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Upper Extremity Return to Sport Functional Testing: A Systematic Review.

Marisa Pontillo1,2, Eric Bellm3, Patrick Barber4

  • 1Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, 7700 Arlington Blvd, Falls Church, VA, 22042, USA. pontillo77@gmail.com.

Sports Medicine - Open
|February 22, 2026
PubMed
Summary
This summary is machine-generated.

This systematic review found the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) and Single Arm Shot Put test (SASP) to be reliable and valid for assessing upper extremity return to sport readiness in athletes.

Keywords:
Functional testMeasurementPsychometric propertiesReturn to sportUpper extremity

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Area of Science:

  • Sports Medicine
  • Rehabilitation Science
  • Biomechanics

Background:

  • Standardized upper extremity return to sport (RTS) assessments are lacking, leading to inconsistent clinical practices.
  • Clinicians may use suboptimal metrics or forgo objective criteria for RTS readiness evaluations.
  • This variability impacts the quality of care for athletes seeking to return to sport.

Purpose of the Study:

  • To systematically review the psychometric properties of upper extremity functional tests for RTS readiness.
  • To evaluate reliability, agreement, validity, and responsiveness of these assessments.
  • To inform clinicians on selecting appropriate RTS evaluation tools.

Main Methods:

  • Systematic review following PRISMA guidelines.
  • Inclusion of studies assessing reliability and/or validity of upper extremity functional tests in athletes.
  • Data extraction and assessment using the PEDro scale.

Main Results:

  • Sixty studies were analyzed, identifying the Single Arm Shot Put (SASP), Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), and Upper Quarter Y-Balance (UQY) as frequently investigated.
  • SASP and CKCUEST demonstrated consistent reliability and validity across various populations.
  • UQY showed mixed reliability, while the Athletic Shoulder Test (ASH) exhibited excellent reliability and high concurrent validity.

Conclusions:

  • The CKCUEST and SASP are reliable and valid for assessing RTS readiness in diverse athletic populations.
  • Understanding the psychometric properties of these tests aids clinicians in selecting appropriate RTS assessments.
  • This knowledge supports evidence-based decision-making for athletes of all ages, sexes, sports, and injury statuses.