Cooke Rosalyn, Rushton Alison, Martin James, Soundy Andy, Herrington Lee, Heneghan Nicola R
School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham College of Life and Environmental Sciences, Birmingham, UK.
School of Physical Therapy, University of Western Ontario, London, Sui generis, Canada.
BMJ Open Sport Exerc Med. 2025 Jun 8;11(2):e002389. doi: 10.1136/bmjsem-2024-002389. eCollection 2025.
OBJECTIVE: To identify functional performance tests (FPTs) with potential to identify athletes at risk of lower extremity injury (LEI) and assess their measurement properties. DESIGN: Systematic review conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses and PRISMA in Exercise, Rehabilitation, Sports Medicine and Sports Science guidance. DATA SOURCES: Two-stage systematic search of Medline, Embase, Cumulative Index to Nursing and Allied Health Literature and SPORTDiscus databases from inception to 24 November 2023, supplemented by hand searching of reference lists, key journals and grey literature. ELIGIBILITY CRITERIA: Search 1 identified FPT predicting LEI in athletes aged >16 years competing at elite, pre-elite or collegiate levels and feasible in the field. Search 2 assessed measurement properties of identified FPT. COnsensus-based Standards for the selection of health Measurement INstruments risk of bias checklist and criteria for good measurement properties were applied, and evidence summarised using modified Grading of Recommendations, Assessment, Development and Evaluations guidelines. RESULTS: Fifty-nine studies evaluating 15 FPTs were included. Reliability (n=14), measurement error (n=11), structural validity/internal consistency (n=2), criterion validity (n=11), construct validity (n=5) and responsiveness (n=1) were assessed. No FPT demonstrated high certainty for measurement properties. Y-balance test (YBT) demonstrated moderate certainty for three properties (intrarater reliability, criterion validity and responsiveness). Knee to wall (KTW), single-leg squat (SLS), drop vertical jump (DVJ) and single hop for distance (SHFD) showed moderate certainty for two properties (reliability, intra/inter test-retest; criterion validity). Side hop, functional movement screen and landing error scoring system showed moderate certainty for one measurement property. Practicability assessment revealed poor reporting of time requirements and results production. CONCLUSION: Moderate-certainty evidence supported reliability and validity of five FPTs (YBT, KTW, SLS, DVJ, SHFD) used to identify athletes at LEI risk. Studies with low bias and comprehensive practicability evaluations are lacking. CRD42020188932.
目的：识别有可能鉴别出下肢受伤风险（LEI）运动员的功能表现测试（FPT），并评估其测量属性。 设计：按照系统评价和荟萃分析的首选报告项目以及运动、康复、运动医学和运动科学指南中的PRISMA进行系统评价。 数据来源：对Medline、Embase、护理及相关健康文献累积索引和SPORTDiscus数据库进行两阶段系统检索，检索时间从数据库创建至2023年11月24日，辅以手工检索参考文献列表、重点期刊和灰色文献。 纳入标准：检索1识别出在精英、准精英或大学水平比赛的16岁以上运动员中预测LEI且在现场可行的FPT。检索2评估已识别FPT的测量属性。应用基于共识的健康测量工具选择标准、偏倚风险清单和良好测量属性标准，并使用改良的推荐分级、评估、制定和评价指南总结证据。 结果：纳入了59项评估15种FPT的研究。评估了信度（n = 14）、测量误差（n = 11）、结构效度/内部一致性（n = 2）、效标效度（n = 11）、构想效度（n = 5）和反应度（n = 1）。没有FPT在测量属性方面表现出高确定性。Y平衡测试（YBT）在三个属性（评分者内信度、效标效度和反应度）方面表现出中等确定性。靠墙静蹲（KTW）、单腿深蹲（SLS）、垂直纵跳（DVJ）和单腿跳远（SHFD）在两个属性（信度，测试内/复测间；效标效度）方面表现出中等确定性。侧向跳跃、功能性动作筛查和落地误差评分系统在一个测量属性方面表现出中等确定性。实用性评估显示时间要求和结果产生的报告较差。 结论：中等确定性证据支持用于鉴别有LEI风险运动员的五种FPT（YBT、KTW、SLS、DVJ、SHFD）的信度和效度。缺乏低偏倚和全面实用性评估的研究。CRD42020188932。
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