PEFA Assessments

• Shoulder


  • Acromion process shape & coracoacromial arch angle - associated with rotator cuff tears
• Knee


  • Prior knee injury within the past 2 years + increased age + increased valgus stress + poor balance - increased risk of knee injuries
• Lower back


  • Asymmetrical movement patterns + poor trunk endurance and pelvic control - association with non-specific lower back injuries
• Each employer and occupation will present a different set of inherent risks
• Shoulder roles

  • Significant overhead work, external rotation strength, scapula tracking and internal ROM
• Shoulder roles

  • Painting, electrical, labour
• Knee roles

  • Repetitive kneeling and crouching
• Knee roles

  • Landscapers, carpenters and renovators
• Lower back roles

  • Repetitive bending and twisting, heavy lifting, and possible risk of falls from heights
• Lower back roles

  • Roofers and removalists
• Protocols for assessing physical requirements


  • Active ROM assessment
  • Manual Muscle Testing (MMT)
  • Isoinertial Lifting Evaluation (Occasional)
  • Progressive Isoninertial Lifting Evaluation (Frequent)
  • Push/Pull
  • Grip strength
  • The Functional Impairment Test - Head, and Neck/Shoulder/Arm (FITT_HaNSA) Protocol
  • Thomas Test
  • ACSM Curl Up Test
  • 90/90 Hamstring flexibility test
  • Star Excursion Balance Test
  • Drop Jump Screening Test
• Progressive Isoninertial Lifting Evaluation


  Capable of frequent lifting capacity - 2/3 of 8hr shift / Between 2 - 29 minutes
• Progressive Isoninertial Lifting Evaluation

  • Repeated 4x within 20 seconds
  • Weight is added until technique failure or requested termination
• Occasional Isoninertial Lifting Evaluation


  Capable of occasionally lifting - 1/3 of 8hr shift / Not lifting every 30 mins
• Occasional Isoninertial Lifting Evaluation

  • Requires lifting only once at each weight
• Measure HR if possible between sets
• No specific standardised protocol to simulate physical demands of the role - hence focus on ensuring safety to complete task using standardised tests (rather than focusing on their ability to complete the task itself)
• Clients with poor abdominal strength + tight lower back musculature


  • May have increased disposition to lower back injury = test trunk ROM, thomas test and 90/90 test
• Grip Strength Test

  Measure maximum isometric strength of hand and forearm muscles for a general measure of overall arm strength

  • Results alone should not be relied upon to determine upper limb function
• Thomas Test


  Indicates likelihood of lower back injury if hip flexors are tight/shortened

  • If foot still resting on bed / tightness = J-Sign or stroke = tight iliotibial band
• 90/90 Test

  Assesses hamstring tightness (more effective than sit-and-reach?) + easily quantifiable and good for progress monitoring

  • If knee within 20 degrees of full extension = positive
• FIT-HaNSA Protocol

  Requires peg board + useful for roles with significant amounts of overhead work, e.g. electrician

  • Battery of three exercises that simulate activities of lifting and sustained overhead work
  • Tests the endurance of the shoulder + monitors degrees of shoulder function
• Star Excursion Balance Test

  Time-consuming, but good evidence-based - identifies future risk of ankle injury, or presence of chronic ankle instability

  
  

  Indication to stop test:

  • Athlete unable to touch their foot to the line before returning back to the start / loss of balance
  • No aiding for balance
  • Hands must stay on hips at all times
  • Athlete must lightly touch the floor - loss of balance due to heavy contact is not allowed
• ACSM Curl Up Test

  1. Simplified way of assessing trunk endurance - important for stabilising movements and balance + prevent injuries
  2. Measured by no. of curl-ups

  • Test will continue until subject is no longer able to keep up with the metronome or has a volitional stop
  • If 75 curl-ups or more achieved, the test may also finish
• Include associated assessment for:

  • Identified Injury risk
  • Physical demands

  Then report results on assessments and compare to normative

  Make a conclusion on the overall ability to meet the requirements of the role