Systematic Review of Clinical and Performance Outcome Measures Reported for Softball Pitchers

Fastpitch softball is popular among adolescent and collegiate female athletes. Softball pitchers are susceptible to overuse injuries, and clinical and performance outcome measures can be used to evaluate injury risk and readiness to return to play. Our purpose was to examine clinical and performance-related outcome measures in pitchers using a systematic review of the softball literature published since 1990. PubMed, Embase, CINAHL, and SPORTDiscus databases were searched using the term "softball" AND "pitching" OR "injuries". Inclusion criteria were studies reporting clinical or performance outcomes like strength, range of motion, anthropometrics, and patient-reported measures. A preliminary screening of studies was completed based on abstracts. Full-text articles were reviewed by two reviewers. Thirty-seven studies met all inclusion criteria. The risk of bias was low for all included studies. Studies reporting body composition (n = 4), range of motion (n = 10), strength (n=12), functional testing (n=4), and patient-reported outcomes (n=3) were included in data extraction. There was a high degree of variability in outcome measures used to evaluate softball pitchers. Ten case studies were included in the discussion of results. Researchers would benefit from a standardized list and protocol for clinical and performance outcome measures used for softball pitchers. This systematic review identifies important gaps in the literature.