Validity of Functional Screening Tests to Predict Lost-Time Lower Quarter Injury in a Cohort of Female Collegiate Athletes

Abstract

Background: Lower quarter injuries account for more than 50% of all injuries in collegiate athletics. Neuromuscular screening tests could potentially identify athletes who are at risk for sustaining an injury. While previous research has studied individual tests, the authors of this paper are unaware of any study that has compared diagnostic accuracy of multiple neuromuscular screening tests within one study cohort. Hypothesis/Purpose:The purpose of this study was to examine the accuracy of three common neuromuscular screening tests to predict the occurrence of a lower quarter injury in female collegiate volleyball and basketball players. Study Design: Prospective CohortMethods: Thirty-five subjects underwent a pre-season screening by performing the Y-balance test, the Functional Movement Screen™, and Single Leg Hop test. Data were collected on lower quarter injury incidence, lost practice time, and lost competition time among subjects throughout the course of one season. Receiver operating characteristics curves were plotted and area under the curve was calculated to assess the relationship between lower extremity injury incidence and the scores of the functional tests. Results:Lost-time injuries occurred in 11 athletes (31.4%), of whom, six athletes (17.1%) lost 50 hours or greater. There were no significant relationships between occurrence of a lost-time lower extremity injury and scores on any of the three tests. Positive and negative likelihood ratios all included the value of 1.0. Conclusions:Although reliable, the screening tests under study did not appear to retain adequate validity to predict lower quarter injury risk within these female collegiate athletes. Level of Evidence: Level 2b

The relationship between physical fitness attributes and sports injury in female, team ball sport players: a systematic review

“…Online resource 3 outlines the key data extracted for this review. Of the 44 studies included, the most frequently studied team ball sport was soccer (represented in 24 studies; 55%) [ 61 – 84 ], followed by basketball (represented in 14 studies, 32%) [ 64 , 65 , 71 , 73 , 83 , 85 – 93 ], and volleyball (represented in 7 studies, 16%) [ 64 , 71 , 83 , 89 – 91 , 94 ]. Other team ball sports investigated included handball [ 81 , 90 , 95 , 96 ], netball [ 97 – 100 ], softball [ 101 – 103 ], field hockey [ 61 , 65 ], lacrosse [ 61 ], and rugby union [ 104 ].…”

“…Time-loss injury definition was used by eight studies [ 74 , 75 , 77 , 80 , 87 , 91 , 92 , 94 ], three studies defined injury by medical attention [ 83 , 98 , 99 ], and two studies utilised both time-loss and medical attention injury definitions [ 71 , 79 ]. Most studies investigated lower body injuries prospectively (levels I and II), and were categorised as any injury to the lower quarter [ 91 ], lower extremity [ 75 , 87 , 92 ], or low back/lower extremity [ 98 ]; acute [ 79 ] or traumatic [ 80 ] injury to the lower extremity; noncontact injuries to the lower extremity injury [ 71 , 79 ] or low back/lower extremity [ 83 , 94 ]; or overuse lower extremity injuries [ 77 , 80 ]. The remaining two studies were retrospective cohort (level II) [ 74 ] and cross-sectional (level III) [ 99 ] in design and used any lower extremity or low back/lower extremity injury classifications, respectively.…”

“…The remaining two studies were retrospective cohort (level II) [ 74 ] and cross-sectional (level III) [ 99 ] in design and used any lower extremity or low back/lower extremity injury classifications, respectively. Three studies were considered to have poor methodological quality and/or high ROB [ 71 , 91 , 92 ].…”

“… Coding: n / N = number of significant associated relationships divided by total number of relationships investigated. The number of relationships is reported with the study reference number in brackets Data removed from univariate analyses’ data synthesis due to poor methodological quality and/or high risk of bias included the following: muscular strength measures (6 relationships [ 92 ]), flexibility measures (4 relationships [ 91 ]), balance measures (10 relationships [ 91 ]), coordination measures (1 relationship [ 71 ], 9 relationships [ 91 ]), and power measures (2 relationships [ 91 ]). Data removed from multivariate analyses’ data synthesis due to poor methodological quality and/or high risk of bias included the following: body composition measures (2 relationships [ 71 ]), balance measures (1 relationship [ 71 ]), coordination measures (6 relationships [ 71 ]), and flexibility measures (2 relationships [ 71 ]) …”

Preseason Lower Extremity Functional Test Scores Are Not Associated With Lower Quadrant Injury – A Validation Study With Normative Data on 395 Division Iii Athletes

“…However, since this initial report, 12 a majority of subsequent studies have failed to validate the original cutoff score (14 or less) and have failed to identify an alternate composite cutoff score for the FMS in order to discriminate injury risk in various sport populations. [13][14][15][16][17][18][19][20] Likewise, Plisky et al reported that female high school basketball players were 6.5 times more likely to have experienced a lower extremity injury when their composite score on the star excursion balance test (later developed into the Y-balance test) was less than or equal to 94 percent of their lower extremity (LE) length. 8 Subsequent studies, albeit with different sport populations, have reported different cutoff scores.…”