Title:
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The clinical utility of physical performance tests and their ability to predict injury
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Physical performance tests (PPTs) have great allure to sports medicine
professionals, coaches, and athletes because they are inexpensive, easy to perform in a
variety of settings, and reportedly can be used as outcome measures to determine
patient progress and readiness for return to sport as well as prognostic variables to
predict injury or performance. However, there has been no evidence-based summary
of literature with regard to the clinical utility of physical performance tests in athletes
and most studies examining the clinical utility of PPTs are of small sample size or
performed in limited populations. In addition, there are very few prospective studies
examining the predictive ability of PPTs in athletes with lower extremity injuries.
This dissertation encompasses 2 systematic reviews highlighting the absolute
dearth of evidence in existence, the introduction of some novel PPTs and the
establishment of their reliability, and a large, pragmatic, prospective study examining
the ability of PPTs to predict lower extremity injury in collegiate athletes. The most
notable findings of the prospective study are first, that PPTs fall cleanly into 5
constructs: stability, active motion, motor control, power, and flexibility. Next, the
constructs of hip stability and active motion predicted injury. Third, the construct of
motor control predicted overuse injury. Finally, the constructs of hip stability, active
motion, and motor control appear to modify the relationship between injury and prior
injury. Finally, the constructs represented by PPTs seem to be more powerful
predictors of injury than the previously established predictors of age, body mass
index, gender, and excessive flexibility when examined in a multivariate model.
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