Journal of Sports Science and Medicine
Journal of Sports Science and Medicine
ISSN: 1303 - 2968   
Ios-APP Journal of Sports Science and Medicine
Androit-APP Journal of Sports Science and Medicine
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©Journal of Sports Science and Medicine (2020) 19, 564 - 576

Review article
Association between Functional Performance and Return to Performance in High-Impact Sports after Lower Extremity Injury: A Systematic Review
Astrid Vereijken1,2,3, , Inne Aerts1, Jorrit Jetten1,3, Bruno Tassignon2, Jo Verschueren2,1, Romain Meeusen2,4, Emiel van Trijffel1,5
Author Information
1 SOMT University of Physiotherapy, Amersfoort, the Netherlands
2 Human Physiology and Sports Physiotherapy research group, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
3 Annatommie MC, Utrecht, the Netherlands
4 Strategic Research Program ‘Exercise and the Brain in Health & Disease: the added value of Human-Centered Robotics, Vrije Universiteit Brussel, Brussels, Belgium
5 Experimental Anatomy research department, Department of Physiotherapy, Human physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium

Astrid Vereijken
✉ SOMT University of Physiotherapy, Softwareweg 5, 3821 BN, Amersfoort, The Netherlands
Email: a.vereijken@somtuniversity.nl
Publish Date
Received: 03-12-2019
Accepted: 06-06-2020
Published (online): 13-08-2020
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ABSTRACT

After lower extremity injury, only half of the injured athletes return to their pre-injury sports level. Even though functional performance tests are often used to make return to sport decisions, it is unknown whether functional performance is associated with return to performance after such injuries. The aim of this systematic review was to identify, critically appraise, and analyze studies that investigated the association of functional performance tests with return to performance after lower extremity injuries in athletes participating in high-impact sports. MEDLINE, Embase, Web of Science, and CINAHL were systematically searched for relevant studies. Articles were independently screened by two authors and data were obtained from each included study using a data extraction form. Two authors independently scored methodological quality using the Quality In Prognosis Studies tool. A qualitative best evidence synthesis was conducted. Eight studies reported the association of functional performance with return to performance after lower extremity injuries, involving 1,246 athletes after anterior or posterior cruciate ligament reconstruction. No studies were found on the association of functional performance with return to performance for lower extremity injuries other than after anterior or posterior cruciate ligament reconstruction. All included studies had a high risk of bias. Two studies found significant but small associations for selected hop tests after anterior cruciate ligament reconstruction. Low evidence of association between functional performance and return to performance was present after anterior cruciate ligament reconstruction for the triple hop for distance, the 6-meter timed hop, the side hop in female athletes, and for the combination of the single and crossover hop for distance. In athletes after posterior cruciate ligament reconstruction, the vertical jump showed a significant but small association with return to performance. There is no high-quality evidence that functional performance is associated with return to performance after lower extremity injuries in athletes practicing high-impact sports. Low quality evidence suggests small associations after anterior and posterior cruciate ligament reconstruction. No evidence exists for lower extremity injuries other than after anterior or posterior cruciate ligament reconstruction. Therefore, research on functional performance associated with return to performance is recommended in high-quality prospective cohort studies including athletes with any type of lower extremity injury.

Key words: Functional performance test, hop test, return to pre-injury sports level, high-impact athletes


           Key Points
  • Low quality evidence suggests that functional performance is associated with return to performance after anterior or posterior cruciate ligament reconstruction in athletes participating in high-impact sports.
  • No evidence exists on the association between functional performance and return to performance for lower extremity injuries other than after cruciate ligament reconstruction.
  • Small associations between functional performance and return to performance were found for the triple hop for distance, 6-meter timed hop, vertical jump, side hop in female athletes, and the combination of the single and crossover hop for distance.
  • High-quality prospective cohort studies on the association between functional performance and return to performance, including athletes with any type of lower extremity injury, are needed.
 
 
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