Differences On The Upper Quarter Y Balance Test Among Young People

Abstract

Upper Quarter Y-Balance Test is a closed kinetic chain assessment of upper quarter mobility and stability using a functional testing device. We started with the question: Are there significant differences in the bilateral upper limbs UQYBT results, recorded by the subjects engaged and not engaged in recreational physical activities? The study identifies bilateral movement limitations and asymmetries in active and not-active young people on shoulder stability and mobility as a closed kinetic chain upper extremity. The subjects are 93 young students (45 females and 48 males), 22.19 average age. They are organised in four groups: not-active and active (females and males). UQYBT is applied on all four groups of subjects. Mathematics methods as One Way ANOVA for Dependent samples and Post ANOVA Tukey HSD Test were used to identify the significant statistic differences between groups. The comparative analysis between active versus not-active groups suggests not significant statistic differences for males. For the female groups, there are not statistically significantly differences, with a few exceptions. There were statistically significantly differences, to benefit the active group, for the right upper limb (SL direction) and for the left upper limb (IL direction). The main conclusion is that UQYBT may be useful in assessing functional deficit in upper extremity stability.

Keywords: Young peoplemobilitystabilityUQYBT

Introduction

There are some factors which contribute shoulder mobility and its stability. Mobility is influenced

by type of joint and articular disc. Stability is influenced by the strong of capsule and ligaments. Joint

mobility is the range of movement around joint. Stability is the ability to maintain and control joint

position and movement. Normal limits of mobility and stability ensure active live and prevent injuries and

provide best function and high performance.

The shoulder is a complex joint that ensures adequate stability and full mobility. The upper limbs

joint the skeleton thoracic and form the shoulder. This is complex mechanical system in the human body,

consisting of bones: the scapula, humerus and clavicle. “These bones interact with each other through

three joints: sternoclavicular, acromioclavicular and scapulothoracic” (Posea & Pasol, 2014).

The sternoclavicular joint provides the movements of the upper limb, and has a high degree of

mobility. This joint provides much stability, as it is the only connection between the upper limb and the

axial skeleton. The scapulothoracal articulation is joints the scapula and dorsal thorax. It is not a true

anatomic joint because it lacks a synovial capsule and there are between the anterior surface of the

scapula and the thorax. “The acromioclavicular joint is a diarthrodial joint between the medial clavicular

facet of the acromion and the distal clavicle. Muscles that cross the joint are Deltoid and Trapezius and

provide dynamic suspensory support” (Nenciu, 2014).

“The interaction between bones produces smooth coordinated movements of the shoulder, such as

reaching; alterations in the position and/or orientation of any of these joints and articulation may interfere

with optimal shoulder coordination” (Amasay and al. 2016). “There is a wide range of shoulders

movement: extension, flexion, abduction, adduction, internal rotation, external rotation” (Sidenco, 2012).

Problem Statement

Gorman and al. (2012) found that “the examination of gender (aged 19-47 years) differences on

the UOYBT revealed no statistically significant differences between men and women for any of the 3

reach directions. The highest scores were recorded for the medial reach, followed by the inferolateral

reach, and then the superolateral reach”. Amasay and al. (2016) underline that in their study the

participants achieved the highest scores during the MR, followed by the ILR, and the lowest scores during

the SLR in both groups the SDK and normal shoulders.

Butler and colleagues (2014) used the UOYBT for collegiate swimmers. No differences were

observed for reach symmetry in any direction. Further, performance on several UOYBT indices was

worse for female than male collegiate swimmers. The test results may have implications for the use of

preseason and return-to-sport testing in swimmers as a measurement of upper quarter function and

symmetry.

Literature points to a higher recurrence rate of the young people and increase functional

impairment in instability that could provoke hyperlaxity of bone and bone injuries. Robinson et al. (2006)

demonstrated that young people and males are more exposed to recurrent shoulder instability. More they

found out that “86% of patients aged 15-20 and 71% aged 21-25 who suffered a primary traumatic

anterior shoulder dislocation, experienced recurrent instability after 3 to 5 years”.

Repeated overhead sports are not indicated on the surgery repaired unstable shoulder. Park et al.

(2013), show that “only 50% of elite athletes overhead sports returned to play at their previous level after

surgery repaired unstable shoulder; in their experiences managing the expectations of the athletic patients

with shoulder instability can be difficult”.

The results of Zahar et al. (2012) study suggest “that patients with shoulder impingement

syndrome will perform worse on the UQYBT in the medial and inferolateral directions than healthy

controls. Thus, upper extremity closed kinetic chain exercises should be added in shoulder rehabilitation

programs”.

Heinbaugh et al. (2015) investigated the effect of time-of-day (morning vs. afternoon) on static

and dynamic balance in recreational athletes. Time-of-day had a minimal effect on dynamic balance and a

noticeable effect on static balance. So, the authors considered that “time-of-day may be a factor in

designing balance training programmes and intervention studies for recreational athletes”.

The objective of Myers et al. study (2015) was to compare performance on the UQYBT between

athletes, whose sport requires some degree of closed chain activity (wrestlers), and athletes whose sport is

primarily open kinetic chain in nature (baseball players). The findings suggest that wrestlers perform

better on the UQYBT than baseball players. The conclusion of their study may suggest a sport specific

normative data for the UQYBT in high school athletes.

Borms et al. (2016) investigated the relationship between isokinetic strength testing for shoulder

and elbow and UQYBT performance in overhead athletes. Performance on the UQYBT did not seem to

be related to upper limb strength. It can help determine rehabilitation goals for injured overhead athletes

because no differences were found in the dominant and not dominant limbs in population of healthy

overhead athletes.

Borsa et al. (2008) point that overhead athletes require a delicate balance of shoulder mobility and

stability in order to meet the functional demands of their respective sport. Altered shoulder mobility has

been reported in overhead athletes and is thought to develop secondary to adaptive structural changes to

the joint resulting from the extreme physiological demands of overhead activity.

Research Questions

We base our research on the following hypotheses:

�Are there significant differences in the bilateral shoulder UQYB test results (right shoulder

versus left shoulder) recorded by the subjects engaged in recreational physical activities?

�Are there significant differences in the bilateral shoulder UQYB test results (right shoulder

versus left shoulder) recorded by the subjects not engaged in recreational physical activities?

�Are there significant differences between the UQYB test results recorded by the subjects

engaged in recreational physical activities and the ones obtained by the subjects who do not

pursue such activities?

Purpose of the Study

The purpose of the study is to report the differences in the Upper Quarter Y Balance Test results

recorded by the young people. The study identifies bilateral movement limitations and asymmetries in

active and not-active young people on shoulder stability and mobility as a closed kinetic chain upper

extremity.

Research Methods

Findings

Findings on groups:

Female – active group

Anthropometric findings

The active group consists of 23 young females. All of them are healthy and no pathological events

are recorded in the last 6 months. The average age of the group is 21.16 years. The oldest subject is 26

years old, while the youngest is 19. The average height at the group level is 167.16 cm. The average

weight is 57.58 kg. The body mass index is 20.63 kg/m2, a value that places the subjects in the reference

weight values, in relation to their age.

Upper Quarter Y Balance Test

Intragroup review One Way ANOVA for Dependent samples (Table 02 )

Upper limb - right. M direction reach average that measures 90.16 cm is the best result for right

limb. The opposite average value is for the SL direction (67.16 cm). On M direction the group has high

homogeneity level (Cv = 8.97%). For the SL direction, the individual values reflect the lack of

homogeneity (Cv = 25.06%). The group has no homogeneity on SL direction and medium homogeneity

for IL direction reach. The best individual value recorded within the female’s group is 102.00 cm for the

SL direction and the lowest individual value for the same limb is 44.99 cm for the SL direction.

Upper limb - left. The results for left upper limb show the best average for M direction with 93.50

cm, but the lowest average is recorded on SL direction (63.75 cm). The active group has high

homogeneity (Cv = 7.73) on M direction and medium homogeneity for the last two directions. The best

individual result recorded within women’s active group is 105 cm on M distance reach, and the opposite

individual value for the same group is 40 cm on SL direction.

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The analysis of the average values recorded by the active women’s group for the two event series

(right upper limb vs. left upper limb), reflects differences between the upper limbs for the three similar

directions. For the M direction, the difference is 3.33 cm, for the SL direction, the difference is 3.41,

while for the IL direction, we notice a 0.25 cm difference. The Critical ANOVA Tukey Test indicates no

significant differences between the upper limbs for the three directions – M, SL, and IL. There are not

statistically significant differences in composite scores.

Males – not active group

Anthropometric results

The not-active group has 26 subjects, who are clinically healthy, with a clear medical bill for the

last 6 months. The average age of this group is 22.45, with a maximum age of 29 and a minimum of 19.

The average body height is of 175.10 cm with a medium weight of 74.65 kg. The body mass index is

24.50 kg/m2. The not-active group is within the normal limits of the body weight.

Upper Quarter Y Balance Test

Intragroup review One Way ANOVA for Dependent samples (table 03 )

The upper – right. The highest average value for the M direction is 102.00 cm, while the lowest

average value for the SL direction is 79.04 cm. For IL, the group average is 87.75 cm. Homogeneity of

the group can be noticed for all directions, with the variability coefficient oscillating between 6.34 and

8.20, an interval that indicates a very low good dispersion of the individual values. The best individual

result of the not-active male group is 109.00 cm on the M direction. For the same right limb, the lowest

individual value is 78.00 cm for SL.

Upper limb – left. Among all three directions, the highest average value is still on M (97.95 cm),

while the lowest average value is on SL (76.65 cm). Homogeneity is good on all the directions in the

upper left limb. The longest individual distance has been obtained for the left arm on the M direction

(105.00 cm). At the opposite end, the lowest individual value is 66.00 cm on SL.

Intergroup review Post ANOVA Tukey HSD Test (table 03 )

The comparison refers to the not-active male group, between the average values for the upper

limbs (right versus left) for all three directions: M, SL and IL distance, as per the UPPER QUARTER Y-

BALANCE test. We notice small differences between the two segments, on all directions: Medial =4.05

cm; SL =2.29 cm; IL =1.67 cm. When applying the Critical ANOVA Turkey test, it is confirmed that the

differences coming from right versus left, for the directions M, SL and IL are insignificant, at the trust

threshold 0.01 and 0.05. It seems that the composite scores indicate no significant differences in bilateral

upper limbs for not active male group.

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Males – active group

Anthropometric results

The active group is made of 22 young males, clinically healthy. The average age of this group is

23.15, with a variation between 29 and 19. The average body height is 179.10 cm and the average weight

is 78.75 kg. The body mass index is 24.70 kg/m2, and this average value indicates a normality of the

body weight in the active group.

Upper Quarter Y Balance Test

Intragroup review One Way ANOVA for Dependent samples (Table 04)

Upper limb – right. M= 105.56 cm is the best result on all three directions. The average value of

80.26 cm describes the group for the direction SL (91.69 cm). The active group is homogeneous on all

directions, where Cv has values under 10 %. The best individual result is 119 cm on M direction, and the

worst is 71.00 cm on SL direction.

Upper limb – left. The average value is still on direction M (103.26 cm); for the same group, the

average value is the lowest on SL direction (75.95 cm). Homogeneity is good only on direction M (Cv =

9.76%). For the other directions, homogeneity is average. The best individual result was for the left arm

on SL (118.00 cm), opposed to 54.00 cm on the direction of SL.

Intergroup review Post ANOVA Turkey HSD Test (Table 04)

The comparison between the upper limbs, right versus left, takes into account the results obtained

on all three directions: M, SL and IL. While comparing the average values, there are small differences

between the upper right and left limbs: Medial=2.30 cm; SL =4.30 cm; IL=4.21 cm. The critical ANOVA

Turkey test confirms the fact that the differences noticed for the superior right and left limb, for the M, SL

and IL directions are not statistically significant for bilateral upper limbs. The composite scores don’t

indicate significant differences in bilateral upper limbs.

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Conclusion

The results derived and statistically processed prove the fact that the homogeneity of the female

groups is relative. The differences between the bilateral results under all aspects examined by UQYBT

are not significant.

Both male groups share the same relative homogeneity. The differences coming from the bilateral

UQYBT are not significant.

The comparative analysis between the active versus not-active groups proves insignificant

differences for males. For the female groups, there are insignificant differences, with a few exceptions.

There will be significant differences to benefit the active group, for the right limb (SL direction) and for

the left limb (IL direction).

The conclusion is that the closed kinetic chain of the shoulders provides stability and balance for

the subjects of both genders, to the same extent. The UQYB is a test that can be used to assess bilateral

function in a closed chain manner. The UQYBT appears to be strong related to dynamic tests involving in

mobility stability. Similarity on the UQYBT between dominant and not-dominant limbs indicates that

performance on this test using may serve as a reasonable measure for young people.

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