Athletic Shoulder Test
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Background[edit | edit source]
Upper extremity injuries are common in overhead sports, however objective criteria to support back to sport decisions remains limited[1].In overhead, the shoulder and elbow are at higher risk of injury due to the high forces required to perform sport specific tasks.(Cain et al., 2003; Wright et al., 2018) cited in advances and Orthopedics and Sports Medicine)[1]. Overhead sports include but are not limited to basketball, water-polo, Javelin and volleyball. Additionally, the majority of shoulder injuries occur in the latter stages of training and matches as a consequence of repeated exposure to tackling, fatigue may contribute to risk
Purpose[edit | edit source]
The athletic shoulder (ASH) test is used to assess and monitor the shoulder isometric strength of athletes during recovery[2]. It is a novel test developed by Ashworth et al. (2018) that focuses on rugby players at risk of shoulder injuries when performing long lever arm tackles.
Technique[edit | edit source]
Both upper extremities were tested to ensure accurate data between dominant and non dominant limbs.[1]
Starting Position : Prone on the floor with the forehead resting on a 4cm foam block and the hand placed on a vertical axis platform.
Procedure[2]:
The subject will push down from the shoulder in three consecutive test positions maximally for 3 seconds:
- I-test: Shoulder positioned in full abduction (180°), forearm in pronation and elbow in full extension. Contralateral arm at the side.
- Y-test: Shoulder positioned at 135°, forearm in pronation and elbow in full extension. The contralateral arm placed behind the back
- T-test: Shoulder positioned at 90°, forearm in pronation and elbow in full extension. The contralateral arm is placed behind the back.
Karlen-Jobe Functional Shoulder Test:
It's clinically relevant to aid in clearance of an athlete for return to overhead sports.
Hypothesis: Ashworth et al. (2018) tested the reliability of a series of tests on portable force plates in various positions (I, Y, T) made to mimic motions in rugby and found excellent reliability, However, these tests were made as a return to tackling test in rugby, which has different demands in comparison to overhead sports.[1]
Shoulder testing positions included: I, Y, Internal rotation (IR), & External Rotation (ER) of the shoulder. It consists of 4 positions, 3 prone and 1 supine position.[1]
Testing protocol: Subject performs 3 trials in each position. In the prone testing positions (I, Y, IR), subjects were directed to maintain their scapula in a neutral position relative to the upper extremity being tested (no winging, anterior tilt, or excessive upward rotation).
Each subject has to press down with maximal effort and verbal encouragement is provided at the start of the test. Each attempt consisted of 3 seconds of exertion, alternating with 5 seconds of rest. A 20 second recovery was used between test positions.
The entire testing protocol took less than 10 minutes per subject, including warm-up and recovery periods.
Result: The high reliability of this test shows a positive trend that the 4 testing positions may have clinical utility when making a return to sport decision with overhead athletes.
Evidence[edit | edit source]
The test demonstrates excellent reliability, but further studies are needed to assess its sensitivity[2]
- Interday reliability in all test positions (ICC 0.94–0.98)
- Absolute reliability (SEM 4.8–10.8)
- Interday measurement error was below 10% in all test positions (CV 5.0–9.9) except for non-dominant arm I-position (CV 11.3%)"
Summary[edit | edit source]
Using a force platform is considered the gold standard in assessing isometric force[4]. However, due to their cost and impracticality, other devices are studied as potential alternatives[5][6]. The Modified-Athletic Shoulder Test (M-AST) is a promising alternative, utilizing a handheld dynamometer for the easier test implementation. A strong concordance was found between ASH Test and M-AST values (ICC = 0.86–0.97; p > 0.05) in all the positions[6].
Resources[edit | edit source]
References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 1.4 -Kerlan-Jobe-Functional-Shoulder-Test-Reliability-of-an-upper-extremity-isometric-strength-test.er Z, Cady A, Serrano B, Banffy M. Research Article Advances in Orthopedics and Sports Medicine AOASM-172 ISSN 2641-6859.
- ↑ 2.0 2.1 2.2 Ashworth B, Hogben P, Singh N, Tulloch L, Cohen DD. The Athletic Shoulder (ASH) test: reliability of a novel upper body isometric strength test in elite rugby players. BMJ open sport & exercise medicine. 2018 Jul 1;4(1):e000365.
- ↑ Physio Network. Athletic Shoulder Testing. Available from: https://www.youtube.com/watch?v=JJbKlVo_ABg [last accessed 18/9/2018]
- ↑ Stark T, Walker B, Phillips JK, Fejer R, Beck R. Hand-held dynamometry correlation with the gold standard isokinetic dynamometry: a systematic review. PM&R. 2011 May 1;3(5):472-9.
- ↑ Królikowska A, Mika A, Plaskota B, Daszkiewicz M, Kentel M, Kołcz A, Kentel M, Prill R, Diakowska D, Reichert P, Stolarczyk A. Reliability and Validity of the Athletic Shoulder (ASH) Test Performed Using Portable Isometric-Based Strength Training Device. Biology. 2022 Apr 11;11(4):577.
- ↑ 6.0 6.1 Tooth C, Forthomme B, Croisier JL, Gofflot A, Bornheim S, Schwartz C. The Modified-Athletic Shoulder Test: Reliability and validity of a new on-field assessment tool. Physical therapy in sport. 2022 Nov 1;58:8-15.
