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Psychometric properties of visually based clinical screening tests for risk of overuse injury

Abstract Background: Visually based, functional screening protocols remain the most common test of choice by manual therapists. Despite this, very few studies have investigated the reliability and validity of such screening protocols. Without this knowledge, therapists cannot make informed choices, and thus the continued use of such tests is hard to justify. Objectives: The purpose of this review was to collate all the current, high quality studies which investigate the psychometric properties of visually based, functional screening assessments. The aims were to provide an overview of current knowledge, and secondly to inform future practice and study directions. Major Findings: A search strategy was carried out, which identified 11 studies that met the inclusion criteria. These studies investigated a variety of screening protocols, and individual findings are discussed. The main finding from this narrative review is that the popularity of these clinical tests far outweighs what is currently known regarding their psychometric properties, and in particular, their validation. This presents problems at every stage of the injury management system – if pre-treatment measures cannot be made accurately, the outcome of managements and optimal selection cannot be achieved or their outcomes assessed. On a more positive note, the findings from this review can be used to provide a better informed development process for future screening tools. Conclusions: Visually based, functional assessments remain the most frequently used injury risk assessments among physical therapists. For this reason, it is essential that more research is conducted which aims to identify the reliability and/or validity of such tests to ensure practices are justified.