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BACKGROUND: The closed kinetic chain upper extremity stability test (CKCUEST) as originally described may not be appropriate for assessing athletes interchangeably considering body size variations. A modified test position may be warranted to normalize the CKCUEST to body size, in order to reflect an accurate representation of upper limb function. PURPOSE: To determine test-retest reliability of the CKCUEST in a modified test position in Division I collegiate basketball players. STUDY DESIGN: Test-retest reliability. METHODS: 15 subjects (8 male, 7 female) were recruited from Division I basketball teams. Subjects began in a push-up position with their hands located directly under their shoulders. Subjects performed one 15 second trial of the modified CKCUEST initially and a second trial one week later. Hand-written data was transferred to a spreadsheet for analysis using Minitab Statistical Software for comparison. RESULTS: Test-retest reliability was 0.88 for men's basketball, 0.79 for women's basketball, and 0.90 when both teams were combined. Test mean for men's basketball were 29.5 ± 4.78, and retest mean were 31.88 ± 4.99. Test mean for women's basketball were 24.86 ± 5.52, and retest mean were 26.71 ± 5.41. Test mean for both teams combined were 27.33 ± 5.5, and retest mean were 29.47 ± 5.67. CONCLUSIONS: The CKCUEST in a modified test position is a reliable assessment tool. Results support previous findings and may contribute to injury prevention and return to sport decision-making. LEVEL OF EVIDENCE: 3b.

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OBJECTIVES: Non-traumatic extremity injuries are particularly common in sports, representing a significant economic, academic, and psychosocial burden on athletes. Proposed musculoskeletal risk factors for increased injury and decreased performance in athletes include movement pattern inefficiency, decreased regional stability, decreased mobility, and asymmetrical movement. The Movement System Screening Tool (MSST) is a comprehensive screening tool designed to assess these factors. Thus, the purpose of this study was to describe the development and determine the content and construct validity and inter-rater reliability of the MSST. METHODS: A modified Delphi panel of experts determined content validity. 80 athletes (40 with and 40 without a current non-traumatic shoulder injury) completed 21 clinical tests, with exploratory factor analysis and known group analysis performed to determine construct validity. Two independent raters were used to establish individual item and composite score inter-rater reliability. RESULTS: Exploratory factor analysis identified three of the four apriori constructs over 7 factors (14 tests), representing 63% of the variance. Known group analysis revealed a significantly lower composite score in athletes with vs. without a current non-traumatic shoulder injury (56.9±5.8 vs. 62.7±4.5, respectively). A preliminary cut score of 62 was chosen with sensitivity of 85% and specificity of 44%. Composite score inter-rater reliability was excellent ICC (2,1)=0.94, 95% CI (0.91, 0.96) and item reliability ranged from κ=.57 to 1.00. CONCLUSIONS: The MSST possesses constructs representative of injury risk and measurement properties acceptable for use in clinical settings. Comprehensive screens with construct validity and known measurement error are needed not only to identify athletes at risk of injury, but also provide an instrument that can be used in studies that seek to validate training approaches proposed to change movement impairment and injury risk in athletes.

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BACKGROUND: The Functional Movement Screen™ (FMS™) has been the focus of recent research related to movement profiling and injury prediction. However, there is a paucity of studies examining the associations between physical performance tasks such as balance and the FMS™ screening system. PURPOSE: The purpose of this study was to compare measures of static balance in stable and unstable conditions between different groups divided by FMS™ scores. A secondary purpose was to discern if balance indices discriminate the groups divided by FMS™ scores. STUDY DESIGN: Cross-sectional study. METHODS: Fifty-seven physically active subjects (25 men and 32 women; mean age of 22.9 ± 3.1 yrs) participated. The outcome was unilateral stance balance indices, composed by: Anteroposterior Index; Medial-lateral Index, and Overall Balance Index in stable and unstable conditions, as provided by the Biodex balance platform. Subjects were dichotomized into two groups, according to a FMS™ cut-off score of 14: FMS1 (score > 14) and FMS2 (score ≤ 14). The independent Students t-test was used to verify differences in balance indices between FMS1 and FMS2 groups. A discriminant analysis was applied in order to identify which of the balance indices would adequately discriminate the FMS™ groups. RESULTS: Comparisons between FMS1 and FMS2 groups in the stable and unstable conditions demonstrated a higher unstable Anteroposterior index for FMS2 (p=0.017). No significant differences were found for other comparisons (p>0.05). The indices did not discriminate the FMS™ groups (p > 0.05). CONCLUSIONS: The balance indices adopted in this study were not useful as a parameter for identification and discrimination of healthy subjects assessed by the FMS™. LEVEL OF EVIDENCE: 2c.

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BACKGROUND: The Functional Movement Screen (FMS™) is a widely used seven-test battery used by practitioners working in sport medicine. The FMS™ composite score (sum of seven tests) in soccer athletes from different competitive levels has been well explored in literature, but the specific movement deficits presented by young high competitive level players remains unclear. PURPOSE: The aim of the present study was to provide a detailed description of the performance of elite young soccer players (age 14-20 years) on the FMS™ testing battery. STUDY DESIGN: Cross-sectional observational study. METHODS: One-hundred and three young soccer players (14-20 years) from a premier league club were assessed by two experienced raters using the FMS™ testing battery. FMS™ composite score, individual-test scores and asymmetries were considered for analysis, and comparisons between age categories were performed. RESULTS: FMS™ composite scores ranged from 9 to 16 points (median=13 points). 82% of the athletes had a composite score ≤14 points, and 91% were classified into the "Fail" group (score 0 or 1 in at least one test). Almost half of athletes (48%) had poor performance (i.e., individual score < 2) in "deep squat" test. Most of athletes in the younger categories (under-15 and under-16) had poor performance in the "trunk stability push-up" test (70%) and in the "rotary stability" test (74%). Asymmetry in at least one of five unilateral FMS™ tests was found in 65% of athletes. CONCLUSION: High-performance young soccer players have important functional deficits, especially in tasks involving deep squat and trunk stability, as well as high prevalence of asymmetry between right and left body side. LEVEL OF EVIDENCE: 3a.

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BACKGROUND: Diagnoses and treatments based on movement system impairment syndromes were developed to guide physical therapy treatment. OBJECTIVES: This masterclass aims to describe the concepts on that are the basis of the syndromes and treatment and to provide the current research on movement system impairment syndromes. RESULTS: The conceptual basis of the movement system impairment syndromes is that sustained alignment in a non-ideal position and repeated movements in a specific direction are thought to be associated with several musculoskeletal conditions. Classification into movement system impairment syndromes and treatment has been described for all body regions. The classification involves interpreting data from standardized tests of alignments and movements. Treatment is based on correcting the impaired alignment and movement patterns as well as correcting the tissue adaptations associated with the impaired alignment and movement patterns. The reliability and validity of movement system impairment syndromes have been partially tested. Although several case reports involving treatment using the movement system impairment syndromes concept have been published, efficacy of treatment based on movement system impairment syndromes has not been tested in randomized controlled trials, except in people with chronic low back pain.

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