Reliability and Association with Injury of Movement Screens: A Critical Review

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Abstract

Subjective assessment of athletes' movement quality is widely used by physiotherapists and other applied practitioners within many sports. One of the beliefs driving this practice is that individuals who display 'poor' movement patterns are more likely to suffer an injury than those who do not. The aim of this review was to summarize the reliability of the movement screens currently documented within the scientific literature and explore the evidence surrounding their association with injury risk. Ten assessments with accompanying reliability data were identified through the literature search. Only two of these ten had any evidence directly related to injury risk. A number of methodological issues were present throughout the identified studies, including small sample sizes, lack of descriptive rater or participant information, ambiguous injury definitions, lack of exposure time reporting and risk of bias. These factors, combined with the paucity of research on this topic, make drawing conclusions as to the reliability and predictive ability of movement screens difficult. None of the movement screens that appear within the scientific literature currently have enough evidence to justify the tag of 'injury prediction tool'.

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Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players.

Phillip Plisky, Mitchell Rauh, Thomas Kaminski … (2006)

Prospective cohort. To determine if Star Excursion Balance Test (SEBT) reach distance was associated with risk of lower extremity injury among high school basketball players. Although balance has been proposed as a risk factor for sports-related injury, few researchers have used a dynamic balance test to examine this relationship. Prior to the 2004 basketball season, the anterior, posteromedial, and posterolateral SEBT reach distances and limb lengths of 235 high school basketball players were measured bilaterally. The Athletic Health Care System Daily Injury Report was used to document time loss injuries. After normalizing for lower limb length, each reach distance, right/left reach distance difference, and composite reach distance were examined using odds ratio and logistic regression analyses. The reliability of the SEBT components ranged from 0.82 to 0.87 (ICC3,1) and was 0.99 for the measurement of limb length. Logistic regression models indicated that players with an anterior right/left reach distance difference greater than 4 cm were 2.5 times more likely to sustain a lower extremity injury (P<.05). Girls with a composite reach distance less than 94.0% of their limb length were 6.5 times more likely to have a lower extremity injury (P<.05). We found components of the SEBT to be reliable and predictive measures of lower extremity injury in high school basketball players. Our results suggest that the SEBT can be incorporated into preparticipation physical examinations to identify basketball players who are at increased risk for injury.

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Consensus statement on injury definitions and data collection procedures for studies of injuries in rugby union.

Willem Meeuwisse, C Fuller, Hilton Donson … (2007)

Wide variations in the definitions and methodologies used for studies of injuries in rugby union have created inconsistencies in reported data and made interstudy comparisons of results difficult. The International Rugby Board established a Rugby Injury Consensus Group (RICG) to reach an agreement on the appropriate definitions and methodologies to standardise the recording of injuries and reporting of studies in rugby union. The RICG reviewed the consensus definitions and methodologies previously published for football (soccer) at a meeting in Dublin in order to assess their suitability for and application to rugby union. Following this meeting, iterative draft statements were prepared and circulated to members of the RICG for comment; a follow-up meeting was arranged in Dublin, at which time all definitions and procedures were finalised. At this stage, all authors confirmed their agreement with the consensus statement. The agreed document was presented to and approved by the International Rugby Board Council. Agreement was reached on definitions for injury, recurrent injury, non-fatal catastrophic injury, and training and match exposures, together with criteria for classifying injuries in terms of severity, location, type, diagnosis and causation. The definitions and methodology presented in this consensus statement for rugby union are similar to those proposed for football. Adoption of the proposals presented in this consensus statement should ensure that more consistent and comparable results will be obtained from studies of injuries within rugby union.

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The Landing Error Scoring System (LESS) Is a valid and reliable clinical assessment tool of jump-landing biomechanics: The JUMP-ACL study.

Grayson W. Marshall, Michelle Boling, D N Padua … (2009)

Anterior cruciate ligament injuries are common in athletes and have serious sequelae. A valid clinical tool that reliably identifies individuals at an increased risk for ACL injury would be highly useful for screening sports teams, because individuals identified as "high-risk" could then be provided with intensive prevention programs. A clinical screening tool (the Landing Error Scoring System, or LESS) will reliably identify subjects with potentially high-risk biomechanics. Cohort study (Diagnosis); Level of evidence, 2. A jump-landing-rebound task was used. Off-the-shelf camcorders recorded frontal and sagittal plane views of the subject performing the task. The LESS was scored from replay of this video. Three-dimensional lower extremity kinematics and kinetics were also collected and used as the gold standard against which the validity of the LESS was assessed. Three trials of the jump-landing task were collected for 2691 subjects. Kinematic and kinetic measures were compared across LESS score quartiles using 1-way analysis of variance; LESS quartiles were compared across genders using the chi-square test. The LESS scores from a subset of 50 subjects were rescored to determine intrarater and interrater reliability. Subjects with high LESS scores (poor jump-landing technique) displayed significantly different lower extremity kinematics and kinetics compared with subjects with low LESS scores (excellent jump-landing technique). Women had higher (worse) LESS scores than men. Intrarater and interrater reliability of the LESS ranged from good to excellent. The LESS is a valid and reliable tool for identifying potentially high-risk movement patterns during a jump-landing task.