The development of a clinical preventative screening tool for the lower quarter [electronic resource] /

by Perez, Brian M.

The Development of a Clinical Preventative Screening Tool for the Lower Quarter Brian M. Perez, BS, ATC Context: There are no concise and thorough lower quarter screening tools found in the literature or the clinical setting. An evaluation tool is needed to identify potential problems that could lead to injury. Purpose: The purpose of this study was to develop a concise and thorough screening tool for the lower quarter. Design: This was a prospective descriptive study following the Modified Delphi Technique, to create a lower quarter screening tool based on opinion from a panel of experts. The dependent variable was the responses ranging from strongly agree to strongly disagree. Setting: This study took place at West Virginia University. Patients or Other Participants: Seven of the eight panelists hold the Certified Athletic Trainer (ATC) credential who have been practicing for over ten years working in the academic setting (37.5%, n=3), athletic training facility (25%, n=2), and the sports medicine/outpatient clinic (37.5%, n=3) for more than 50% of their job. One of the participants is a PT. Five have a MS degree,while 3 are PhD’s. Thirty-seven and a half percent (n=3) hold both PT and ATC credentials. Twelve and a half percent (n=1) are ATC’s and Certified Strength and Conditioning Specialist (CSCS). One participant is an ATC, Board Certified Orthotist (BOCO). The group average is 38.75 publications and presentations on the lower quarter in the past ten years. Criteria for selection were based on publications, presentations and clinical experience with the lower quarter. Interventions: A lower quarter screening tool was created through a series of successive revisions with input being offered from colleagues and a psychometric expert. Two rounds of questionnaires were used prior to the development of the tool. The first round questionnaire was sent via mail to the panel of experts. This panel rated the elements of a lower quarter evaluation on the Likert scale from strongly agree to strongly disagree. A 75% consensus of agreement and a mean score of four met the inclusion criteria. Following the changes and additions made to the questionnaire based on the input from the first round, a second round questionnaire and cover letter was sent again to the panel of experts. This panel again rated the elements of a lower quarter evaluation on the Likert scale from strongly agree to strongly disagree. A 75% consensus and a mean score of four met the inclusion criteria. After the second round material was reviewed and analyzed, a lower quarter screening tool was developed. Main Outcomes Measures: According to a 75% consensus of each item rated four or higher, the evaluation process, medical history, inspection/observation and palpation, range of motion, flexibility and strength and biomechanical assessment for the lower quarter were similar. Results: Eight participants returned the questionnaire for the first round, accounting for a 100% return rate. Eight participants returned the questionnaire for the first round, accounting for a 100% return rate. Six participants returned the second round questionnaire for a 75% return rate. Sixty items in the screening tool did not meet consensus after the first round. Sixty-six items in the screening tool did not meet consensus after the second round. The final lower quarter screening tool contained 66 items. Conclusion: The information gained from this final screening tool by the panel of experts may help health care professionals in various settings prevent lower extremity injuries in athletes. Since there is no known preventative screening tools in the literature, this tool could serve as a basis for developing an even more concise, yet complete, lower quarter screening tool in the future.