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

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.