Examination of Age-Related Differences on Clinical Tests of Postural Stability

Abstract

Background:The modified Balance Error Scoring System (mBESS) and Y-Balance Test are common clinical measurements of postural control, but little is known about the effect of age on performance of these tasks. The purpose of this study was to examine how healthy child and adolescent athletes perform on 2 common clinical measurements of postural control.Hypothesis:Younger athletes would demonstrate poorer postural control compared with older athletes.Study Design:Cross-sectional study.Level of Evidence:Level 3.Methods:Three hundred eighty-nine athletes between the ages of 10 and 18 years underwent an evaluation of postural control. Each participant completed the mBESS in the double-leg, single-leg, and tandem stances as well as the Y-Balance Test. Postural stability data were analyzed between age groups (10-12, 13-15, and 16-18 years) using univariate analyses of covariance.Results:The youngest athletes (10-12 years) had a greater mean number of errors in the single-leg stance of the mBESS than the 13- to 15-year-old and 16- to 18-year-old athletes (3.8, 3, and 2.5 errors, respectively; P < 0.01). They also had greater right to left asymmetry compared with the 16- to 18-year-old athletes on the Y-Balance Test in the posterolateral (6.8 and 3.8 cm, respectively; P = 0.006) and posteromedial (5.3 and 3.6 cm, respectively; P = 0.014) directions of movement.Conclusion:Athletes between the ages of 10 and 12 years performed worse on the single-leg stance of the mBESS and demonstrated more asymmetry on the Y-Balance Test in the posterolateral and posteromedial directions compared with older athletes.Clinical Relevance:In the absence of a baseline balance test for athletes younger than the age of 13 years, caution should be used in interpreting postural stability assessments, as age may be a modifying factor in performance.

Functional movement screen and Y-Balance test scores across levels of American football players

“…We also found no statistically significant difference in reach direction asymmetry between MS and HS football players although HS players displayed roughly 28% greater reach distance difference in the ANT direction and 22% less reach distance difference in the PL direction than MS players. This finding is in contrast to a recent study that reported greater PM and PL reach direction asymmetries in athletes between 10 and 12 years of age in comparison to 16 to 18-yr olds while controlling for sex, BMI, and history of injury [ 46 ]. It is reasonable to suggest that the greater difference in age between groups in the previous study versus that seen in our MS and HS groups was influential in these contrasting results.…”

Limb Differences in Unipedal Balance Performance in Young Male Soccer Players with Different Ages

“…Previous studies investigating leg-based postural control in soccer players at different ages (i.e., levels of experience) showed inconsistent findings [3,4,5,6]. Specifically, some studies [3,4] did not detect significant differences between age groups while others [5,6] revealed significant differences in unipedal balance performance in older, more experienced—compared to younger, less experienced—athletes. For example, Butler et al [3] investigated leg differences in maximal reach distances in the Lower Quarter Y Balance Test (YBT-LQ) using soccer players playing at high school, collegiate or professional level.…”

“…The authors attributed these findings to the more frequent use of the standing leg to stabilize the body during soccer-related movements (e.g., passing and/or kicking). Further, Breen and colleagues [6] argued that motor control strategies might differ between older, more experienced players and younger, less experienced players.…”

Physical activity outside of organised sports is associated with functional performance

“…This test has previously been used to identify age-related postural control deficits (22) and the risk of sustaining a lower extremity injury (23). During the assessment, participants stood barefoot with the distal aspect of their right foot on the stance plate and push an indicator box with their left foot as far as possible in the anterior, posteromedial and posterolateral directions, returning to the original standing position without losing balance.…”

“…The protocol was repeated with the left foot on the platform and the right foot reaching in each direction. We calculated the asymmetry in each direction of movement, defined as the absolute difference between left and right total reach length in the anterior, posteromedial and posterolateral directions (22).…”