Missing The Forest For The Trees: A Lack Of Upper Extremity Physical Performance Testing In Sports Physical Therapy.
Matthew L Gauthier, Casey A Unverzagt, Luciana De Michelis Mendonça and 1 others
PMID 37020447WHAT IT FOUND
Most surveyed sports physical therapists reported using time, range of motion, manual muscle tests, readiness and questionnaires to clear athletes after shoulder or elbow injury while upper limb performance tests were uncommon.
Equipment, time, and uncertainty about evidence were common barriers.
Key findings
01Most surveyed sports physical therapists used time from injury, range of motion, manual muscle testing, patient self-reported readiness, and patient reported outcome measures, but few used upper extremity physical performance tests.
02Only 45.2% of participants used any upper extremity physical performance test to determine sport clearance, and sports specialists used the Closed Kinetic Chain Upper Extremity Stability Test and Upper Quarter Y-Balance Test more often than non-specialists.
03The most commonly reported barriers were lack of equipment (51.8%), lack of understanding of available evidence (50.2%), and lack of time (44.2%).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study reports self-reported survey responses, not observed clinical behaviour or patient outcomes. It was distributed through sports rehabilitation mailing lists and social media, so response rate could not be calculated and respondents may already be more interested in performance testing than other therapists. Most participants practised in the United States, so patterns may not represent global practice. Three participants did not report years of experience, but their data were included.
Declared interests
Authors reported no conflicts of interest. Funding is not stated in the supplied text.
The easy way to misread this
Do not read this as proof that upper extremity physical performance tests improve return to sport decisions. It describes what therapists said they use and what barriers they report, not patient outcomes after testing.