Background Balance tests are often selected to screen for injury risk, but only evaluate pre-planned movements. Recently, adaptability was put forward as a key driver in injury prevention. Adaptability is defined as athletes’ ability to adequately adapt their responses under a comprehensive variety of conditions. The reactive balance test (RBT) is designed as a neurocognitive functional test that integrates environmental perception and decision-making to evaluate adaptability while maintaining unilateral balance.

Objective To determine test-retest, intra- and inter-rater reliability of the RBT in healthy recreational athletes.

Design Test-retest reliability study design.

Setting Primary prevention in clinical setting.

Participants Twenty-one healthy recreational athletes (age = 22±1 years, height = 175±9 cm, weight = 69±7 kg).

Interventions Two experimental trials were separated by an average of 33±15 days. During experimental trials participants performed the Y-balance test (to determine maximal reach distances) four times and the RBT once. The LED lights of the RBT were set at 80% of the maximal reach distance on each axis of the Y-balance test. The RBT consists out of 36 randomised stimuli.

Main Outcome Measurements Outcome measures of the RBT are accuracy and visuomotor response time. Intraclass correlation coefficients (ICC), standard errors of measurement and prediction, and minimal detectable difference were calculated.

Results Excellent intra- rater reliability was observed for visuomotor response time (ICC: 0.992, [0.981;0.997]) and accuracy (ICC: 0.925, [0.827;0.969]). Excellent inter-rater reliability was also observed for both visuomotor response time (ICC: 0.978, [0.946;0.991]) and accuracy (ICC: 0.920, [0.803;0.968]). Test-retest reliability for visuomotor response time could be considered good (ICC: 0.831, [0.629;0.928]), while moderate test-retest reliability was found for accuracy (ICC: 0.706, [0.420;0.820]).

Conclusions Our results indicate that overall test-retest, intra- and inter-rater reliability of the RBT was moderate to excellent. Thus, the RBT possesses acceptable reliability to use in group level analyses. Future research should further determine the clinimetric properties of the RBT in specific populations and research the RBT along the sport injury continuum.