A Peek Behind the Paper: Objective and subjective measures to guide upper extremity return to sport testing: A modified Delphi survey

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Description

Objective
To identify which subjective and objective tests do content experts utilize to help guide return to sport (RTS) decision making for an athlete after an upper extremity (UE) injury?
Methods
A modified Delphi survey was utilized, including content experts in UE rehabilitation. Survey items were identified based on a literature review identifying current best evidence and practice for UE RTS decision making. Content experts (n = 52) were identified, having a minimum of 10 years of experience with rehabilitation of UE athletic injuries, and 5 years of experience using an UE RTS algorithm to guide decision making.
Results
Expert consensus was achieved on a combination of tests utilized within an UE RTS algorithm: 1. Tissue healing time frame is an important consideration in RTS decision making; 2. Patient reported outcome measures should be utilized specifically, DASH and NPRS 3. Strength is measured by handheld dynamometer and is an important consideration. 4. ROM should be utilized and is an important consideration. 5. Physical performance tests utilized include: Closed Kinetic Chain Upper Extremity Stability test, Seated shot-put test and lower extremity/core tests.
Conclusions
This survey reached expert consensus on which subjective and objective measures to utilize to evaluate RTS readiness after UE injury.

Contributors

Patrick Barber, PT, DPT, SCS

Author: Patrick Barber is a residency trained Board Certified Specialist in Sports Physical therapy working at the University of Rochester. He is the coordinator of the Shoulder Rehabilitation Program at the University of Rochester, a multi-disciplinary program focused on improving patient outcomes and clinical results. He serves as a mentor and faculty member within the Sports and Orthopaedic Physical Therapy Residency program at the University of Rochester. In 2021 Patrick was selected as a Centennial Scholar for the American Academy of Sports Physical Therapy (AASPT). Prior to that in 2019 Patrick was selected to complete the Kevin Wilk Travelling Fellowship through the AASPT He is an active member of the American Physical Therapy Association (APTA), the American Academy of Sports Physical Therapy (AASPT), the AASPT Shoulder SIG, and New York PT Association (NYPTA).
Bailey Lanser, SCS, LAT

Interviewer: Bailey Lanser, SCS, LAT is the clinical sports physical therapist for The University of Wisconsin/Badger Athletics. She provides rehabilitation services to athletes across all collegiate sports with a variety of injuries, but has a special interest in management of long term rehabilitation and upper extremity return to sport testing. She completed her sports residency at the Cleveland Clinic and assists with developing and performing upper extremity post-operative testing in the Badger Athletic Performance Lab. She is a member of the American Physical Therapy Association, where she serves as the Education chair for the College and Pro Sports special interest group of the American Academy of Sports Physical Therapy, as well as a member of the National Athletic Trainer’s Association. She is a passionate advocate for maximizing the benefits collaboration between physical therapy, athletic training, and strength and conditioning in the care of student athletes.

Thank you

Description

Contributors

Patrick Barber, PT, DPT, SCS

Bailey Lanser, SCS, LAT