Functional Performance Assessments in Overhead Athletes With Shoulder Injury

Can Functional Performance Assessments in Overhead Athletes With Shoulder Injury Assess the Ability of Return to Play (RTP)?

Background & Purpose: Shoulder injuries are commonly seen in overhead athletes due to the mechanism of the repetitive and high velocity movement. While the injury usually cost the lost of time in playing, making the decision of the time to return to play (RTP) is a critical issue that should be standardized and objective. However, current studies showed that the decision making of RTP is so complicated that there's lack of objective measurements especially for upper extremity injuries. So, investigating the usage of convenient and valid tools, functional performance assessments for assessing the ability to RTP is the main objective of this study.

Objective: There are 2 objectives for this study: (1) to investigate the difference between RTP group and non-RTP in overhead athletes with shoulder injury; (2) to investigate the responsiveness of the functional performance assessment in return to play for overhead athletes with shoulder injury. Methods: Overhead athletes with shoulder injury or surgery which leads to temporary leaving to the sport within will be recruited in this study. The shoulder joint range of motion (flexion, extension, external/internal rotation, and abduction), shoulder muscle strength (flexors, abductors and external/internal rotators), patient-reported outcome (KJOC and DASH questionnaire) and functional performance assessments (FMS, YBT-UQ, CKCUEST, USSP and TPUT) will be assessed at 6 months after the athlete was injured or received surgery, and at the time point if the athletes successfully complete at least one formal game or practice game (RTP group). If the athlete doesn't return within 12 months after injury or surgery, the assess will be done at the 12th month after injury or surgery. Significance and Contribution: This study is going to provide an objective measurement value of functional performance assessment in injured overhead athletes, determining whether the strength, endurance or power of the upper extremity is good enough to return to the sport that the athlete played before this injury. The result is also expected to have significant contribution in the area of sports medicine in return to play especially in overhead athletes, which has limited evidence providing specific criteria and objective measurement value previously.

Study Overview

• Status: Completed
• Conditions: Rehabilitation; Sports Physical Therapy
• Intervention / Treatment: Diagnostic test: functional performance test

• Study Type: Observational
• Enrollment (Actual): 38

Contacts and Locations

Study Locations

• Taiwan
  • Taipei city, Taiwan, 110
    • Institute of Physical Therapy, College of Medicine, National Taiwan University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years to 43 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Overhead athletes with shoulder injury

Description

Inclusion Criteria:

• overhead athletes diagnosed with shoulder injury within 6 months and can't play the current sports
• accepting the routine rehabilitation
• have the intention to go back to current sports

Exclusion Criteria:

• Other severe orthopedic injuries in upper extremity, lower extremity and spine within 1 year
• has no intention to return to play

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Symptomatic group; There is no intervention in this group, only functional assessments and general physical examinations will be done	Diagnostic test: functional performance test; Functional performance test is to test the ability of the athletes in functional movements
Healthy control group; There is no intervention in this group, only functional assessments and general physical examinations will be done	Diagnostic test: functional performance test; Functional performance test is to test the ability of the athletes in functional movements

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
FMS	functional movement screen	10 minutes
YBTUQ	y-balance test upper quarter	10 minutes
USSP	unilateral seated shot put test	minutes
CKCUEST	closed kinetic chain upper extremity stability test	5 minutes
TPUT	timed push up test	5 minutes

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
shoulder range of motion	shoulder flexion, extension, abduction, external and internal rotation	10 minutes
shoulder muscle strength	shoulder flexion, abduction, external and internal rotation	15 minutes
Disability of Arm, Shoulder and Hand questionnaire	patient reported outcome about the functional status of the shoulder The questionnaire is divided into 4 parts, the first part assesses the disability in daily activities, the second part assesses the severity of the symptom, the third and fourth part assesses the disability in working and playing sports or music instruments. The scale is from 1 to 5, which higher points indicates greater disability. First and second part will be sum up and get the total score, which higher score indicates greater disability in arm, shoulder or hand region. The third and fourth part will be assessed independently, and the score as well as higher scores indicates higher degree of disability in arm, shoulder, and hand region.	10 minutes
KJOC questionnaire	patient reported outcome about the functional status of the shoulder This questionnaire contains 10 different items, which are about the performance during overhead sports competition. Each item score ranges from 0 to 10, which higher scores indicate better performance or less change or influence in their performance and each item will be sum up to get the total score. Therefore, the total score ranges from 0 to 100, and the higher the score, the better the functional status they were.	10 minutes

Collaborators and Investigators

• Sponsor: National Taiwan University Hospital
• Investigators: Principal Investigator: Yuan-Hung Chao, Institution of Physical Therapy, National Taiwan University

Study record dates

Study Major Dates

• Study Start (Actual): September 25, 2018
• Primary Completion (Actual): December 31, 2019
• Study Completion (Actual): January 31, 2020

Study Registration Dates

• First Submitted: September 5, 2018
• First Submitted That Met QC Criteria: September 5, 2018
• First Posted (Actual): September 7, 2018

Study Record Updates

• Last Update Posted (Actual): March 26, 2020
• Last Update Submitted That Met QC Criteria: March 24, 2020
• Last Verified: August 1, 2018

More Information

Terms related to this study

• Keywords: sports; physical therapy; return to play; overhead athletes
• Additional Relevant MeSH Terms: Wounds and Injuries; Shoulder Injuries
• Other Study ID Numbers: 201807118RINB

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No