The Sitting Apprehension Throw Test (SATT): Reliability Study of a New Upper Limb Open Kinetic Chain Physical Performance Test

A Rich¹, S J Donoghue^{1, 2,} , C Spencer¹, A L Cox³, R Hemingway³, J P Evans^{4, 5} and P Guyver¹

¹Univeristy Hospitals Plymouth NHS Trust, Derriford Hospital, Plymouth, PL6 8DH, UK

²Royal Cornwall Hospital, Truro, Cornwall, TR1 3LJ, UK

³Parker Hall Rehabilitation Centre, CTCRM Lympstone, Exmouth, Devon, EX8 5AR, UK

⁴University of Exeter Medical School, Exeter, EX1 2LU, UK

⁵Royal Devon University Healthcare NHS Foundation Trust, Barrack Road, Exeter, Devon, EX2 5DW, UK

Cite this paper:
A Rich, S J Donoghue, C Spencer, A L Cox, R Hemingway, J P Evans and P Guyver. The Sitting Apprehension Throw Test (SATT): Reliability Study of a New Upper Limb Open Kinetic Chain Physical Performance Test. Journal of Physical Activity Research. 2025; 10(1):37-42. doi: 10.12691/jpar-10-1-5

Abstract

The shoulder is vulnerable to injury and dislocation in a variety of sports. A new physical performance test (PPT) is presented: The Sitting Apprehension Throw Test (SATT), which assesses power of the shoulder in the 90/90 position and readiness to return to sport. This pilot study determines the intra and inter-rater reliability of the SATT in a healthy adult population.18 male military volunteers were assessed by experienced physiotherapists. A test-retest design was used with 14-day intervals between sessions. The participant was seated with their arm resting on a plinth in the 90/90 position. A 2kg weighted ball was coated in chalk and thrown. Distance thrown was measured and repeated three times for each arm. Mean distance was calculated. 18 males, mean age 22 (± 4) had mean SATT score 206cm (SD 35), SEM 17cms and MDC90 40cms. There was high interobserver and intraobserver reliability with strong correlation between right and left arms (r=0.7)The SATT is reliable and can be used to evaluate shoulder power and inform assessment of readiness to return to sport after injury. It is simple, quick and easy to perform.

Keywords:
Shoulder Rehabilitation Physiotherapy Physical Performance Test Sitting Apprehension Throw Test

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References:

[1]	Abrams GD, Renstrom PA, Safran MR. Epidemiology of musculoskeletal injury in the tennis player. British journal of sports medicine. 2012; 46(7): 492-8.
[2]	Horsley IG, Fowler EM, Rolf CG. Shoulder injuries in professional rugby: a retrospective analysis. Journal of Orthopaedic surgery and research. 2013; 8: 1-6.
[3]	Johnson CD, Nijst BK, Eagle SR, Kessels MW, Lovalekar MT, Krajewski KT, et al. Evaluation of shoulder strength and kinematics as risk factors for shoulder injury in United States special forces personnel. Orthopaedic journal of sports medicine. 2019;7(3):2325967119831272.
[4]	Wanivenhaus F, Fox AJ, Chaudhury S, Rodeo SA. Epidemiology of injuries and prevention strategies in competitive swimmers. Sports health. 2012; 4(3): 246-51.
[5]	Wilk KE, Obma P, Simpson CD, Cain EL, Dugas J, Andrews JR. Shoulder injuries in the overhead athlete. Journal of orthopaedic & sports physical therapy. 2009; 39(2): 38-54.
[6]	Linaker CH, Walker-Bone K. Shoulder disorders and occupation. Best practice & research Clinical rheumatology. 2015; 29(3): 405-23.
[7]	Poploski KM, Picha KJ, Winters JD, Royer SD, Heebner NR, Lambert B, et al. Patterns and associations of shoulder motion, strength, and function in MARSOC personnel without history of shoulder injury. Military medicine. 2018; 183(11-12): e685-e92.
[8]	Ciccotti MC, Syed U, Hoffman R, Abboud JA, Ciccotti MG, Freedman KB. Return to play criteria following surgical stabilization for traumatic anterior shoulder instability: a systematic review. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2018; 34(3): 903-13.
[9]	Cools AM, Maenhout AG, Vanderstukken F, Declève P, Johansson FR, Borms D. The challenge of the sporting shoulder: From injury prevention through sport-specific rehabilitation toward return to play. Annals of physical and rehabilitation medicine. 2021; 64(4): 101384.
[10]	Wilk KE, Bagwell MS, Davies GJ, Arrigo CA. Return to sport participation criteria following shoulder injury: a clinical commentary. International journal of sports physical therapy. 2020; 15(4): 624.
[11]	Goldbeck TG, Davies GJ. Test-retest reliability of the closed kinetic chain upper extremity stability test: a clinical field test. Journal of Sport Rehabilitation. 2000; 9(1): 35-45.
[12]	Decleve P, Attar T, Benameur T, Gaspar V, Van Cant J, Cools AM. The “upper limb rotation test”: reliability and validity study of a new upper extremity physical performance test. Physical therapy in sport. 2020; 42: 118-23.
[13]	Westrick RB, Miller JM, Carow SD, Gerber JP. Exploration of the y-balance test for assessment of upper quarter closed kinetic chain performance. International journal of sports physical therapy. 2012; 7(2): 139.
[14]	Alizadehkhaiyat O, Hawkes DH, Kemp GJ, Frostick SP. Electromyographic analysis of shoulder girdle muscles during common internal rotation exercises. International journal of sports physical therapy. 2015; 10(5): 645.
[15]	Reinold MM, Curtis AS. Microinstability of the shoulder in the overhead athlete. International journal of sports physical therapy. 2013;8(5):601.
[16]	Monti CB, Ambrogi F, Sardanelli F. Sample size calculation for data reliability and diagnostic performance: a go-to review. European Radiology Experimental. 2024; 8(1): 79.
[17]	Walter S, Eliasziw M, Donner A. Sample size and optimal designs for reliability studies. Statistics in medicine. 1998; 17(1): 101-10.
[18]	Mascarin NC, Vancini RL, Lira CA, Andrade MS. Stretch-induced reductions in throwing performance are attenuated by warm-up before exercise. The Journal of Strength & Conditioning Research. 2015; 29(5): 1393-8.
[19]	Dolan M, Sevene TG, Berninig J, Harris C, Climstein M, Adams KJ, et al. Post-activation potentiation and the shot put throw. Int J Sports Sci. 2017; 7(4): 170-6.
[20]	Davó JLH, Solana RS, Marín JMS, Fernández JF, Ramón MM. Rest interval required for power training with power load in the bench press throw exercise. The Journal of Strength & Conditioning Research. 2016; 30(5): 1265-74.
[21]	Portney LG, Watkins MP. Foundations of clinical research: applications to practice: Pearson/Prentice Hall Upper Saddle River, NJ; 2009.
[22]	Chan Y. Biostatistics 104: correlational analysis. Singapore Med J. 2003; 44(12): 614-9.
[23]	Ashworth B, Hogben P, Singh N, Tulloch L, Cohen DD. The Athletic Shoulder (ASH) test: reliability of a novel upper body isometric strength test in elite rugby players. BMJ Open Sport & Exercise Medicine. 2018; 4(1): e000365.
[24]	Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology Part I: pathoanatomy and biomechanics. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2003; 19(4): 404-20.
[25]	Lin DJ, Wong TT, Kazam JK. Shoulder injuries in the overhead-throwing athlete: epidemiology, mechanisms of injury, and imaging findings. Radiology. 2018; 286(2): 370-87.
[26]	Hess SA, Richardson C, Darnell R, Friis P, Lisle D, Myers P. Timing of rotator cuff activation during shoulder external rotation in throwers with and without symptoms of pain. Journal of Orthopaedic & Sports Physical Therapy. 2005; 35(12): 812-20.
[27]	Chen B, Liu L, Chen LB, Cao X, Han P, Wang C, et al. Concurrent validity and reliability of a handheld dynamometer in measuring isometric shoulder rotational strength. Journal of Sport Rehabilitation. 2021; 30(6): 965-8.
[28]	Fieseler G, Molitor T, Irlenbusch L, Delank K-S, Laudner KG, Hermassi S, et al. Intrarater reliability of goniometry and hand-held dynamometry for shoulder and elbow examinations in female team handball athletes and asymptomatic volunteers. Archives of orthopaedic and trauma surgery. 2015; 135: 1719-26.
[29]	Holt K, Raper D, Boettcher C, Waddington G, Drew M. Hand-held dynamometry strength measures for internal and external rotation demonstrate superior reliability, lower minimal detectable change and higher correlation to isokinetic dynamometry than externally-fixed dynamometry of the shoulder. Physical Therapy in Sport. 2016; 21: 75-81.
[30]	Kolber MJ, Beekhuizen K, Cheng M-SS, Fiebert IM. The reliability of hand-held dynamometry in measuring isometric strength of the shoulder internal and external rotator musculature using a stabilization device. Physiotherapy Theory and practice. 2007; 23(2): 119-24.
[31]	Loepfe JG, Nagelli CV, Larson DR, Tagliero AJ, Cherny CE, Johnson AJ. Reliability and Validity of Measuring Shoulder Internal and External Rotation Strength in Volleyball Specific Positions. International Journal of Sports Physical Therapy. 2025; 20(4): 532.
[32]	Chamorro C, Arancibia M, Trigo B, Arias-Poblete L, Jerez-Mayorga D. Absolute reliability and concurrent validity of hand-held dynamometry in shoulder rotator strength assessment: systematic review and meta-analysis. International Journal of Environmental Research and Public Health. 2021; 18(17): 9293.
[33]	Roy J-S, MacDermid JC, Orton B, Tran T, Faber KJ, Drosdowech D, et al. The concurrent validity of a hand-held versus a stationary dynamometer in testing isometric shoulder strength. Journal of Hand Therapy. 2009; 22(4): 320-7.
[34]	Croteau F, Robbins SM, Pearsall D. Hand-held shoulder strength measures correlate with isokinetic dynamometry in elite water polo players. Journal of Sport Rehabilitation. 2021; 30(8): 1233-6.
[35]	Ellenbecker TS, Aoki R. Step by step guide to understanding the kinetic chain concept in the overhead athlete. Current reviews in musculoskeletal medicine. 2020; 13: 155-63.
[36]	Lorenz D, Morrison S. Current concepts in periodization of strength and conditioning for the sports physical therapist. International journal of sports physical therapy. 2015; 10(6): 734.
[37]	Suchomel TJ, Nimphius S, Stone MH. The importance of muscular strength in athletic performance. Sports medicine. 2016; 46: 1419-49.
[38]	Harris C, Wattles AP, DeBeliso M, Sevene-Adams PG, Berning JM, Adams KJ. The seated medicine ball throw as a test of upper body power in older adults. The Journal of Strength & Conditioning Research. 2011; 25(8): 2344-8.
[39]	Beckham G, Lish S, Disney C, Keebler L, DeBeliso M, Adams KJ. The reliability of the seated medicine ball throw as assessed with accelerometer instrumentation. Journal of Physical Activity Research. 2019; 4(2).
[40]	Leite MAFdJ, Sasaki JE, Lourenço CLM, Zanetti HR, Cruz LG, Mota GRd, et al. Medicine ball throw test predicts arm power in rugby sevens players. Revista Brasileira de Cineantropometria & Desempenho Humano. 2016; 18(2): 166-76.
[41]	Marques MC, Van Den Tillaar R, Vescovi JD, González-Badillo JJ. Relationship between throwing velocity, muscle power, and bar velocity during bench press in elite handball players. International journal of sports physiology and performance. 2007; 2(4): 414-22.
[42]	November RV-C. The relationship between shoulder complex strength and throwing velocity in club cricketers. 2016.
[43]	Olds M, Coulter C, Marant D, Uhl T. Reliability of a shoulder arm return to sport test battery. Physical therapy in sport. 2019; 39: 16-22.