Validity of an Upper Extremity Physical Performance Test Battery in Healthy Athletes

Upper extremity physical performance tests (PPTs) of the upper limb are physically challenging tests and are supposed to be sport-specific and mimic the sport specific movements or load. Currently, there is no strong evidence for the validity of many upper extremity physical performance tests, although these tests are widely used in the return-to-sport phase after upper limb injuries. There is a clear need for a validating test physical performance tests. Validation of these PPTs is possible in several ways, e.g. correlation to an analytical construct such as strength. However, it is important that these tests are sport-specific. For this reason, the correlation between physical performance tests on the one hand and sports performance (in swimming and tennis) and upper limb kinematics during a tennis serve on the other hand will be evaluated in this study. However, a single PPT is unlikely to correlate strongly with sport performance or tennis serve kinematics, as previous studies have shown a weak to moderate association when a single PPT was correlated with sport performance or another construct. Therefore, a cluster of tests will be assessed; four PPTs per sport and three analytical tests measuring strength and mobility of shoulder and hand, since these are the cornerstone of testing protocols in sports rehabilitation. In addition, patient-reported outcome measures (PROMs), questionnaires that measure physical and psychosocial factors, are becoming increasingly important in sports. Recent studies show that these factors influence sports performance and rehabilitation outcomes. Therefore, these questionnaires can be very useful in the return-to-sport phase and injury risk screening. The PROMs that will be used in this study are the following: Kerlan-Jobe Orthopedic Clinic Shoulder and Elbow Score (KJOC-SES), Competitive State Anxiety Inventory-2 (CSAI-2) and the general self-efficacy scale. To conclude, the test battery consists of PPTs, analytical tests (strength and mobility) and PROMs.