THE DEVELOPMENT OF A REACTIVE BALANCE TEST

INTRODUCTION:Balance tests are commonly used in clinical practice with applicability in injury prevention and return to sport decisions.
While most sports injuries occur in a changing environment where reacting to a non-planned stimulus is of great importance, these
balance tests only evaluate pre-planned movements without taking these dynamics environmental aspects into account. Glasgow et al.
(2013) illustrated that reacting to a non-planned stimulus is of great importance in sports. They state that the key driver for effective sporting performance and injury prevention is the athlete’s ability to adapt his or her responses under a comprehensive variety of conditions
(1). Therefore, the goal of this paper is to develop a clinician-friendly test that respects these contextual interactions and to describe the
test protocol of an adapted y-balance test that includes environmental perception and decision-making.
METHODS: The methodology of Kazman et al (2016) (2) is used to systematically describe the development of the reactive balance test
(RBT). Within the theoretical construct of balance and adaptability, balance errors are selected as outcomes measures for balance ability
and visuomotor reaction time and accuracy are selected as outcome measures for adaptability. A reactive balance task is developed
and described using the Y-balance test for the balance component, while the FitLight training system© was chosen for the environmental
perception and decision-making component of the test.
RESULTS: This paper describes the test protocol of a reactive balance test as an adapted Y-balance test. Instructions and recommendations for standardized YBT protocol, with corresponding rationale for every recommendation are adopted from Plisky and colleagues
(2009) (3) and applied to the RBT. To induce cognitive load, the VMT task was developed using 12 randomised stimuli along each axis of
the YBT to reach a test duration of 90 to 120 seconds. Within the visuomotor task, colours are fixed to a corresponding axis with both the
order of the visual stimuli as the interstimulus time being randomised to integrate environmental perception and decision-making. The
reach distance of the reactive balance test is set to 80% of the maximal reach distance on each of the Y-balance axes to adequately
stress balance and induce balance errors, while still enabling the subject to timely continue the test sequence.
CONCLUSION: This test protocol describes a reactive balance test that adds environmental perception, decision-making and variable
motor responses as additional dynamic components to the construct of balance. The reactive balance test is a functional test that allows
clinicians to score balance ability and athlete adaptability easily.
References
1. Glasgow et al. (2013) BJSM.
2. Kazman et al. (2016) BJSM.
3. Plisky et al. (2009) N Am J Sports Phys Ther