Healthy Subjects
Conditions
Keywords
Y-Balance Test, Ankle Strength, Ankle Function, Exercise Training, Lower Limb Injury Risk
Brief summary
This randomized controlled study investigated whether a 6-week home-based training program based on the Y-Balance Test could improve ankle function and lower limb functional performance in university students. The Y-Balance Test is a functional task that involves standing on one leg while reaching in different directions with the other leg, and it is commonly used to assess dynamic balance and postural control. Participants were randomly assigned to either an experimental group, which performed the Y-Balance Test-based training program, or a control group, which maintained its usual routine without intervention. All participants were assessed at baseline and after 6 weeks. The study assessed Y-Balance Test performance, weight-bearing ankle dorsiflexion, ankle maximal isometric strength, and self-reported ankle function. These outcomes were selected because they are relevant components of ankle function and lower limb performance. The main goal of the study was to determine whether this structured training program led to greater improvements in Y-Balance Test composite score than no intervention. Secondary aims included assessing changes in normalized reach distances, ankle dorsiflexion, ankle strength, and self-reported ankle function. The study did not directly assess injury incidence, but focused on functional measures commonly used in the assessment of factors related to lower limb injury risk.
Interventions
BEHAVIORALY-Balance Test-Based Training Program
Participants completed a 6-week home-based training program based on the Y-Balance Test, performed 5 times per week, for a total planned dose of 30 sessions. The program used a paper Y-Balance Test kit provided to participants. In each session, participants performed six maximal attempts per lower limb, reaching in the anterior, posteromedial, and posterolateral directions. Rest between attempts was self-managed. The program was self-administered, with initial face-to-face instructions and access to online demonstration videos.
Sponsors
Aveiro University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Intervention model description
Participants were randomly assigned in a 1:1 ratio to one of two parallel groups using a sex-stratified block randomization procedure. The experimental group completed a 6-week Y-Balance Test-based home training program, while the control group maintained its usual routine without intervention. Assessments were conducted at baseline and after 6 weeks.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Enrolled in an undergraduate degree at the School of Health Sciences, University of Aveiro. Aged 18 years or older. Able and willing to provide written informed consent.
Exclusion criteria
Current pain, injury, or medical condition that prevents the safe performance of the study assessments, based on self-report during the baseline assessment. Unable to comply with the intervention protocol or the assessment sessions. Not willing to agree to the terms of the informed consent.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from Baseline in Dominant Lower Limb Y-Balance Test Composite Score at 6 Weeks | Baseline and 6 weeks | Composite score (%) of the dominant lower limb calculated from the maximal reach distances in the anterior, posteromedial, and posterolateral directions of the Y-Balance Test, normalized to lower limb length using the formula: \[(anterior + posteromedial + posterolateral) / (3 × lower limb length)\] × 100. Higher values indicate better performance on the test. |
| Change from Baseline in Non Dominant Lower Limb Y-Balance Test Composite Score at 6 Weeks | Baseline and 6 weeks | Composite score (%) of the non dominant lower limb calculated from the maximal reach distances in the anterior, posteromedial, and posterolateral directions of the Y-Balance Test, normalized to lower limb length using the formula: \[(anterior + posteromedial + posterolateral) / (3 × lower limb length)\] × 100. Higher values indicate better performance on the test. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change from Baseline in Dominant Ankle Weight-Bearing Dorsiflexion at 6 Weeks | Baseline and 6 weeks | Weight-bearing ankle dorsiflexion measured using the Knee-to-Wall Test. The distance between the great toe and the wall was recorded in centimeters at the maximal position in which the participant could touch the knee to the wall while maintaining the heel in contact with the floor. The mean of three trials was used. Higher values indicate greater weight-bearing dorsiflexion. |
| Change from Baseline in Non Dominant Ankle Weight-Bearing Dorsiflexion at 6 Weeks | Baseline and 6 weeks | Weight-bearing ankle dorsiflexion measured using the Knee-to-Wall Test. The distance between the great toe and the wall was recorded in centimeters at the maximal position in which the participant could touch the knee to the wall while maintaining the heel in contact with the floor. The mean of three trials was used. Higher values indicate greater weight-bearing dorsiflexion. |
| Change from Baseline in Dominant Ankle Inversion Maximal Isometric Strength at 6 Weeks | baseline and 6 weeks | Maximal isometric strength of Dominant ankle inversion measured using a microFET2 handheld dynamometer during a standardized make test. Three maximal 5-second contractions were performed, and the highest peak force was used for analysis. Results are expressed in kilogram-force (kgf), with higher values indicating greater maximal isometric strength. |
| Change from Baseline in Non Dominant Ankle Inversion Maximal Isometric Strength at 6 Weeks | Baseline and 6 weeks | Maximal isometric strength of Non Dominant ankle inversion measured using a microFET2 handheld dynamometer during a standardized make test. Three maximal 5-second contractions were performed, and the highest peak force was used for analysis. Results are expressed in kilogram-force (kgf), with higher values indicating greater maximal isometric strength. |
| Change from Baseline in Dominant Ankle Eversion Maximal Isometric Strength at 6 Weeks | Baseline and 6 weeks | Maximal isometric strength of Dominant ankle eversion measured using a microFET2 handheld dynamometer during a standardized make test. Three maximal 5-second contractions were performed, and the highest peak force was used for analysis. Results are expressed in kilogram-force (kgf), with higher values indicating greater maximal isometric strength. |
| Change from Baseline in Non Dominant Ankle Eversion Maximal Isometric Strength at 6 Weeks | Baseline and 6 weeks | Maximal isometric strength of non Dominant ankle eversion measured using a microFET2 handheld dynamometer during a standardized make test. Three maximal 5-second contractions were performed, and the highest peak force was used for analysis. Results are expressed in kilogram-force (kgf), with higher values indicating greater maximal isometric strength. |
| Change from Baseline in Dominant Ankle Dorsiflexion Maximal Isometric Strength at 6 Weeks | baseline and 6 weeks | Maximal isometric strength of Dominant ankle dorsiflexion measured using a microFET2 handheld dynamometer during a standardized make test. Three maximal 5-second contractions were performed, and the highest peak force was used for analysis. Results are expressed in kilogram-force (kgf), with higher values indicating greater maximal isometric strength. |
| Change from Baseline in Non Dominant Ankle Dorsiflexion Maximal Isometric Strength at 6 Weeks | Baseline and 6 weeks | Maximal isometric strength of Non Dominant ankle dorsiflexion measured using a microFET2 handheld dynamometer during a standardized make test. Three maximal 5-second contractions were performed, and the highest peak force was used for analysis. Results are expressed in kilogram-force (kgf), with higher values indicating greater maximal isometric strength. |
| Change from Baseline in Dominant Ankle Plantar Flexion Maximal Isometric Strength at 6 Weeks | Baseline and 6 weeks | Maximal isometric strength of Dominant ankle plantar flexion measured using a microFET2 handheld dynamometer during a standardized make test. Three maximal 5-second contractions were performed, and the highest peak force was used for analysis. Results are expressed in kilogram-force (kgf), with higher values indicating greater maximal isometric strength. |
| Change from Baseline in Non Dominant Ankle Plantar Flexion Maximal Isometric Strength at 6 Weeks | Baseline and 6 weeks | Maximal isometric strength of Non Dominant ankle plantar flexion measured using a microFET2 handheld dynamometer during a standardized make test. Three maximal 5-second contractions were performed, and the highest peak force was used for analysis. Results are expressed in kilogram-force (kgf), with higher values indicating greater maximal isometric strength. |
| Change from Baseline in Dominant Ankle Self-Reported Function Assessed by the Portuguese Cumberland Ankle Instability Tool at 6 Weeks | Baseline and 6 weeks | Self-reported Dominant ankle function and perceived instability assessed using the Portuguese version of the Cumberland Ankle Instability Tool. The questionnaire contains nine items and is scored separately for each ankle. The total score ranges from 0 to 30, with higher scores indicating better self-reported ankle function and less perceived instability. |
| Change from Baseline in Non Dominant Ankle Self-Reported Function Assessed by the Portuguese Cumberland Ankle Instability Tool at 6 Weeks | Baseline and 6 weeks | Self-reported Non Dominant ankle function and perceived instability assessed using the Portuguese version of the Cumberland Ankle Instability Tool. The questionnaire contains nine items and is scored separately for each ankle. The total score ranges from 0 to 30, with higher scores indicating better self-reported ankle function and less perceived instability. |
| Change from Baseline in Dominant Lower Limb Y-Balance Test Anterior Reach Distance at 6 Weeks | Baseline and 6 weeks | Normalized reach distance (%) in the specified Y-Balance Test direction, calculated as maximal reach distance divided by lower limb length and multiplied by 100. Higher values indicate better reach performance in that direction. |
| Change from Baseline in Non-Dominant Lower Limb Y-Balance Test Anterior Reach Distance at 6 Weeks | Baseline and 6 weeks | Normalized reach distance (%) in the specified Y-Balance Test direction, calculated as maximal reach distance divided by lower limb length and multiplied by 100. Higher values indicate better reach performance in that direction. |
| Change from Baseline in Dominant Lower Limb Y-Balance Test Posteromedial Reach Distance at 6 Weeks | Baseline and 6 weeks | Normalized reach distance (%) in the specified Y-Balance Test direction, calculated as maximal reach distance divided by lower limb length and multiplied by 100. Higher values indicate better reach performance in that direction. |
| Change from Baseline in Non-Dominant Lower Limb Y-Balance Test Posteromedial Reach Distance at 6 Weeks | Baseline and 6 weeks | Normalized reach distance (%) in the specified Y-Balance Test direction, calculated as maximal reach distance divided by lower limb length and multiplied by 100. Higher values indicate better reach performance in that direction. |
| Change from Baseline in Dominant Lower Limb Y-Balance Test Posterolateral Reach Distance at 6 Weeks | Baseline and 6 weeks | Normalized reach distance (%) in the specified Y-Balance Test direction, calculated as maximal reach distance divided by lower limb length and multiplied by 100. Higher values indicate better reach performance in that direction. |
| Change from Baseline in Non-Dominant Lower Limb Y-Balance Test Posterolateral Reach Distance at 6 Weeks | Baseline and 6 weeks | Normalized reach distance (%) in the specified Y-Balance Test direction, calculated as maximal reach distance divided by lower limb length and multiplied by 100. Higher values indicate better reach performance in that direction. |
Countries
Portugal
Contacts
PRINCIPAL_INVESTIGATORMário A Lopes, PhD
Escola Superior de Saúde da Universidade de Aveiro
Outcome results
None listed