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Physical performance tests predict injury in National Collegiate Athletic Association athletes: a three-season prospective cohort study
  1. Eric J Hegedus1,
  2. Suzanne McDonough2,
  3. Chris Bleakley3,
  4. G David Baxter4,
  5. J Tyler DePew5,
  6. Ian Bradbury6,
  7. Chad Cook7
  1. 1Department of Physical Therapy, High Point University, High Point, North Carolina, USA
  2. 2Centre for Health and Rehabilitation Technologies, School of Health Sciences, Institute of Nursing and Health Research, University of Ulster, Newtownabbey, County Antrim, UK
  3. 3Lecturer Ulster Sports Academy, Sport and Exercise Sciences Research Institute, University of Ulster, Carrickfergus, UK
  4. 4School of Physiotherapy, University of Otago, Dunedin, New Zealand
  5. 5Athletic Trainer, Department of Athletics, High Point University, High Point, North Carolina, USA
  6. 6University of Ulster, Institute of Nursing and Health Research, Newtownabbey, County Antrim, UK
  7. 7Division of Physical Therapy, Duke University, Durham, North Carolina, USA
  1. Correspondence to Dr Eric J Hegedus, Department of Physical Therapy, High Point University, High Point, North Carolina, 833 Montlieu Ave, High Point 27262, NC, USA; ehegedus{at}


Background The ability to predict injury is difficult. Prior injury is the only risk factor that has been reported consistently in multiple research studies. Convenient and easy to perform, physical performance tests (PPTs) have great allure as prognostic factors.

Methods 11 PPTs were issued to 359 participants over the course of three seasons of National Collegiate Athletic Association Division I athletic competition. Injuries were monitored and reported in a centralised university tracking system. Exploratory factor analysis was performed in order to group the PPTs into constructs. The relationship between injury and these PPT-based constructs and other known predictors of injury was explored using univariate and multivariate regression.

Results PPTs clustered into five constructs: (1) active motion, (2) power, (3) hip stability, (4) flexibility and (5) motor control. When these five were placed into a multiple regression equation along with known risk factors (age, body mass index (BMI), gender, excessive flexibility and past injury), hip stability and active motion were predicted injury. In addition, motor control predicted non-traumatic injury. Past injury did not predict injury in the multivariate model.

Summary In college athletes, hip stability, active motion and motor control as assessed through PPTs can be useful as part of preseason screening. These PPT-related constructs seem to have a mediating effect on the relationship between past injury and future injury. This study provides the rationale to test targeted interventions to address these limitations.

Clinical trial registration number NCT01804894.

  • Lower extremity
  • Injury

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  • Contributors EJH developed and executed the study, performed the statistical analysis and wrote the initial draft of the manuscript. SM, CB and GDB edited the manuscript. JTD collected data, provided injury surveillance and edited the manuscript. IB performed the statistical analysis. CC planned and consulted on the statistical analysis and edited the manuscript.

  • Competing interests None declared.

  • Ethics approval High Point University IRB.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The authors are happy to share with receipt of a written request by the corresponding author.

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