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Workshop #2

In Search for RTS-Criteria in LAS and CAI Populations – Which Functional Tests Make Sense and How to Integrate Adaptability in Functional Testing?

Speaker 1: Bruno Tassignon

Speaker 2: Jo Verschueren

Background & Relevance: This workshop will give an overview of the relevant functional performance tests in LAS injury and CAI-populations (e.g. Y-balance test, hop tests) and discuss new functional tests that have added environmental perception, decision-making and variable motor responses as additional dynamic components (e.g. reactive balance test, neurocognitive hop tests). Given the importance of adaptability in sports performance, these insights can be of added value in the functional test repertoire used to objectify the progress throughout rehabilitation or support RTS decision-making.

A recent review documented that there are currently no prospectively validated RTS criteria in LAS or CAI populations [1]. Given the high recurrence rate after LAS injury and the risk of developing CAI, it is important to address both the functional performance of the injured athlete during rehabilitation as well as the sensorimotor control alterations after LAS injury and its possible implications towards the concept of adaptability. The rationale for the use of functional performance tests is to assess possible impairments that need to be addressed in rehabilitation, monitor rehabilitation progress and to form an impression as to whether an athlete is ready to start working towards performance enhancement [2-4]. Such tests often encompass more generic movements (e.g. walking, hopping) or simpler tasks (e.g. unilateral leg stance) with research in different populations investigating their role in rehabilitation and injury prevention.

Part one of the workshop will give an overview of the current relevant functional performance tests that are documented in LAS and CAI populations, integrate these into a practical session so that participants can easily use them in clinical practice, and discuss the specific relevance of these tests in both rehabilitation and prevention.

Nevertheless, an important insight that is currently lacking in literature is the importance of adaptability relating to prevention, rehabilitation and RTS decisions. Adaptability is defined as the ability of an athlete to effectively modify responses under a broad spectrum of conditions [5]. Functional performance tests currently neglect the importance of environment perception and the coupled adequate motor responses. Furthermore, it was found that this concept was not implemented in the current functional test repertoire for LAS injury and CAI patients.

Integrating adaptability in functional testing can be done by evaluating an athlete’s response to unanticipated stimuli during goal-oriented motor tasks. Some new functional tests (e.g. reactive balance test, neurocognitive hop tests) have been developed to bridge this gap, but these tests are still in their infancy. Nevertheless, these tests can be an important step in the rehabilitation and RTS decision-making process, because there is a need to develop and implement evidence-based progressive rehabilitation programmes, as well as specific evidence- based criteria to guide RTS decisions for individuals with acute LAS injury.

Therefore, part two of the workshop will focus on reactive balance testing, neurocognitive hop tests and other functional tests that integrate the construct of adaptability. Also, the relevance in rehabilitation and possible implications for injury prevention and RTS-decision making will be discussed in combination with a practical session, where participants can try out these new tests.

Learning Objective 1: The participant expands his/her knowledge on current and newly developed relevant functional performance tests in LAS injury and CAI-populations.

Learning Objective 2: The participant is able to perform, instruct and interpret the current functional performance tests in LAS injury and CAI-populations.

Learning Objective 3: The participant is able to perform, instruct and interpret the newly developed neurocognitive and reactive functional performance tests and recognize their potential value in LAS and CAI populations.