REHABILITATION
Functional testing of the physical demands identified in the SKTA should not be done in isolation but in the combination that repro- duces the sport’s demands ie. if the sport demands require high endurance, but also high sprint demands (power) then the ath- letes capacity to generate power should be tested after a fatigu- ing level of activity.
In clinical practice it is often difficult to have the time to spend with the athlete during the entire procedure. Where possible I will carry out the clinical orthopaedic testing and then send the ath- lete out to perform the functional activities with the team train- er, reporting back to me if they have any problems.
CONCLUSION This approach is just one attempt at providing a strategy for the development of valid screening programmes for the injured ath- lete returning to sport. As described in this review, there is a paucity of literature to support the predictive qualities of the pre- participation screening tests. My clinical experience indicates that screening is a worthwhile procedure that has an effect on the prediction and prevention of sporting injuries, however testing needs to be specific to the athlete/sport.
It appears that sporting injuries are very difficult to predict. Hopefully sports medicine professionals can develop standard screening protocols, based on an understanding of the needs of the athlete, that have been proven to be valid (both externally and internally) and that can be reproduced with the same results by different examiners. This standardised protocol for pre- participation screening will allow the development of databases that can be used to pool the results of thousands of athletes for statistical analysis.
Despite the lack of definitive evidence physiotherapists should continue with their role in the pre-participation screening of athletes returning to sport. The evidence has, as in many areas of physiotherapy, significant study design faults that affect the validity of the results. However as sports medicine professionals we should be pro-active in amassing the evidence that can make a difference to the identification and prevention of future sporting injuries. As clinicians we should drive the researchers to provide us with the evidence for what appears to work in the clinic.
THE AUTHOR Steve Milanese,
B.App.Sc. (Physiotherapy), Grad.Cert. (Sports Physiotherapy), Grad.Dip. (Ergonomics),
M.App.Sc. (Manipulative Physiotherapy) works as a research officer at the Centre for Allied Health Research, University of South Australia. He has worked extensively in sports medicine as a traveling physiotherapist with the South Australian Rugby Union team and as past president of the Sports Physiotherapy Special Interest group of the South Australian branch of the Australian Physiotherapy Association.
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