Handball and movement screening - can non-contact injuries be predicted in adolescent elite handball players? A 1-year prospective cohort study

Introduction: The nine-test screening battery (9SB) consists of 11 tests used to assess injury risk in sports populations. Objectives: To evaluate the predictive value of the composite score and underlying factors of the 9SB for sustaining non-contact injury in adolescent elite handball players. Methods: Forty-five (23 females) adolescent elite handball players, median age 17 (range 16-18), pre-seasonally performed the 9SB, followed by weekly recordings of injuries for 52 weeks using a web-based questionnaire. Results: The median value for seasonal substantial injury prevalence was 22% (25-75(th) percentiles 6-41). An exploratory factor analysis extracted three factors, complex movements, mobility, and lower extremity control, that explained a cumulative variance of 56%, where each factor contributed with 13-26% of the total variance. Based on the identified cutoff values, none of the factors or the complete 9SB could predict the risk of a non-contact new injury as well as the risk of reporting a substantial injury. Area under the curve values were ranged 0.50 to 0.59, with the corresponding 95% CI including 0.50 for all factors. Conclusion: Based on the limited predictive ability of the 9SB, it is not recommended that clinicians use the 9SB to predict injury in adolescent elite handball players.