Upper-Extremity Functional Performance Tests: Reference Values for Overhead Athletes

Abstract

This study aimed to provide an age, gender and sport-based normative database for three functional shoulder tests: Y Balance Test – Upper Quarter (YBT-UQ), Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), and Seated Medicine Ball Throw (SMBT). A second aim was to discuss gender, age and sports differences. Finally, correlation between tests was evaluated. Overhead athletes (106 male, 100 female) between 18 and 50 years old and from three different sports (volleyball, tennis, handball) performed all functional tests. A linear mixed or regression model was applied to determine significant differences in test scores between gender, age and sports. Pearson correlation coefficients were analyzed to determine the relationship between tests. Normative values were established and divided by gender, sports and age. Results showed significant gender and age differences for all tests. For YBT-UQ, also significant side and sports differences were recorded. CKCUEST is moderately correlated with SMBT and YBT-UQ. Weak correlation was found between SMBT and YBT-UQ. In conclusion, this study provides normative data for YBT-UQ, CKCUEST and SMBT, which is clinically relevant for functionally screening overhead athletes and benchmark their performance to others from the same gender, age and sports. A combination of included tests is recommended.

Key words

normative database - physical performance test - upper-extremity functional testing

• References

• 1 Abrams GD, Renstrom PA, Safran MR. Epidemiology of musculoskeletal injury in the tennis player. Br J Sports Med 2012; 46: 492-498
• 2 Borms D, Maenhout A, Cools AM. Upper quadrant field tests and isokinetic upper limb strength in overhead athletes. J Athl Train 2016; 51: 789-796
• 3 Boyd JC. Defining laboratory reference values and decision limits: populations, intervals, and interpretations. Asian J Androl 2010; 12: 83-90
• 4 Butler R, Arms J, Reiman M, Plisky P, Kiesel K, Taylor D, Queen R. Sex differences in dynamic closed kinetic chain upper quarter function in collegiate swimmers. J Athl Train 2014; 49: 442-446
• 5 Butler RJ, Myers HS, Black D, Kiesel K, Plisky P, Moorman CT, Queen R. Bilateral differences in the upper quarter function of high school aged baseball and softball players. Int J Sports Phys Ther 2014; 9: 518-524
• 6 Clarsen B, Bahr R, Andersson SH, Munk R, Myklebust G. Reduced glenohumeral rotation, external rotation weakness and scapular dyskinesis are risk factors for shoulder injuries among elite male handball players: A prospective cohort study. Br J Sports Med 2014; 48: 1327-1333
• 7 Cools AM, Johansson FR, Borms D, Maenhout A. Prevention of shoulder injuries in overhead athletes: a science-based approach. Braz J Phys Ther 2015; 19: 331-339
• 8 Cools AM, Vanderstukken F, Vereecken F, Duprez M, Heyman K, Goethals N, Johansson F. Eccentric and isometric shoulder rotator cuff strength testing using a hand-held dynamometer: Reference values for overhead athletes. Knee Surg Sports Traumatol Arthrosc 2016; 24: 3838-3847
• 9 Cronin JB, Owen GJ. Upper-body strength and power assessment in women using a chest pass. J Strength Cond Res 2004; 18: 401-404
• 10 Dines JS, Bedi A, Williams PN, Dodson CC, Ellenbecker TS, Altchek DW, Windler G, Dines DM. Tennis injuries: Epidemiology, pathophysiology, and treatment. J Am Acad Orthop Surg 2015; 23: 181-189
• 11 Edouard P, Degache F, Oullion R, Plessis JY, Gleizes-Cervera S, Calmels P. Shoulder strength imbalances as injury risk in handball. Int J Sports Med 2013; 34: 654-660
• 12 Ellenbecker T, Manske R, Davies G. Closed kinetic chain testing techniques of the upper extremities. Orthop Phys Ther Clin N Am 2000; 9: 219-229
• 13 Forthomme B, Wieczorek V, Frisch A, Crielaard JM, Croisier JL. Shoulder pain among high-level volleyball players and preseason features. Med Sci Sports Exerc 2013; 45: 1852-1860
• 14 Goldbeck T, Davies G. Test-retest reliability of the closed kinetic chain upper extremity stability test. J Sport Rehabil 2000; 9: 35-45
• 15 Gorman PP, Butler RJ, Plisky PJ, Kiesel KB. Upper quarter Y balance test: Reliability and performance comparison between genders in active adults. J Strength Cond Res 2012; 26: 3043-3048
• 16 Harriss DJ, Macsween A, Atkinson G. Standards for ethics in sport and exercise science research: 2018 update. Int J Sports Med 2017; 38: 1126-1131
• 17 Hegedus EJ, McDonough S, Bleakley C, Cook CE, Baxter GD. Clinician-friendly lower extremity physical performance measures in athletes: A systematic review of measurement properties and correlation with injury, part 1. The tests for knee function including the hop tests. Br J Sports Med 2015; 49: 642-648
• 18 Hegedus EJ, McDonough SM, Bleakley C, Cook CE. Clinician-friendly lower extremity physical performance tests in athletes: A systematic review of measurement properties and correlation with injury. Part 2--the tests for the hip, thigh, foot and ankle including the star excursion balance test. Br J Sports Med 2015; 49: 649-656
• 19 Hjelm N, Werner S, Renstrom P. Injury risk factors in junior tennis players: a prospective 2-year study. Scand J Med Sci Sports 2012; 22: 40-48
• 20 Kilic O, Maas M, Verhagen E, Zwerver J, Gouttebarge V. Incidence, aetiology and prevention of musculoskeletal injuries in volleyball: A systematic review of the literature. Eur J Sport Sci 2017; 17: 765-793
• 21 Myers H, Poletti M, Butler RJ. Difference in functional performance on the upper-quarter y-balance test between high school baseball players and wrestlers. J Sport Rehabil 2017; 26: 253-259
• 22 Myklebust G, Hasslan L, Bahr R, Steffen K. High prevalence of shoulder pain among elite Norwegian female handball players. Scand J Med Sci Sports 2013; 23: 288-294
• 23 Pontillo M, Spinelli BA, Sennett BJ. Prediction of in-season shoulder injury from preseason testing in division I collegiate football players. Sports Health 2014; 6: 497-503
• 24 Read PJ, Lloyd RS, De Ste Croix M, Oliver JL. Relationships between field-based measures of strength and power and golf club head speed. J Strength Cond Res 2013; 27: 2708-2713
• 25 Reeser JC, Joy EA, Porucznik CA, Berg RL, Colliver EB, Willick SE. Risk factors for volleyball-related shoulder pain and dysfunction. PM R 2010; 2: 27-36
• 26 Reeser JC, Verhagen E, Briner WW, Askeland TI, Bahr R. Strategies for the prevention of volleyball related injuries. Br J Sports Med 2006; 40: 594-600
• 27 Roush JR, Kitamura J, Waits MC. Reference values for the closed kinetic chain upper extremity stability test (CKCUEST) for collegiate baseball players. N Am J Sports Phys Ther 2007; 2: 159-163
• 28 Santos EJ, Janeira MA. The effects of resistance training on explosive strength indicators in adolescent basketball players. J Strength Cond Res 2012; 26: 2641-2647
• 29 Schmidt-Wiethoff R, Rapp W, Mauch F, Schneider T, Appell HJ. Shoulder rotation characteristics in professional tennis players. Int J Sports Med 2004; 25: 154-158
• 30 Sciascia A, Uhl T. Reliability of strength and performance testing measures and their ability to differentiate persons with and without shoulder symptoms. Int J Sports Phys Ther 2015; 10: 655-666
• 31 Seminati E, Minetti AE. Overuse in volleyball training/practice: A review on shoulder and spine-related injuries. Eur J Sport Sci 2013; 13: 732-743
• 32 Stockbrugger BA, Haennel RG. Contributing factors to performance of a medicine ball explosive power test: A comparison between jump and nonjump athletes. J Strength Cond Res 2003; 17: 768-774
• 33 Taylor JB, Wright AA, Smoliga JM, DePew JT, Hegedus EJ. Upper-extremity physical-performance tests in college athletes. J Sport Rehabil 2016; 25: 146-154
• 34 Tucci HT, Felicio LR, McQuade KJ, Bevilaqua-Grossi D, Camarini PM, Oliveira AS. Biomechanical analysis of the closed kinetic chain upper-extremity stability test. J Sport Rehabil 2017; 26: 42-50
• 35 Tucci HT, Martins J, Sposito Gde C, Camarini PM, de Oliveira AS. Closed kinetic chain upper extremity stability test (CKCUES test): A reliability study in persons with and without shoulder impingement syndrome. BMC Musculoskelet Disord 2014; 15: 1
• 36 Wang HK, Cochrane T. Mobility impairment, muscle imbalance, muscle weakness, scapular asymmetry and shoulder injury in elite volleyball athletes. J Sports Med Phys Fitness 2001; 41: 403-410