Background Despite being the most commonly incurred sports injury with a high recurrence rate, there are no guidelines to inform return to sport (RTS) decisions following acute lateral ankle sprain injuries. We aimed to develop a list of assessment items to address this gap. Methods We used a three-round Delphi survey approach to develop consensus of opinion among 155 globally diverse health professionals working in elite field or court sports. This involved surveys that were structured in question format with both closed-response and open-response options. We asked panellists to indicate their agreement about whether or not assessment items should support the RTS decision after an acute lateral ankle sprain injury. The second and third round surveys included quantitative and qualitative feedback from the previous round. We defined a priori consensus being reached at >70% agree or disagree responses. Results Sixteen assessment items reached consensus to be included in the RTS decision after an acute lateral ankle sprain injury. They were mapped to five domains with 98% panellist agreement—PAASS: Pain (during sport participation and over the last 24 hours), Ankle impairments (range of motion; muscle strength, endurance and power), Athlete perception (perceived ankle confidence/reassurance and stability; psychological readiness), Sensorimotor control (proprioception; dynamic postural control/balance), Sport/functional performance (hopping, jumping and agility; sport-specific drills; ability to complete a full training session). Conclusion Expert opinion indicated that pain severity, ankle impairments, sensorimotor control, athlete perception/readiness and sport/functional performance should be assessed to inform the RTS decision following an acute lateral ankle sprain injury. Trial registration number ACTRN12619000522112.

Several anthropometric and physiological factors have been argued to explain sex differences in performance and injury,1 yet sex-comparisons do not allow perinatal considerations to be explored. For example, female breasts lack intrinsic support and fluctuate in size …

Objective: To identify functional performance tests (FPTs) with potential to identify athletes at risk of lower extremity injury (LEI) and assess their measurement properties. Design: Systematic review conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses and PRISMA in Exercise, Rehabilitation, Sports Medicine and Sports Science guidance. Data sources: Two-stage systematic search of Medline, Embase, Cumulative Index to Nursing and Allied Health Literature and SPORTDiscus databases from inception to 24 November 2023, supplemented by hand searching of reference lists, key journals and grey literature. Eligibility criteria: Search 1 identified FPT predicting LEI in athletes aged >16 years competing at elite, pre-elite or collegiate levels and feasible in the field. Search 2 assessed measurement properties of identified FPT. COnsensus-based Standards for the selection of health Measurement INstruments risk of bias checklist and criteria for good measurement properties were applied, and evidence summarised using modified Grading of Recommendations, Assessment, Development and Evaluations guidelines. Results: Fifty-nine studies evaluating 15 FPTs were included. Reliability (n=14), measurement error (n=11), structural validity/internal consistency (n=2), criterion validity (n=11), construct validity (n=5) and responsiveness (n=1) were assessed. No FPT demonstrated high certainty for measurement properties. Y-balance test (YBT) demonstrated moderate certainty for three properties (intrarater reliability, criterion validity and responsiveness). Knee to wall (KTW), single-leg squat (SLS), drop vertical jump (DVJ) and single hop for distance (SHFD) showed moderate certainty for two properties (reliability, intra/inter test-retest; criterion validity). Side hop, functional movement screen and landing error scoring system showed moderate certainty for one measurement property. Practicability assessment revealed poor reporting of time requirements and results production. Conclusion: Moderate-certainty evidence supported reliability and validity of five FPTs (YBT, KTW, SLS, DVJ, SHFD) used to identify athletes at LEI risk. Studies with low bias and comprehensive practicability evaluations are lacking. PROSPERO registration number CRD42020188932.

Introduction Lower extremity injury (LEI) is highly prevalent and its occurrence increases the risk of future injury in athletic populations. Identifying athletes at risk of injury is the key to target injury-prevention programmes. Functional performance tests (FPT) assess an athlete’s ability to produce and accept forces during movement tasks reflective of those experienced in sport, and are used to identify deficits in physical qualities or neuromuscular control. This review aims to identify FPT which have potential to predict LEI and assess their measurement properties associated with reliability, validity, responsiveness and practicability (interpretability and feasibility). Methods/analysis This protocol will be reported using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol and the COnsensus-based Standards for the selection of health Measurement INstruments Methodology. The search strategy has two stages: stage 1 will identify lower limb FPT used in athletic populations; and stage 2 will assess the measurement properties of the identified FPT. A sensitive search strategy will use MEDLINE, EMBASE, CINHAL and SPORTdiscus databases; from inception to June 2020. Hand searching reference lists, key journals and grey literature will be completed. One reviewer will complete search 1 and data extraction. Two reviewers will complete the search, data extraction and risk-of-bias assessment for search 2. Evidence will be pooled or summarised by individual measurement property by each individual study and grouped by FPT. Meta-analysis using a random effects model with subgroup analysis will be performed where possible. Pooled or summarised results for each FPT in relation to each measurement property will be rated against the criteria for good measurement properties. Two reviewers will assess the overall body of evidence per measurement property per FPT using the modified Grading of Recommendations, Assessment, Development and Evaluation guidelines. This review will enable clinicians to make an informed choice when selecting FPT. Ethics and dissemination No ethical approval is required for this review and the results will be disseminated through peer-reviewed publications and submitted for conference presentation. PROSPERO registration number CRD42020188932.

As participation in women’s football grows, more players who wish to become mothers will be faced with the physical, psychological and performance adaptations brought about by pregnancy and motherhood. Despite the growing number of mother-athletes—including elite footballers—practical and sport-specific perinatal guidelines are scant, owing, in part, to a relative lack of field-based research. Exercise during and following pregnancy is well established to be safe and beneficial for the majority of individuals; however, participation in football during the perinatal period presents additional considerations. Fostering an open culture in which footballers feel safe and supported when communicating their needs around pregnancy, birth and return to football is essential. Individualised player-centred protocols delivered collaboratively by an extended specialist perinatal multidisciplinary team (including obstetrics, midwifery and pelvic health physiotherapy) is recommended. Clear and open communication, timely protocol preparation, regular monitoring and multidimensional, criteria-based progression are key to enabling players’ progress back onto the pitch whilst meeting their needs as mothers. Players’ wellbeing, illness and injury risk should be key considerations. The aim of this chapter is to enhance the scientific knowledge of readers and increase their confidence in collaboratively managing perinatal footballers in the training environment. <!----> <!----> <!----> <!---->