The Pro sports blog
The material provided here is general information and individual advice should be obtained with an evaluation or assessment by an appropriate physical therapist
Connor Fedge, SPT
Return to sporting activity is the final phase of the rehabilitation process for many athletes. It is an essential step to be sure that the patient can safely return to a practice or game situations without putting him or herself at an increased risk for injury. However, many authors agree that before beginning sport specific movements certain criteria must be met. It has been reported in the literature that a patient rehabilitating an upper extremity injury should demonstrate the following prior to beginning return to sport training; full functional range of motion, no pain or tenderness, strength 75- 80% to the non injured extremity and satisfactory shoulder stability. The Gleno- Humeral joint is designed more for mobility than stability; therefore neuromuscular control is required to create a stable joint. Neuromuscular control is difficult to assess with a single measurement, therefore the each of the factors that impact shoulder stability needs to be thoroughly assessed. Numerous studies have pointed out that there is a lack of a correlation from certain measurements (strength, ROM, subjective reports, etc.) and the ability to perform functional activity, emphasizing the importance of functional testing. Functional testing is common in the lower extremity when attempting to return to sporting activity, however there is a lack of evidence and tests that involve the upper extremity. The following presentation explains and summarizes nine upper extremity functional tests and discusses the strengths and weaknesses of each. More research is needed to determine the ideal populations or outcomes in many of these tests, yet despite the lack of statistical support they may still contribute to the assessment of the upper extremity shoulder stability. For more information: 1. Wilk, Kevin E., et al. "Current concepts in the recognition and treatment of superior labral(SLAP) lesions." Journal of Orthopaedic & Sports Physical Therapy 35.5 (2005): 273-291. 2. Wilk K, Romaniello W, Soscia S, Arrigo C, Andrews J. The relationship between subjective knee scores, isokinetic testing, and functional testing in the ACL-reconstructed knee. J Orthop Sports Phys Ther. 1994;20:60–73. 3. Wilk, Kevin E., Christopher A. Arrigo, and James R. Andrews. "Current concepts: the stabilizing structures of the glenohumeral joint." Journal of Orthopaedic & Sports Physical Therapy 25.6 (1997): 364-379. 4. Wilk, Kevin E., and Christopher Arrigo. "Current concepts in the rehabilitation of the athletic shoulder." Journal of Orthopaedic & Sports Physical Therapy 18.1 (1993): 365-378 5. Yang JL, Lin JJ. Reliability of function-related tests in patients with shoulder pathologies. J Orthop Sports Phys Ther. 2006;36:572-576. https://doi.org/10.2519/jospt.2006.2133 6. Shah, Kshamata M., Timothy Baker, Abigail Dingle, Thomas Hansmeier, Matthew Jimenez, Sarah Lopez, Dylan Marks, Daniel Safford, Amanda Sternberg, Jeffrey Turner, and Philip W. Mcclure. "Early Development and Reliability of the Timed Functional Arm and Shoulder Test." Journal of Orthopaedic & Sports Physical Therapy 47.6 (2017): 420-31. Web. 7. Kumta P, MacDermid JC, Mehta SP, Stratford PW. The FIT-HaNSA demonstrates reliability and convergent validity of functional performance in patients with shoulder disorders. J Orthop Sports Phys Ther. 2012; 42: 455– 464. https://doi.org/10.2519/jospt.2012.3796 [Link] 8. MacDermid, Joy C et al. “Validation of a New Test That Assesses Functional Performance of the Upper Extremity and Neck (FIT-HaNSA) in Patients with Shoulder Pathology.” BMC Musculoskeletal Disorders 8 (2007): 42. PMC. Web. 14 June 2017. 9. Negrete, Rodney J., et al. "Reliability, minimal detectable change, and normative values for tests of upper extremity function and power." The Journal of Strength & Conditioning Research 24.12 (2010): 3318-3325 10. Baumgartner, Ted A., et al. "Objectivity, reliability, and validity for a revised push-up test protocol." Measurement in Physical Education and Exercise Science 6.4 (2002): 225-242. 11. Goldbeck TG, Davies GJ. (2000). Test-retest reliability of the Closed Kinetic Chain Upper Extremity Stability Test: a clinical field test. J Sport Rehabil. 9:35-45. 12. Hegedus EJ, Vidt, ME & Tarara, DT. (2014). The best combination of physical performance and self-report measures to capture function in three patient groups. Physical Therapy Reviews. 19(3), 196-203. 13. Roush, J. R., Kitamura, J., & Waits, M. C. (2007). Reference Values for the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) for Collegiate Baseball Players. North American Journal of Sports Physical Therapy : NAJSPT. 2(3), 159–163. 14. Schulte-Edelman, J, Davies, GJ, Kernozek, TW, & Gerberding, ED. (2005). The Effects of Plyometric Training of the Posterior Shoulder and Elbow. Journal of Strength and Conditioning Research. 19(1), 129-134. 15. Tucci, HT, Martins, J, Carvalho Sposito, G, Camarini, PM, Siriani de Oliveria, A. (2014). Closed Kinetic Chain Upper Extremity Stability test (CKCUES test): a reliability study in persons with and without shoulder impingement syndrome. BMC Musculoskeletal Disorders. 15(1), 1-9. 16. Butler, Robert J., Myers, Heather S., Black, Douglass et al. (2014). Bilateral Differences in Upper Quarter Function of High School Aged Baseball and Softball Players. The International Journal of Sports Physical Therapy, 9(4). 518-524. 17. Garrigues, G., Gorman, P., Plisky, P., Kiesel, K., Myers, H., Black, D. Queen, R., Butler, R. (2012). Differences on the Upper Quarter Y Balance Test Between High School and College Baseball Players. American College of Sports Medicine. 18. Gorman, P. P., Butler, R. J., Plisky, P. J., & Kiesel, K. B. (2012). Upper quarter y balance test:reliability and performance comparison between genders in active adults. Journal of Strength and Conditioning Research, 26(11), 3043-3048 19. Hazar, Z., Ulug, N., Yuksel, I. (2014). Upper Quarter Y Balance Test score of patients with shoulder impingement syndrome. Orthopaedic Journal of Sports Medicine, 2(3). 20. Teyhen, Deydre S., Riebel, Mark A., McArthur, Derrick R. et al. (2014). Normative Data and the Influence of Age and Gender on Power, Balance, Flexibility, and Functional Movement in Healthy Service Members. Military Medicine, 179(4), 413-420. 21. Westrick, R. B., PT, DPT, DSc, OCS, SCS, Miller, J. M., PT, DPT, DSc, OCS, SCS, Carow, S. D., PT, DPT, DSc, OCS, & Gerber, J. P., PT, PhD, SCS, ATC. (2012). Exploration of the Y-balance test for assessment of upper quarter closed kinetic chain performance. The International Journal of Sports Physical Therapy, 7(2), 140-147. 22. Falsone SA, Gross MT, Guskiewicz KM, et al. Onearm hop test: reliability and effects of arm dominance. J Orthop Sports Phys Ther. 2002;32(3):98- 103
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AuthorPRO Sports Staff and Students Archives
February 2021
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