International Journal of Sports Physical Therapy最新文献

{"title":"Barriers and Facilitators Influencing Physiotherapists' Adherence to Clinical Practice Guidelines and Return to Sport Criteria after Anterior Cruciate Ligament Reconstruction: A Qualitative Study in Austria.","authors":"Sophie Bacher, Owen Cronin, Gertie Janneke Oostingh","doi":"10.26603/001c.169919","DOIUrl":"10.26603/001c.169919","url":null,"abstract":"<p><strong>Background: </strong>Despite well-established clinical practice guidelines (CPGs) and return to sport (RTS) criteria following anterior cruciate ligament reconstruction (ACLR), adherence in clinical physiotherapy practice remains inconsistent. Suboptimal adherence may contribute to impaired rehabilitation outcomes and increased long-term knee morbidity.</p><p><strong>Hypothesis/purpose: </strong>The purpose of this study was to explore barriers and facilitators influencing Austrian physiotherapists' adherence to CPGs and RTS criteria during rehabilitation after ACLR.</p><p><strong>Study design: </strong>Qualitative study.</p><p><strong>Methods: </strong>Nine physiotherapists (mean professional experience 9 years; 78% sports-specialized) involved in ACLR rehabilitation participated in semi-structured interviews. Data were analyzed using reflexive thematic analysis following Braun and Clarke's framework.</p><p><strong>Results: </strong>Four key themes describing barriers were identified: limited usability of ACLR CPGs, patient expectations and engagement, professional attitudes and resource limitations, and interprofessional misalignment. Facilitators included structured and transparent guidelines, ongoing professional development and resource availability, patient motivation and individualized training plans, and institutional support (e.g., insurance coverage). RTS criteria application varied, with some physiotherapists using structured testing batteries and others relying on individualized clinical judgment.</p><p><strong>Conclusion: </strong>Physiotherapists' adherence to ACLR CPGs and RTS criteria is influenced by guideline design, clinician factors, patient engagement, interdisciplinary dynamics, and institutional support. Addressing educational gaps, promoting reflective practice, enhancing guideline usability, and strengthening interdisciplinary communication could improve adherence and optimize rehabilitation outcomes following ACLR.</p><p><strong>Level of evidence: </strong>Level 3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 10","pages":"934-949"},"PeriodicalIF":2.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Force Plate Based Assessment of Maximal and Rapid Isometric Shoulder Strength During the Return-to-Sport Process After Pectoralis Major Repair in a World-Class Female Wrestler: A Case Report.","authors":"Kazuya Yamazaki, Ayano Tanaka, Masashi Aoyagi, Kohei Nakajima, Hideki Takeda, Daichi Yamashita","doi":"10.26603/001c.169927","DOIUrl":"10.26603/001c.169927","url":null,"abstract":"<p><strong>Background: </strong>Pectoralis major tendon rupture in high-level female wrestlers is extremely rare, and evidence regarding rehabilitation and return-to-sport criteria is limited. The purpose of this case report was to provide detailed information regarding quantitative assessment of postoperative recovery, focusing on maximal and rapid isometric force production following pectoralis major tendon repair in a world-class female wrestler.</p><p><strong>Study design: </strong>Case report.</p><p><strong>Case description: </strong>A world-class female wrestler in her 20s sustained rupture of the sternocostal and abdominal heads of the right pectoralis major at the humeral attachment and underwent tendon repair six days after injury. Resistance training began at week nine and wrestling-specific drills began at week 14. She returned to competitive training at week 18 and official competition at week 24.</p><p><strong>Outcomes: </strong>Shoulder strength was assessed weekly from postoperative week 6 to 16 using the Athletic Shoulder (ASH) Test with a force plate. Net peak force (NPF) and net force at 200 ms (NF200) were measured in the I-position (180°), Y-position (135°), and T-position (90°). NPF limb symmetry improved by week 11 in the I- and Y-positions, while NF200 recovery lagged behind NPF, particularly in the Y-position. A temporary decrease in NPF and NF200 was observed at week 14, most pronounced in the Y-position. Coefficient of variation for NF200 remained higher on the operated side than on the contralateral side. Training progression and return-to-sport clearance were guided by pain response, shoulder range of motion, exercise and sport-specific tolerance, ASH test findings, and physician assessment.</p><p><strong>Discussion: </strong>NF200 recovery lagged behind NPF, suggesting that rapid force production may remain impaired after peak force has recovered. Recovery patterns were angle-dependent, supporting multidirectional assessment. Strength decline after wrestling-specific training also supports continued neuromuscular monitoring.</p><p><strong>Conclusion: </strong>In this athlete, repeated ASH testing appeared to assist clinical monitoring by detecting position-specific changes in maximal and rapid force production during the return-to-sport process.</p><p><strong>Level of evidence: </strong>5.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 10","pages":"1003-1016"},"PeriodicalIF":2.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Movement Assessment after ACL Reconstruction in Youth: A Clinical Framework to Guide Rehabilitation and Return-to-Sport Decision-Making.","authors":"Lauren Butler, Alexa Martinez, Dai Sugimoto, William Marrone, Joseph Janosky, Sophia Ulman","doi":"10.26603/001c.169922","DOIUrl":"10.26603/001c.169922","url":null,"abstract":"<p><p>Anterior cruciate ligament (ACL) injury is one of the most common knee injuries requiring surgical intervention in youth athletes. After ACL reconstruction surgery, youth athletes undergo prolonged rehabilitation which often concludes with return-to-sport (RTS) testing to determine the athlete's readiness to resume sports participation. Most rehabilitation and RTS literature have focused primarily on quantitative outcomes to guide these decisions. Given the relationship between trunk and lower extremity biomechanics with ACL injury risk, there has been a call to action for the inclusion of qualitative assessments in rehabilitation and return-to-sport assessments. The purpose of this commentary is to describe quality of movement assessment tools that can guide rehabilitation and RTS decision making in pediatric and adolescent patients following ACL reconstruction. Specifically, it provides a framework for the implementation and interpretation of tools to assess single-leg, double-leg, and change of direction tasks as well as practical strategies and considerations for their use with pediatric and adolescent patients after ACL reconstruction. # Level of Evidence 5.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 10","pages":"1017-1033"},"PeriodicalIF":2.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Musculoskeletal Ultrasound in the Evaluation of the Subacromial Bursa.","authors":"Robert C Manske, Chris Wolfe, Phil Page, Michael Voight","doi":"10.26603/001c.171639","DOIUrl":"10.26603/001c.171639","url":null,"abstract":"<p><p>The subacromial and subdeltoid bursa commonly communicate and, for all intents and purposes, function as a single bursa. The subacromial bursa lies between the supraspinatus and the acromion process, while the subdeltoid bursa is the lateral extension of the subacromial bursa. These bursae function to limit frictional forces between the various structures. These bursae can become irritated and inflamed when they are impinged between the greater tubercle of the humerus and the acromion and/or the coracoacromial ligament when one lifts the shoulder into elevation and internal rotation. It is difficult to determine whether the bursa, the supraspinatus tendon, or both are irritated when diagnosing shoulder pain. An accurate diagnosis of bursitis is essential for appropriate treatment planning and optimizing patient outcomes. Diagnostic musculoskeletal ultrasound (MSKUS) has become a widely used imaging modality for assessing several shoulder pathologies. It offers a portable, real-time, and cost-effective alternative that is gaining traction in rehabilitation and sports medicine settings. MSKUS has emerged as a valuable, non-invasive imaging modality for evaluating shoulder bursal tissue. This manuscript will review the utility of MSKUS in evaluating the quality, size, and sonographic features of subacromial and subdeltoid bursal tissue, as well as the clinical implications for professionals in the rehabilitation field. By integrating MSKUS into clinical practice, providers can improve diagnostic accuracy, enhance diagnostic confidence, monitor healing progression, and guide rehabilitation strategies to achieve optimal patient outcomes for those with shoulder bursal injuries.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 10","pages":"1068-1072"},"PeriodicalIF":2.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of a Standardized Isokinetic Knee Strength Protocol Across a Slow-Fast Velocity Spectrum in Physically Active Adults with the Biodex System 4 Pro.","authors":"Jesper Augustsson, Jannie Strågegård, Elin Peterson, Ted Gunhamn","doi":"10.26603/001c.169848","DOIUrl":"10.26603/001c.169848","url":null,"abstract":"<p><strong>Background: </strong>Isokinetic dynamometry is widely used to assess knee muscle strength in both clinical and athletic settings; however, the reliability of measurements across different angular velocities representing distinct regions of the force-velocity spectrum requires further investigation. Purpose: To examine the test-retest reliability of concentric isokinetic knee extension and flexion strength at slow and fast angular velocities using the Biodex System 4.</p><p><strong>Study design: </strong>Repeated measures.</p><p><strong>Methods: </strong>A total of 15 healthy, physically active adults, women (n=7) and men (n=8), within the age range 21-34 years (inclusion criterion: 18-40 years) participated in the study. Each subject completed two test sessions spaced one week apart. Peak torques of the dominant leg during knee extension and flexion were measured using the Biodex System 4 at angular velocities of 90°/s and 180°/s. Reliability was analyzed using intraclass correlation coefficient (ICC) with 95% confidence intervals and the coefficient of variation (CV).</p><p><strong>Results: </strong>The results showed high to very high reliability across all test conditions (ICC = 0.92-0.99; 95% CI: 0.78-1.00). CV values ranged from 2.7% to 4.2%, and no significant differences in peak torque were observed between test sessions.</p><p><strong>Conclusion: </strong>The isokinetic measurements were reliable at both 90°/s and 180°/s, supporting their use in rehabilitation and strength training evaluations. As distinct strength qualities exist and muscle performance can be assessed across a dynamic velocity spectrum, isokinetic testing at multiple angular velocities may provide a more comprehensive characterization of muscle function than a single-speed assessment alone.</p><p><strong>Level of evidence: </strong>2.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 10","pages":"961-967"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Comparison of Passive Shoulder Horizontal Adduction Range of Motion in Elite Tennis Players.","authors":"Todd S Ellenbecker, Glenn Harrison Smith, Zach Bornholtz","doi":"10.26603/001c.171298","DOIUrl":"10.26603/001c.171298","url":null,"abstract":"<p><strong>Background: </strong>Elite level tennis players subject their dominant extremity to high levels of repetitive eccentric deceleration as the shoulder undergoes extensive internal rotation and cross arm adduction, placing large demands on posterior shoulder structures. While the associated loss of dominant (D) arm internal rotation range of motion (ROM) relative to the non-dominant (ND) arm has been extensively studied and quantified among overhead athletes, horizontal adduction (HADD) loss has been far less explored in current literature. The purpose of this study was to objectively measure passive D and ND HADD ROM and examine differences in D-ND HADD ROM in elite tennis players. The authors hypothesized that significantly lower D shoulder HADD ROM compared to the ND upper extremity would be observed in both male and female elite tennis players at all ages.</p><p><strong>Study design: </strong>Cross-sectional observational study.</p><p><strong>Methods: </strong>A total of 317 uninjured, elite-level tennis players were assessed for differences between D-ND HADD passive ROM using a digital inclinometer. Subjects volunteered to participate and were currently training and competing. Subjects were divided into two groups by age (12 to 17, and 18 and over). Subjects were positioned supine while a single physiotherapist stabilized the ipsilateral scapula and performed all measurements without applied overpressure. A descriptive analysis was performed, with paired-samples t-tests examining D-ND differences within each group and independent-samples t-tests comparing the deficit between age groups.</p><p><strong>Results: </strong>There were (178 males and 139 females) measured in this investigation. Significantly less D arm HADD was measured compared to the ND arm in male (7.58±6.97°) (p<0.001) and female players (3.80±6.01°) (p<.0001). Additionally, the D-ND deficit was significantly larger in 18-30-year-old male players (8.2°) than in junior males (4.7°) (p = 0.005), whereas the deficit in female players was not statistically different across age groups (p = 0.71).</p><p><strong>Conclusion: </strong>The results of this descriptive study demonstrate a significant decrease in D arm HADD ROM in elite tennis players compared to the ND arm. Larger differences were measured in older male players, likely associated with the increased number of years played with this population. Decreased HADD likely represents the chronic adaptations that develop in the posterior shoulder structures with extensive repetitions required for skill development and training.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 10","pages":"977-983"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Objective Assessment for Plank Performance in Active Adults With and Without Low Back Pain: A Reliability and Comparison Study.","authors":"Matt Turner, Michael O'Dwyer, Cassie Schumacher, Kelli Brizzolara, Amanda Arnold, Sharon Wang-Price","doi":"10.26603/001c.171302","DOIUrl":"10.26603/001c.171302","url":null,"abstract":"<p><strong>Background: </strong>Timed plank tests often are used to assess trunk performance in patients with low back pain (LBP). However, a timed test does not assess the quality of movement or the amount of compensatory movement patterns that may reflect altered motor control. Currently, an objective method to quantify trunk deviation during the plank is lacking.</p><p><strong>Purpose: </strong>To determine the inter-rater and intra-rater reliability of the maximum amount of trunk deviation (MOTD), measured using a digital inclinometer during forward- and side-plank testing, and to compare MOTDs and time to failure (TTF) between active adults with and without LBP.</p><p><strong>Study design: </strong>Reliability and comparison study.</p><p><strong>Methods: </strong>Thirty-four active young adults (17 without LBP, 17 with LBP) completed two sessions of the forward and side-plank tests separated by a 10-minutes rest period. Both tests were elbow-supported and performed with extended legs. A digital inclinometer was placed at L4-L5 during the forward-plank test and above iliac crest during the side-plank test. Each trial was video-recorded from a sagittal-plane view during forward-plank testing and a frontal-plane view during side-plank testing. Two investigators performed independent testing sessions to establish the inter-rater reliability. For the intra-rater reliability, one investigator extracted data by viewing the recordings of the live exam at least two weeks after the initial assessment. Intraclass correlation coefficients (ICCs) were calculated to determine reliability, and independent t-tests were used to compare MOTD and TTF between groups.</p><p><strong>Results: </strong>The results showed good intra-rater reliability (ICC = .81-.85), and moderate inter-rater reliability (ICC = .61-.66) for both groups, with the LBP group having lower ICCs. A significant between-group difference was observed for side-plank MOTD (p = 0.005), with the LBP group demonstrating smaller MOTDs. No differences were observed in TTF.</p><p><strong>Conclusion: </strong>The study supports the use of a digital inclinometer as a reliable tool for measuring trunk deviation during planks in active young adults. In addition, individuals with LBP may perform a side plank differently than those without LBP.</p><p><strong>Level of evidence: </strong>2b.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 10","pages":"984-995"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surveillance of Athletes' Health in Resource-Constrained African Sports Contexts: Why Context Matters and Time To Catch Up.","authors":"Davie Mulenga, Camille Tooth, Pascal Edouard, Ummukulthoum Bakare, Florian Forelli, Oluwatoyosi B A Owoeye","doi":"10.26603/001c.171307","DOIUrl":"10.26603/001c.171307","url":null,"abstract":"<p><p>Athlete health surveillance is fundamental to understanding, preventing, and managing injuries, illnesses, and other health problems in sport. While standardized surveillance systems developed by organizations such as the International Olympic Committee (IOC) have substantially advanced sports medicine globally, their applicability across diverse African sporting environments remains insufficiently examined. Many existing surveillance approaches assume the availability of trained medical personnel, robust health infrastructure, standardized documentation systems, and stable sporting environments-conditions that are not readily accessible across Africa. The continent is not homogeneous; some countries and elite sporting programs have surveillance capacities comparable to international standards, while many others operate under significant resource constraints. This commentary aims to examine the limitations of conventional athlete health surveillance approaches in African settings and to advocate for context-sensitive, African-led surveillance systems capable of generating locally relevant evidence to inform injury prevention, health policy, and athlete welfare. Leveraging collaborations among African researchers, clinicians, universities, sports federations, healthcare organizations, and international partners offers an opportunity to develop sustainable surveillance systems while strengthening research and clinical capacity across the continent.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 10","pages":"1057-1060"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Sagittal Plane: The Lateral Countermovement Jump as a Clinical Tool for Return-to-Play Decision-Making and Performance Evaluation.","authors":"Michael L Voight, Robert C Manske, Phil Page, Peter Draovitch, Barbara J Hoogenboom","doi":"10.26603/001c.169844","DOIUrl":"10.26603/001c.169844","url":null,"abstract":"<p><p>Return-to-play (RTP) decision-making after lower-extremity injury has traditionally emphasized sagittal-plane assessments, including double and single leg vertical jump metrics, double and single-leg hop batteries, and quadriceps strength limb symmetry indices (LSI). Yet many sports place a disproportionate demand on frontal-plane, lateral force production; basketball players, for example, spend up to a third of their live game actions in a defensive shuffle or lateral cutting posture. Recent force-plate evidence supports the single-leg lateral countermovement jump (LCMJ) as a reliable, time-efficient, and low-load assessment capable of stratifying lateral movement competency in elite athletes. This clinical commentary reviews recent reliability and discriminant-validity data on the LCMJ, places the test within the broader RTP evidence base and its known limitations, and proposes a practical framework for incorporating relative lateral force testing into RTP and performance batteries used by physical therapists and sports medicine clinicians.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 10","pages":"1061-1067"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strength Testing in the High School-Aged Baseball Athlete: Reliability, Percentage Ratios, and Pain with Throwing.","authors":"Ryan Monti, Elliot M Greenberg, Kelby Kaplan, Alicia Fernandez-Fernandez","doi":"10.26603/001c.169850","DOIUrl":"10.26603/001c.169850","url":null,"abstract":"<p><strong>Background: </strong>Digital handheld dynamometry (HHD) is widely used to measure strength. However, among youth baseball athletes, it shows inconsistencies in isometric strength measurements, determination of within-limb strength percentage ratios (SPRs), and tracking changes in strength across a season.</p><p><strong>Purpose: </strong>To establish intra-tester reliability of isometric HHD strength testing of shoulder and elbow, describe throwing arm strength trends and SPRs across chronological ages, and report throwing with pain after seasonal participation for high school-aged baseball athletes.</p><p><strong>Design: </strong>Quasi-experimental observational study.</p><p><strong>Methods: </strong>Isometric strength for throwing arm musculature was assessed in 34 male high school-aged baseball athletes using an externally fixated HHD and normalized to throwing arm ulnar length. Assessed muscles included (1) shoulder external and internal rotators (ER & IR) in neutral, (2) elbow flexors and extensors at 90˚ shoulder flexion, and (3) shoulder ER and IR at 90˚ abduction. SPRs were calculated for antagonistic groups: shoulder ER/IR and elbow extensors/flexors. Intra-tester reliability was also analyzed. Throwing-related pain was assessed with the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score (KJOC) after one baseball season. Intra-tester reliability intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable change (MDC₉₅) were determined for each testing position. Descriptive trends were reported for strength, SPRs, and KJOC scores.</p><p><strong>Results: </strong>Thirty-four high school-aged male baseball athletes (average age 15.7 ±1.2 years) were recruited for this study, and 30 completed all aspects of the study. Intra tester reliability ICC's were .822-.902. The SEM was 3.01-6.47 Newton-Meters (Nm), MDC₉₅ 8.34-18.0 Nm. Mean SPR values for these athletes for shoulder ER/IR in neutral was 64.0%, elbow extensors/flexors 70.1%, and shoulder ER/IR at 90° abduction 69.7%. SPRs showed increasing trends with greater chronological age. Post-season KJOC scores revealed no pain with throwing for all subjects.</p><p><strong>Conclusions: </strong>Isometric strength assessment using digital HHD is a reliable method to quantify upper extremity strength in high school-aged baseball athletes. Descriptive SPR trends could aid future research on normative values and analysis of throwing with and without pain.</p><p><strong>Level of evidence: </strong>Level 3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 10","pages":"968-976"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}