A comprehensive functional performance test battery, the Advanced Lower Extremity Sport Assessment (ALESA), to establish functional movement competence in athletes as pre-participation screening and return-to-sport criteria for determining lower extremity injury risk

This paper includes one published journal article and two additional papers that explore the concept of return-to-sport (RTS) assessment and pre-participation screenings. Globally, sport participation is increasing, and physical activity is being emphasized in youth and adult populations. Injury-related risks are inherent in physical activity and sport participation. Therefore, the need for injury prevention strategies and identifying functional deficits leading to possible injury is essential. The first paper was published as a clinical commentary and systematic literature review on RTS assessment used with youth athletes following lower extremity injury. The consensus of the current literature revealed functional performance measures (FPM) and quantitative assessment of functional limitations are useful in determining these intrinsic risk factors contributing to injury. In contrast to the literature consensus, current assessment tools used for RTS are neither standardized, nor extensive and are often time based. Due to the number of rehabilitation considerations necessary once injury occurs, the need for a criteria-based RTS test battery is clear. Currently there is no curation of functional performance testing that is agreed upon by the medical or healthcare community for the lower extremity that incorporates current valid and reliable FPM. It is out of necessity, in this body of work, that Paper 2 presents the design, development, and validation of a comprehensive test battery, the Advanced Lower Extremity Sport Assessment (ALESA). Paper 2 was a methodological study establishing content, face and construct validity for the ALESA. Field trials were performed to determine clinical relevance. A proportional hazards model was then used in Paper 3 to determine predictive validity using male professional soccer players. A multivariate analysis was performed to investigate if ALESA scores were associated with an increased risk of lower extremity injuries during a pre-season and competitive soccer season. These results supported the use of ALESA as a pre-season screening tool or evaluating an athlete’s readiness to return to sport after participating in a rehabilitation program. The critical constructs have been established in the literature and the utility of ALESA in RTS assessment could be pivotal in reducing lower extremity injury rates across youth to professional athletes.Kinesiology and Health Educatio