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Updated: Apr 1, 2026

Measuring 3D In-vivo Shoulder Kinematics using Biplanar Videoradiography
Published on: March 12, 2021
Sport-Specific Outcome Measures Improve Clinical Assessment of Shoulder Injury in Swimmers: A Cohort Study of
Diogo Nunes Sousa1,2, Tiago Velho1,2, Rui Escaleira1,2,3,4
1Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.
Background:
Swimming is among the most widely practiced sports globally. Up to 70% of swimmers report shoulder pain that impairs performance. Patient-reported outcome measures (PROMs) are effective, objective tools for assessing such injuries. The aim of this study was to develop and validate swimming-specific adaptations of established shoulder PROMs (ASES-swim and SSV-swim) and compare their psychometric properties and discriminatory ability with generic existing instruments.
Hypothesis:
Swimming-specific PROMs may more accurately assess shoulder condition in swimmers and monitor recovery, thereby enabling improved evaluation of health status and, ultimately, athletic performance.
Study Design:
Cohort study.
Methods:
A total of 167 athletes registered with the Portuguese Swimming Federation (FPN) during the 2023-2024 season were enrolled. Participants were stratified into asymptomatic group (AG = 92) and injured group (IG = 75). Monthly assessments included training characteristics, injury status, and responses to ASES, SSV, SSV-sport, and newly developed ASES-swim and SSV-swim questionnaires over 6 months.
Results:
SSV-swim correlated strongly with SSV and SSV-sport (r = 0.769, P < 0.001 and r = 0.857, P < 0.001, respectively). ASES-swim scores were highly correlated with ASES scores (r = 0.994, P < 0.001). Both SSV-swim and ASES-swim demonstrated higher internal consistency than the nonadapted PROMs (Cronbach alpha = 0.849 and 0.870, respectively). SSV, SSV-sport, and SSV-swim showed moderate discriminatory ability (area under the curve [AUC] = 0.760, 0.809, and 0.851, respectively), whereas ASES and ASES-swim showed excellent discriminatory ability for detecting injury (AUC = 0.967 and 0.970, respectively).
Conclusion:
ASES-swim and SSV-swim are a valid, reliable, and easy to administer tool for the assessment of shoulder injury and recovery in swimmers. Swimming-specific PROMs provide clinically meaningful improvements in shoulder injury assessment accuracy.
Clinical Relevance:
Swimming-specific PROMs provide clinicians with a sensitive and reliable method for assessing shoulder injury in swimmers, enabling more accurate diagnosis and individualized rehabilitation. Further research should investigate sports-specific PROM adaptations to optimize athlete care across disciplines.

