Inertial Sensor Technology Can Capture Changes in Dynamic Balance Control during the Y Balance Test

Abstract

Introduction: The Y Balance Test (YBT) is one of the most commonly utilised clinical dynamic balance assessments. Research has demonstrated the utility of the YBT in identifying balance deficits in individuals following lower limb injury. However, quantifying dynamic balance based on reach distances alone fails to provide potentially important information related to the quality of movement control and choice of movement strategy during the reaching action. The addition of an inertial sensor to capture more detailed motion data may allow for the inexpensive, accessible quantification of dynamic balance control during the YBT reach excursions. As such, the aim of this study was to compare baseline and fatigued dynamic balance control, using reach distances and 95EV (95% ellipsoid volume), and evaluate the ability of 95EV to capture alterations in dynamic balance control, which are not detected by YBT reach distances. Methods: As part of this descriptive laboratory study, 15 healthy participants completed repeated YBTs at 20, 10, and 0 min prior to and following a modified 60-s Wingate test that was used to introduce a short-term reduction in dynamic balance capability. Dynamic balance was assessed using the standard normalised reach distance method, while dynamic balance control during the reach attempts was simultaneously measured by means of the 95EV derived from an inertial sensor, worn at the level of the 4th lumbar vertebra. Results: Intraclass correlation coefficients for the inertial sensor-derived measures ranged from 0.76 to 0.92, demonstrating strong intrasession test-retest reliability. Statistically significant alterations (p < 0.05) in both reach distance and the inertial sensor-derived 95EV measure were observed immediately post-fatigue. However, reach distance deficits returned to baseline levels within 10 min, while 95EV remained significantly increased (p < 0.05) beyond 20 min for all 3 reach distances. Conclusion: These findings demonstrate the ability of an inertial sensor-derived measure to quantify alterations in dynamic balance control, which are not captured by traditional reach distances alone. This suggests that the addition of an inertial sensor to the YBT may provide clinicians and researchers with an accessible means to capture subtle alterations in motor function in the clinical setting.

Capturing concussion related changes in dynamic balance using the Quantified Y Balance Test – a case series of six elite rugby union players

“…However, the traditional clinical scoring method does not allow for the objective quantification of information related to an individual's balance 'stability' or 'strategy'. Recent research has resulted in the development of an inertial sensor quantified YBT (QYBT), demonstrating that it can provide a reliable measure of performance [17], is more sensitive to change than the traditional scoring method [18,19] and can identify deficits in performance that increase an athletes risk of concussion [20]. To date, despite a call for research, there have been no prospective investigations conducted to determine the capability of an inertial sensor based assessment to quantify motor function following 'clinical recovery' from concussion [7].…”

Athletes with a concussion history in the last two years have impairments in dynamic balance performance

“…The intra-session reliability and inter-session reliability of the data acquisition parameters and sensor mounting location have been previously published. 14,15 Furthermore, recent research has demonstrated the discriminant validity of the inertial sensorbased approach, 13,20 as well as highlighted the capacity of the assessment to capture balance deficits with are associated with an increased risk of concussion in rugby union players. 15 It has previously been reported that investigating the discriminant capabilities of inertial sensor-based variables may be the most appropriate method for validation of these tools.…”

“…5 For example, recent research has shown that a single lumbar-worn inertial sensor can provide a valid and reliable measure of dynamic movement control during the YBT. 13,14 Early investigations of this approach within the clinical context have shown that it may have value in identifying athletes at a three-times higher relative risk of sustaining a concussion, 15 as well as identifying post-concussion deficits. 6 Therefore, the inertial sensor instrumentation of the YBT may allow for the accessible and objective quantification of sensorimotor performance outside of the laboratory environment, helping to identify individuals who may be at an increased risk of future injury.…”

Reliability, Validity and Utility of Inertial Sensor Systems for Postural Control Assessment in Sport Science and Medicine Applications: A Systematic Review

“…Twelve studies assessed discriminant validity in healthy cohorts, assessing the ability of inertial sensor systems to discriminate between known stance, visual, hearing, fatigue or taping conditions [25,28,32,41,[43][44][45][46][47][48][49][50].…”

“…A single prospective cohort study investigated the association of inertial sensor-based PC assessment scores with sports related injuries in a cohort of collegiate American football players, reporting that players with poorer PC were at a 5.19 times greater-odds of sustaining a sports related injury [61]. Table here 3.6 MEASUREMENT RELIABILITY Thirteen of the included studies were identified as assessing measurement reliability [16,27,28,33,40,41,45,47,58,[62][63][64][65]. Eleven of these studies investigated intra-session test retest reliability, demonstrating reliability ranging from poor to excellent (ICC = 0.03 to 0.97) [16,27,33,40,41,45,47,58,[63][64][65], while five studies reported poor to excellent (ICC = 0.02 to 0.95) inter-session reliability [16,28,[62][63][64].…”