Y-Balance Test for Predicting Concussion Risk

Recruiting at 1 trial location

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Arkansas Colleges of Health Education

Disqualifiers: History of seizure

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

1000 Participants Needed

Trial Summary

What is the purpose of this trial?

The Y Balance Test for the lower quarter (YBT-LQ) is a movement screen used to assess an athlete's risk for injury. The YBT-LQ is a dynamic balance test where the participant stands on a single leg and with the opposite lower extremity reaches are far in the anterior direction as they can, and this value is measured. The process is repeated in the posterior medial, and the posterior lateral directions. The final values are controlled for leg length of the participants. The YBT-LQ has been shown to be predictive of lower extremity injury in high school basketball players, but it is typically used as part of a battery of tests to determine the athlete's overall injury risk, but more questions remain to be answered. The research question: Is the YBT-LQ predictive of concussion in high school athletes? What are the norms for YBT-LQ in high school athletes? Does history of concussion effect YBT-LQ? Is the YBT-LQ with visual perturbations predictive of concussions? Is the YBT-LQ with visual perturbations predictive of lower extremity injury? What is the impact of visual perturbations on Y-balance and its injury prevention capability? The target student participants will be 9th through 12th grade students; however, 6th to 8th grade students will be allowed to participate depending on the school or organization request. Informed consent will be obtained reiterating that participation is voluntary. Testing utilizing the YBT-LQ will occur, and sport of participation, age, height, weight, dorsiflexion, and leg length will be obtained. Follow up will be made via the athletic trainers and school personnel to indicate the effected athletes. Once the post-test follow up is complete athletes will be able to see their pre-test scores, and any questions will be answered at that time. This will be a longitudinal study where testing will take place at least two times per year, preferably three times per year over 4 years.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Y Balance Plus Visual Perturbations for predicting concussion risk?

The Y Balance Test (YBT) is used to assess balance in both healthy and concussed athletes, suggesting its potential usefulness in identifying balance issues related to concussion risk. Additionally, balance disturbances are common in people with concussions, indicating that treatments focusing on balance, like the Y Balance Test, could be relevant for predicting concussion risk. ^{1 2 3 4 5}

Is the Y-Balance Test safe for humans?

The research articles reviewed do not provide specific safety data for the Y-Balance Test or its variations, but they do not report any safety concerns or adverse effects in healthy or concussed adolescent athletes. ^{1 3 5 6 7}

How does the Y-Balance Test treatment differ from other treatments for predicting concussion risk?

The Y-Balance Test is unique because it focuses on assessing balance and postural control to predict concussion risk, rather than treating symptoms after a concussion has occurred. This approach is different from other treatments that typically address symptoms post-injury, as it aims to identify individuals at risk before a concussion happens. ^{2 3 4 6 8}

Eligibility Criteria

This trial is for high school athletes, grades 9-12, who play sports either through their school or a club. Middle school students from grades 6-8 may also join if requested by the school or organization. Athletes with a history of seizures cannot participate.

Inclusion Criteria

Participates in sport either school sanctioned or club

Exclusion Criteria

I have had seizures in the past.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Testing

Participants perform the Y Balance Test for the lower quarter (YBT-LQ) to assess risk for injury and potential concussion prediction

Ongoing over 4 years

Testing at least two times per year, preferably three times per year

Follow-up

Follow-up with athletic trainers and school personnel to monitor for concussions and lower extremity injuries

1 year

Treatment Details

Interventions

• Y Balance Plus Visual Perturbations
• Y Balance Test

Trial Overview The study is testing whether the Y Balance Test (YBT-LQ), which measures dynamic balance, can predict concussions in athletes. It includes standard YBT-LQ and an additional version with visual disturbances to see if they affect concussion prediction or lower extremity injury risk.

Participant Groups

Group I: Standard Y Balance Active Control 1 Intervention

Subjects will perform Y-balance lower quarter

Group II: Y Balance Plus Stroboscopic Glasses Active Control 1 Intervention

Subjects will perform Y-balance lower quarter with and without stroboscopic lenses

Who Is Running the Clinical Trial?

Arkansas Colleges of Health Education

Lead Sponsor

Trials

7

Recruited

1,200+

Findings from Research

The study involved 224 adolescent athletes (180 healthy and 44 with concussions) and found that dynamic balance testing using the Y Balance Test (YBT) showed significant differences in performance between healthy males and females, indicating its effectiveness in assessing balance.

Combining dynamic (YBT) and static (BESS) balance tests may provide a more comprehensive evaluation of balance skills in athletes recovering from concussions, as some concussed athletes performed well on the BESS but not on the YBT.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Static and Dynamic Balance Assessment in Healthy and Concussed Adolescent Athletes. Lowe, L., Castillo, F., Gokun, Y., et al.[2023]

In a study of 18 young concussion patients, improvements in self-reported symptoms and postural stability were observed over four clinical visits, indicating a positive recovery trend (P<0.0001-0.001).

Dual-task interference balance testing revealed significant differences in postural stability between concussion patients and healthy adolescents, particularly during cognitive tasks, suggesting this method may be crucial for assessing recovery in young patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tracking postural stability of young concussion patients using dual-task interference. Dorman, JC., Valentine, VD., Munce, TA., et al.[2016]

In a study of 158 concussed youths, the Vestibular/Ocular Motor Screening (VOMS) items were found to significantly contribute to the severity of concussion symptoms, explaining 9.6% of the variance in symptom severity after accounting for other factors.

Specifically, the VOMS items related to vertical saccades and vertical vestibulo-ocular reflex (VOR) were particularly influential, indicating their potential importance in assessing concussion severity in young patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Vestibular/Ocular Motor Screening is Independently Associated With Concussion Symptom Severity in Youths. Babicz, MA., Woods, SP., Cirino, P., et al.[2022]

In a study of 106 individuals with concussion, a significant number reported balance disturbances (54%) and dizziness (63%), but objective balance tests showed that only 66% and 58% had measurable balance impairments, respectively.

There was a poor correlation between self-reported balance symptoms and actual balance performance, suggesting that subjective reports may not accurately reflect objective balance deficits, which is important for assessing recovery in concussion patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Self-reported Balance Disturbance and Performance-Based Balance Impairment After Concussion in the General Population. Inness, EL., Sweeny, M., Habib Perez, O., et al.[2020]

In a study of 190 healthy youth athletes aged 11 to 18, 29.5% showed at least one abnormality in the visio-vestibular examination (VVE), but multiple abnormalities were rare, suggesting that finding several issues may indicate a concussion.

The VVE demonstrated consistent results across various patient characteristics and did not show significant associations with other concussion assessment tools like the SCAT-5, King-Devick, or Postconcussion Symptom Inventory, highlighting its unique role in evaluating potential concussions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Visio-Vestibular Deficits in Healthy Child and Adolescent Athletes. Corwin, DJ., McDonald, CC., Arbogast, KB., et al.[2023]

A new assessment model for vestibular and oculomotor impairments after a concussion showed high accuracy (98.6%) in distinguishing concussed athletes from healthy controls using specific tests, including the Sensory Organization Test and near point convergence.

A simplified version of the model, using only the optokinetic stimulation and gaze stabilization tests along with near point convergence, still achieved a high accuracy of 94.4%, suggesting it could be a practical tool for concussion management without needing expensive equipment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Vestibular and Oculomotor Assessments May Increase Accuracy of Subacute Concussion Assessment. McDevitt, J., Appiah-Kubi, KO., Tierney, R., et al.[2021]

In a study of 56 adolescents with recent concussions, postural sway was significantly greater when participants performed balance tasks with their eyes closed compared to when their eyes were open, indicating that visual input plays a crucial role in balance.

The study found that greater postural sway was associated with concussion symptoms like dizziness and confusion, suggesting that measuring sway could help assess balance impairments and the severity of symptoms in clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using Accelerometers to Record Postural Sway in Adolescents With Concussion: A Cross-Sectional Study. Alkathiry, AA., Sparto, PJ., Freund, B., et al.[2020]

Adolescents with concussion demonstrated significantly slower walking speeds and fewer steps per minute compared to uninjured controls, indicating impaired postural control shortly after injury.

Smartphone-based gait measures and tandem gait tests effectively distinguished between concussed adolescents and controls, with an excellent ability to differentiate groups (AUC = 0.91), highlighting the importance of using multiple assessment methods for recognizing postural control issues in concussed individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A multifaceted and clinically viable paradigm to quantify postural control impairments among adolescents with concussion. Howell, DR., Lugade, V., Potter, MN., et al.[2020]

References

1. United States pubmed.ncbi.nlm.nih.gov

Static and Dynamic Balance Assessment in Healthy and Concussed Adolescent Athletes. [2023]

2. Australia pubmed.ncbi.nlm.nih.gov

Tracking postural stability of young concussion patients using dual-task interference. [2016]

3. United States pubmed.ncbi.nlm.nih.gov

Vestibular/Ocular Motor Screening is Independently Associated With Concussion Symptom Severity in Youths. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Self-reported Balance Disturbance and Performance-Based Balance Impairment After Concussion in the General Population. [2020]

5. United States pubmed.ncbi.nlm.nih.gov

Visio-Vestibular Deficits in Healthy Child and Adolescent Athletes. [2023]

6. Germany pubmed.ncbi.nlm.nih.gov

Vestibular and Oculomotor Assessments May Increase Accuracy of Subacute Concussion Assessment. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Using Accelerometers to Record Postural Sway in Adolescents With Concussion: A Cross-Sectional Study. [2020]

8. England pubmed.ncbi.nlm.nih.gov

A multifaceted and clinically viable paradigm to quantify postural control impairments among adolescents with concussion. [2020]