-154. .

Teyhen, Deydre S., Riebel, Mark A., McArthur, Derrick R. et al. (2014). Normative Data and the Influence of Age and Gender on Power, Balance, Flexibility, and Functional Movement in Healthy Service Members. Military Medicine, 179(4), 413-420.

Westrick, R. B., PT, DPT, DSc, OCS, SCS, Miller, J. M., PT, DPT, DSc, OCS, SCS, Carow, S. D., PT, DPT, DSc, OCS, & Gerber, J. P., PT, PhD, SCS, ATC. (2012). Exploration of the Y-balance test for assessment of upper quarter closed kinetic chain performance. The International Journal of Sports Physical Therapy, 7(2), 140-147.

Williamson, J.D., Lawson, B.L., Sigley, D., Nasypany, A., Baker, R.T. (2019). Intra- and inter-rater reliability for limb length measurement and trial and error assessment of the Upper-Quarter Y-Balance test in healthy adults. Int J Sports Phys Ther. 14(5), 707-714.

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Purpose

Link to Instrument

Area of Assessment

Assessment Type

Cost

Actual Cost

Cost Description

Number of Items

Required Training

Instrument Reviewers

Body Part

ICF Domain

Measurement Domain

Professional Association Recommendation

Considerations

Standard Error of Measurement (SEM)

Minimal Detectable Change (MDC)

Normative Data

Test/Retest Reliability

Interrater/Intrarater Reliability

Internal Consistency

Criterion Validity (Predictive/Concurrent)

Construct Validity

Standard Error of Measurement (SEM)

Normative Data

Test/Retest Reliability

Interrater/Intrarater Reliability

Construct Validity

Bibliography

Psychosocial Impact of Ass...

Leicester Cough Questionna...

Closed Kinetic Chain Upper...

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