Reliability of the Athletic Shoulder Test in Asymptomatic and Symptomatic Overhead Racquet Athletes

Objectives: Assessing intra- and inter-rater reliability of the Athletic Shoulder (ASH) test using a force plate in asymptomatic and symptomatic overhead racquet athletes.

Design: Within-session, intra- and inter-rater reliability.

Setting: Physiotherapy practice in Belgium.

Participants: Forty-two overhead racquet athletes (21 asymptomatic, 21 symptomatic with shoulder complaints), all playing tennis, badminton, and/or padel for at least 4 h weekly.

Main Outcome Measures: Intra- and inter-rater reliability (intraclass correlation coefficients), standard errors of measurement, minimum detectable change, and agreement (Bland-Altman plots).

Results: The ASH test demonstrated excellent intra-rater reliability among asymptomatic (ICC 0.93-0.98) and symptomatic athletes (ICC 0.91-0.98) in all positions (I,Y,T). Inter-rater reliability ranged from good to excellent (asymptomatic: ICC 0.80-0.95, symptomatic: ICC 0.79-0.91).

Conclusions: The ASH test demonstrated excellent reliability for single-rater use, supporting its utility for assessing isometric strength in overhead racquet athletes, with or without shoulder complaints. In the asymptomatic group, excellent inter-rater reliability was observed in the Y and T positions. In the symptomatic group, only the non-dominant T position showed excellent inter-rater reliability, making consistent use of a single rater preferable in this population. Future applications may aid injury rehabilitation and return-to-play protocols in sports medicine.