FIELD-BASED PHYSICAL AND FUNCTIONAL
ASSESSMENT IN AMATEUR TEAM SPORT:
ANTHROPOMETRY, PERFORMANCE, AND
PREPARTICIPATION SCREENING AS A BASIS FOR
INJURY PREVENTION AND TRAINING GUIDANCE.
A SCOPING REVIEW
EVALUACIÓN FÍSICA Y FUNCIONAL EN EL TERRENO DE JUEGO EN DEPORTES
DE EQUIPO AMATEUR: ANTROPOMETRÍA, RENDIMIENTO Y CRIBADO PREVIO
A LA PARTICIPACIÓN COMO BASE PARA LA PREVENCIÓN DE LESIONES Y LA
ORIENTACIÓN DEL ENTRENAMIENTO. UNA REVISIÓN EXPLORATORIA
Pedro Antonio Valdez Lizárraga
Autonomous University of Sinaloa, Mexico
Daniel Hernández Muñoz
Universidad del Valle de Atemajac, Mexico
María Fernanda Rincón Díaz
Universidad Autónoma de Chiapas, Mexico
Perla Jacqueline Wlin Rodríguez
Autonomous University of Sinaloa, Mexico
M.C. Gloria Patricia Garcia Lopez
Autonomous University of Sinaloa, Mexico
pág. 5549
DOI: https://doi.org/10.37811/cl_rcm.v10i5.26407
Field-based Physical and Functional Assessment in Amateur Team Sport:
Anthropometry, Performance, and Preparticipation Screening as a Basis
for Injury Prevention and Training Guidance. A Scoping Review
M.C. Pedro Antonio Valdez Lizárraga1
Pedro.valdez@uas.edu.mx
https://orcid.org/0000-0001-5773-4628
Autonomous University of Sinaloa
Mexico
Daniel Hernández Muñoz
0312415218@alumnos.univa.mx
https://orcid.org/0009-0006-3568-0212
Universidad del Valle de Atemajac
Mexico
María Fernanda Rincón Díaz
maria.rincon44@unach.mx
https://orcid.org/0009-0006-4836-0146
Universidad Autónoma de Chiapas
Mexico
M.C. Gloria Patricia Garcia Lopez
gopagalo@hotmail.com
https://orcid.org/0009-0009-6338-4674
Autonomous University of Sinaloa
Mexico
M.C. Perla Jacqueline Wlin Rodríguez
perlajacqueline.rodriguez@uas.edu.mx
https://orcid.org/0009-0002-9343-4870
Autonomous University of Sinaloa
Mexico
ABSTRACT
Amateur team sports impose repeated physical and neuromuscular demands on athletes who differ in
age, sex, training history, playing position, competitive level, and exposure. Nevertheless, assessment
in resource-limited settings is often fragmented, standardized inconsistently, or restricted to isolated
indicators. This scoping review mapped evidence on field-based anthropometric, functional,
performance, and preparticipation assessment in amateur and non-elite team-sport populations and
examined how these domains are associated with physical performance, musculoskeletal injury history,
and preventive decision-making. The review followed PRISMA-ScR and the Arksey and O’Malley
framework. PubMed/MEDLINE was searched for publications from 2021 to July 2026 using a title-
anchored strategy restricted to English, Spanish, and Chinese. Of 145 records identified, 119 were
retained after title and abstract screening for full-text eligibility assessment; therefore, the synthesis
remains provisional until full-text confirmation is completed. Evidence was organized into three
components: anthropometry and body composition; functional and field performance; and
preparticipation screening, injury epidemiology, and prevention. The emerging evidence indicates that
body mass index has limited value as a standalone indicator and should be complemented by measures
of central adiposity and body composition. Intermittent endurance, sprinting, change of direction,
explosive performance, mobility, and balance represent related but nonredundant dimensions whose
associations with body profile vary across sex, age, sport, position, and competitive level. Injury
evidence supports multifactorial interpretation, systematic recording of previous injury, and
multicomponent prevention, while cautioning against using any single test to predict injury. The review
proposes an integrative framework and a resource-proportional assessment pathway prioritizing safety,
standardization, measurement error, and contextual interpretation.
Keywords: body composition; soccer; rugby; intermittent endurance; measurement error; athlete
monitoring
1 Autor principal
Correspondencia: Pedro.valdez@uas.edu.mx
DOI: https://doi.org/10.37811/cl_rcm.v10i5.26407
Field-based Physical and Functional Assessment in Amateur Team Sport:
Anthropometry, Performance, and Preparticipation Screening as a Basis
for Injury Prevention and Training Guidance. A Scoping Review
M.C. Pedro Antonio Valdez Lizárraga1
Pedro.valdez@uas.edu.mx
https://orcid.org/0000-0001-5773-4628
Autonomous University of Sinaloa
Mexico
Daniel Hernández Muñoz
0312415218@alumnos.univa.mx
https://orcid.org/0009-0006-3568-0212
Universidad del Valle de Atemajac
Mexico
María Fernanda Rincón Díaz
maria.rincon44@unach.mx
https://orcid.org/0009-0006-4836-0146
Universidad Autónoma de Chiapas
Mexico
M.C. Gloria Patricia Garcia Lopez
gopagalo@hotmail.com
https://orcid.org/0009-0009-6338-4674
Autonomous University of Sinaloa
Mexico
M.C. Perla Jacqueline Wlin Rodríguez
perlajacqueline.rodriguez@uas.edu.mx
https://orcid.org/0009-0002-9343-4870
Autonomous University of Sinaloa
Mexico
ABSTRACT
Amateur team sports impose repeated physical and neuromuscular demands on athletes who differ in
age, sex, training history, playing position, competitive level, and exposure. Nevertheless, assessment
in resource-limited settings is often fragmented, standardized inconsistently, or restricted to isolated
indicators. This scoping review mapped evidence on field-based anthropometric, functional,
performance, and preparticipation assessment in amateur and non-elite team-sport populations and
examined how these domains are associated with physical performance, musculoskeletal injury history,
and preventive decision-making. The review followed PRISMA-ScR and the Arksey and O’Malley
framework. PubMed/MEDLINE was searched for publications from 2021 to July 2026 using a title-
anchored strategy restricted to English, Spanish, and Chinese. Of 145 records identified, 119 were
retained after title and abstract screening for full-text eligibility assessment; therefore, the synthesis
remains provisional until full-text confirmation is completed. Evidence was organized into three
components: anthropometry and body composition; functional and field performance; and
preparticipation screening, injury epidemiology, and prevention. The emerging evidence indicates that
body mass index has limited value as a standalone indicator and should be complemented by measures
of central adiposity and body composition. Intermittent endurance, sprinting, change of direction,
explosive performance, mobility, and balance represent related but nonredundant dimensions whose
associations with body profile vary across sex, age, sport, position, and competitive level. Injury
evidence supports multifactorial interpretation, systematic recording of previous injury, and
multicomponent prevention, while cautioning against using any single test to predict injury. The review
proposes an integrative framework and a resource-proportional assessment pathway prioritizing safety,
standardization, measurement error, and contextual interpretation.
Keywords: body composition; soccer; rugby; intermittent endurance; measurement error; athlete
monitoring
1 Autor principal
Correspondencia: Pedro.valdez@uas.edu.mx
pág. 5550
Evaluación Física y Funcional en el Terreno de Juego en Deportes de
Equipo Amateur: Antropometría, Rendimiento y Cribado Previo a la
Participación como base para la Prevención de Lesiones y la Orientación
del Entrenamiento. Una Revisión Exploratoria
RESUMEN
Los deportes de equipo amateur imponen demandas físicas y neuromusculares repetidas sobre
deportistas que difieren en edad, sexo, experiencia de entrenamiento, posición de juego, nivel
competitivo y exposición. Sin embargo, la evaluación en contextos con recursos limitados suele
encontrarse fragmentada, estandarizada de manera inconsistente o restringida an indicadores aislados.
Esta revisión de alcance mapeó la evidencia sobre evaluación antropométrica, funcional, del
rendimiento y preparticipativa realizada mediante procedimientos de campo en poblaciones amateur y
no élite de deportes de equipo, y examinó cómo estos dominios se asocian con el rendimiento físico,
los antecedentes de lesión musculoesquelética y la toma de decisiones preventivas. La revisión siguió
PRISMA-ScR y el marco de Arksey y O’Malley. Se realizó una búsqueda en PubMed/MEDLINE de
publicaciones comprendidas entre 2021 y julio de 2026, mediante una estrategia anclada en el título y
restringida an inglés, español y chino. De los 145 registros identificados, 119 fueron retenidos después
del cribado de título y resumen para la evaluación de elegibilidad a texto completo; por tanto, la síntesis
permanece provisional hasta completar dicha confirmación. La evidencia se organizó en tres
componentes: antropometría y composición corporal; evaluación funcional y rendimiento de campo; y
tamizaje preparticipativo, epidemiología de lesiones y prevención. La evidencia emergente indica que
el índice de masa corporal presenta un valor limitado como indicador aislado y debe complementarse
con medidas de adiposidad central y composición corporal. La resistencia intermitente, la velocidad, el
cambio de dirección, el rendimiento explosivo, la movilidad y el equilibrio representan dimensiones
relacionadas, pero no redundantes, cuyas asociaciones con el perfil corporal varían según sexo, edad,
deporte, posición y nivel competitivo. La evidencia sobre lesiones respalda una interpretación
multifactorial, el registro sistemático de lesiones previas y la prevención multicomponente, al tiempo
que desaconseja utilizar una sola prueba para predecir lesiones. La revisión propone un marco
integrador y una ruta de evaluación proporcional a los recursos que prioriza la seguridad, la
estandarización, el error de medición y la interpretación contextual.
Palabras clave: composición corporal; fútbol; rugby; resistencia intermitente; error de medición;
seguimiento del deportista
Artículo recibido 20 agosto 2026
Aceptado para publicación: 20 setiembre 2026
Evaluación Física y Funcional en el Terreno de Juego en Deportes de
Equipo Amateur: Antropometría, Rendimiento y Cribado Previo a la
Participación como base para la Prevención de Lesiones y la Orientación
del Entrenamiento. Una Revisión Exploratoria
RESUMEN
Los deportes de equipo amateur imponen demandas físicas y neuromusculares repetidas sobre
deportistas que difieren en edad, sexo, experiencia de entrenamiento, posición de juego, nivel
competitivo y exposición. Sin embargo, la evaluación en contextos con recursos limitados suele
encontrarse fragmentada, estandarizada de manera inconsistente o restringida an indicadores aislados.
Esta revisión de alcance mapeó la evidencia sobre evaluación antropométrica, funcional, del
rendimiento y preparticipativa realizada mediante procedimientos de campo en poblaciones amateur y
no élite de deportes de equipo, y examinó cómo estos dominios se asocian con el rendimiento físico,
los antecedentes de lesión musculoesquelética y la toma de decisiones preventivas. La revisión siguió
PRISMA-ScR y el marco de Arksey y O’Malley. Se realizó una búsqueda en PubMed/MEDLINE de
publicaciones comprendidas entre 2021 y julio de 2026, mediante una estrategia anclada en el título y
restringida an inglés, español y chino. De los 145 registros identificados, 119 fueron retenidos después
del cribado de título y resumen para la evaluación de elegibilidad a texto completo; por tanto, la síntesis
permanece provisional hasta completar dicha confirmación. La evidencia se organizó en tres
componentes: antropometría y composición corporal; evaluación funcional y rendimiento de campo; y
tamizaje preparticipativo, epidemiología de lesiones y prevención. La evidencia emergente indica que
el índice de masa corporal presenta un valor limitado como indicador aislado y debe complementarse
con medidas de adiposidad central y composición corporal. La resistencia intermitente, la velocidad, el
cambio de dirección, el rendimiento explosivo, la movilidad y el equilibrio representan dimensiones
relacionadas, pero no redundantes, cuyas asociaciones con el perfil corporal varían según sexo, edad,
deporte, posición y nivel competitivo. La evidencia sobre lesiones respalda una interpretación
multifactorial, el registro sistemático de lesiones previas y la prevención multicomponente, al tiempo
que desaconseja utilizar una sola prueba para predecir lesiones. La revisión propone un marco
integrador y una ruta de evaluación proporcional a los recursos que prioriza la seguridad, la
estandarización, el error de medición y la interpretación contextual.
Palabras clave: composición corporal; fútbol; rugby; resistencia intermitente; error de medición;
seguimiento del deportista
Artículo recibido 20 agosto 2026
Aceptado para publicación: 20 setiembre 2026
pág. 5551
INTRODUCTION
Amateur team sport is a regulated competitive practice that, despite its non-professional status, imposes
real and repeated physical demands on a highly heterogeneous population differing in age, training
experience, playing position, and exposure (Hernandez-Martinez et al., 2024). In these settings,
decisions about participation, selection, and training load are frequently grounded in observation and
physical appearance rather than in objective measurement, and structured, systematized assessment
remains rare (Asimakidis et al., 2024). The gap is not trivial. Amateur athletes sustain musculoskeletal
injuries at rates that are far from negligible (Sonesson et al., 2023), and even lower-contact modalities
such as flag football report meaningful injury burdens (Balachandran et al., 2025; Barber Foss et al.,
2023). The scarcity of feasible, reproducible field assessment therefore constrains both the
individualization of training and the early identification of athletes who might benefit from preventive
attention.
A first obstacle to sound assessment is the widespread reliance on body mass index as a proxy for
physical condition. Body mass index is an accessible mass-for-stature ratio, but it cannot distinguish fat
mass from fat-free mass or describe how tissue is distributed, and its conventional cut-off points perform
poorly in athletic populations (Milanese et al., 2025). The body-composition methods that do capture
these dimensions are not interchangeable, since each carries distinct assumptions, sources of error, and
dependence on technician standardization (Campa et al., 2021; Kasper et al., 2021). A defensible body
reading in sport is therefore multidimensional, complementing body mass index with indicators of
central adiposity and with estimates of body composition rather than treating a single value as sufficient
(Ben Brahim et al., 2023).
The relationship between body profile and physical performance is, moreover, neither linear nor
uniform. Higher adiposity tends to accompany poorer sprint and change-of-direction times, whereas
greater fat-free mass tends to accompany jumping and power output, but the magnitude and even the
direction of these associations vary with age, sex, playing position, and the specific quality assessed
(Bustamante-Garrido et al., 2024; Ishida et al., 2021; Leão et al., 2022). Evidence in female and semi-
professional cohorts shows that anthropometric profiles differ by position and sex, which cautions
against adopting a single normative reference (Hernandez-Martinez et al., 2024; Ramírez-Munera et al.,
INTRODUCTION
Amateur team sport is a regulated competitive practice that, despite its non-professional status, imposes
real and repeated physical demands on a highly heterogeneous population differing in age, training
experience, playing position, and exposure (Hernandez-Martinez et al., 2024). In these settings,
decisions about participation, selection, and training load are frequently grounded in observation and
physical appearance rather than in objective measurement, and structured, systematized assessment
remains rare (Asimakidis et al., 2024). The gap is not trivial. Amateur athletes sustain musculoskeletal
injuries at rates that are far from negligible (Sonesson et al., 2023), and even lower-contact modalities
such as flag football report meaningful injury burdens (Balachandran et al., 2025; Barber Foss et al.,
2023). The scarcity of feasible, reproducible field assessment therefore constrains both the
individualization of training and the early identification of athletes who might benefit from preventive
attention.
A first obstacle to sound assessment is the widespread reliance on body mass index as a proxy for
physical condition. Body mass index is an accessible mass-for-stature ratio, but it cannot distinguish fat
mass from fat-free mass or describe how tissue is distributed, and its conventional cut-off points perform
poorly in athletic populations (Milanese et al., 2025). The body-composition methods that do capture
these dimensions are not interchangeable, since each carries distinct assumptions, sources of error, and
dependence on technician standardization (Campa et al., 2021; Kasper et al., 2021). A defensible body
reading in sport is therefore multidimensional, complementing body mass index with indicators of
central adiposity and with estimates of body composition rather than treating a single value as sufficient
(Ben Brahim et al., 2023).
The relationship between body profile and physical performance is, moreover, neither linear nor
uniform. Higher adiposity tends to accompany poorer sprint and change-of-direction times, whereas
greater fat-free mass tends to accompany jumping and power output, but the magnitude and even the
direction of these associations vary with age, sex, playing position, and the specific quality assessed
(Bustamante-Garrido et al., 2024; Ishida et al., 2021; Leão et al., 2022). Evidence in female and semi-
professional cohorts shows that anthropometric profiles differ by position and sex, which cautions
against adopting a single normative reference (Hernandez-Martinez et al., 2024; Ramírez-Munera et al.,
pág. 5552
2025; Toro-Román et al., 2023). These patterns are associated: they describe how body characteristics
and performance co-vary, not how one produces the other, a distinction that governs the interpretation
offered throughout this review.
Assessment matters not only for describing athletes but also for protecting them. Exercise-based
neuromuscular and multicomponent programs can reduce non-contact musculoskeletal injuries in
football and related team sports, yet their benefit depends on adequate adherence and, logically, on a
prior diagnostic phase that identifies whom and what to target (Bullock et al., 2025; Lemes et al., 2021;
Mandorino et al., 2023). Body composition and field fitness have, in turn, been combined to model
injury risk in footballers, an empirical bridge that links the performance axis to the injury axis and
shows that description and prevention are continuous rather than separate concerns (Martins et al.,
2022).
Before any effortful test is administered, a basic preparticipation appraisal of health status, symptoms,
and medical and injury history is warranted. This screening is preventive, proportionate, and explicitly
non-diagnostic; its purpose is to decide whether to proceed, adapt, postpone, or refer, not to certify
fitness (Weise et al., 2025). Much of the available guidance rests on consensus rather than on trial
evidence, yet the ethical and methodological function of this gate is clear: it is what makes the remainder
of field assessment defensible (Harmon et al., 2013).
Two formative research protocols motivated the present review, one concerned with anthropometry and
performance in amateur football and the other with preparticipation conditioning, functional evaluation,
and injury history in amateur flag football. Rather than juxtaposing them, we raise the object of study
to a common level: the system of field-based physical and functional assessment in amateur team sport,
of which football and flag football are two applications of the same underlying problem, namely, how
to evaluate an amateur athlete safely, feasibly, and reproducibly in the absence of laboratory resources,
and what such measurements inform. Accordingly, this scoping review asks what recent evidence (2021
to 2026) supports field-based anthropometric, functional, and preparticipation assessment in amateur
team-sport athletes, and how these indicators relate to physical performance and to musculoskeletal
injury history and risk.
2025; Toro-Román et al., 2023). These patterns are associated: they describe how body characteristics
and performance co-vary, not how one produces the other, a distinction that governs the interpretation
offered throughout this review.
Assessment matters not only for describing athletes but also for protecting them. Exercise-based
neuromuscular and multicomponent programs can reduce non-contact musculoskeletal injuries in
football and related team sports, yet their benefit depends on adequate adherence and, logically, on a
prior diagnostic phase that identifies whom and what to target (Bullock et al., 2025; Lemes et al., 2021;
Mandorino et al., 2023). Body composition and field fitness have, in turn, been combined to model
injury risk in footballers, an empirical bridge that links the performance axis to the injury axis and
shows that description and prevention are continuous rather than separate concerns (Martins et al.,
2022).
Before any effortful test is administered, a basic preparticipation appraisal of health status, symptoms,
and medical and injury history is warranted. This screening is preventive, proportionate, and explicitly
non-diagnostic; its purpose is to decide whether to proceed, adapt, postpone, or refer, not to certify
fitness (Weise et al., 2025). Much of the available guidance rests on consensus rather than on trial
evidence, yet the ethical and methodological function of this gate is clear: it is what makes the remainder
of field assessment defensible (Harmon et al., 2013).
Two formative research protocols motivated the present review, one concerned with anthropometry and
performance in amateur football and the other with preparticipation conditioning, functional evaluation,
and injury history in amateur flag football. Rather than juxtaposing them, we raise the object of study
to a common level: the system of field-based physical and functional assessment in amateur team sport,
of which football and flag football are two applications of the same underlying problem, namely, how
to evaluate an amateur athlete safely, feasibly, and reproducibly in the absence of laboratory resources,
and what such measurements inform. Accordingly, this scoping review asks what recent evidence (2021
to 2026) supports field-based anthropometric, functional, and preparticipation assessment in amateur
team-sport athletes, and how these indicators relate to physical performance and to musculoskeletal
injury history and risk.
pág. 5553
Four subquestions structure the synthesis, addressing (a) anthropometry and body composition, (b)
functional and field performance, (c) preparticipation screening and injury, and (d) the integration of
these components and their modulation by sex, sport, and competitive level. The review advances three
contributions: an integrative conceptual framework of field assessment in amateur team sport, presented
in Figure 1; a resource-proportional field-assessment battery transferable across team modalities; and a
critical synthesis of the direction and heterogeneity of the anthropometry, performance, and injury
relationships, with sex, sport, and level treated as an explicit analytic axis rather than a peripheral caveat.
Figure 1 Integrative Framework for Field-Based Physical and Functional Assessment in Amateur Team Sport
Note. The framework positions Component III (preparticipation screening and safety) as the entry gate to assessment and,
separately, as the evidence base for injury epidemiology, risk factors, and prevention. Component I (anthropometry and body
composition) and Component II (functional and field performance) function as descriptors that feed a resource-proportional
field-assessment battery, which in turn informs two applied aims: training guidance and injury prevention. Sex, sport or
modality, and competitive level operate as cross-cutting modulators (Objective 4). The guiding principle is association rather
than causation, together with standardization and control of measurement error. Own elaboration.
METHOD
Protocol, design, and reporting
This study was designed as a scoping review, an approach suited to mapping a broad and heterogeneous
body of evidence and to clarifying concepts and gaps rather than answering a narrow effect question.
The review was conducted and is reported in accordance with the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR; Tricco et al.,
2018) and was structured following the methodological stages proposed by Arksey and O'Malley (2005)
and refined by Levac et al. (2010): identifying the review question, identifying relevant records,
selecting sources, charting the data, and collating and summarizing the results. Because most of the
primary studies anticipated in this field are observational, their reporting was appraised with the
Four subquestions structure the synthesis, addressing (a) anthropometry and body composition, (b)
functional and field performance, (c) preparticipation screening and injury, and (d) the integration of
these components and their modulation by sex, sport, and competitive level. The review advances three
contributions: an integrative conceptual framework of field assessment in amateur team sport, presented
in Figure 1; a resource-proportional field-assessment battery transferable across team modalities; and a
critical synthesis of the direction and heterogeneity of the anthropometry, performance, and injury
relationships, with sex, sport, and level treated as an explicit analytic axis rather than a peripheral caveat.
Figure 1 Integrative Framework for Field-Based Physical and Functional Assessment in Amateur Team Sport
Note. The framework positions Component III (preparticipation screening and safety) as the entry gate to assessment and,
separately, as the evidence base for injury epidemiology, risk factors, and prevention. Component I (anthropometry and body
composition) and Component II (functional and field performance) function as descriptors that feed a resource-proportional
field-assessment battery, which in turn informs two applied aims: training guidance and injury prevention. Sex, sport or
modality, and competitive level operate as cross-cutting modulators (Objective 4). The guiding principle is association rather
than causation, together with standardization and control of measurement error. Own elaboration.
METHOD
Protocol, design, and reporting
This study was designed as a scoping review, an approach suited to mapping a broad and heterogeneous
body of evidence and to clarifying concepts and gaps rather than answering a narrow effect question.
The review was conducted and is reported in accordance with the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR; Tricco et al.,
2018) and was structured following the methodological stages proposed by Arksey and O'Malley (2005)
and refined by Levac et al. (2010): identifying the review question, identifying relevant records,
selecting sources, charting the data, and collating and summarizing the results. Because most of the
primary studies anticipated in this field are observational, their reporting was appraised with the
pág. 5554
Strengthening the Reporting of Observational Studies in Epidemiology statement in mind (von Elm et
al., 2007). No meta-analysis was planned, given the expected heterogeneity of sports, sexes, competitive
levels, and outcomes.
Information sources and search strategy
Records were identified in a single bibliographic database, PubMed/MEDLINE. The use of one
database is an explicit boundary of the review's scope and is acknowledged as a limitation; a fully
exhaustive map would additionally interrogate Scopus, Web of Science, SPORTDiscus, SciELO, and
Dialnet. The last search was executed on July 15, 2026.
The search used a title-anchored Boolean strategy composed of three concept blocks combined with the
AND operator: (a) team sport (soccer, football, rugby, futsal, or flag football), (b) competitive level
(amateur, recreational, semi-professional, sub-elite, university, or collegiate), and (c) the object of
assessment (body composition, anthropometry, injury, or fitness). Anchoring all three blocks in the title
field prioritized precision, so that sport, level, and object of study were simultaneously present in the
record title. The search was restricted by language to English, Spanish, and Chinese, and by publication
date to the period 2021 through 2026. The complete search string, field tags, filters, and eligibility
parameters are reported in Table 1. Indispensable methodological classics outside the temporal window
were admitted when justified, specifically the Yo-Yo intermittent recovery test protocol (Bangsbo et al.,
2008) and the rating of perceived exertion scale (Borg, 1998).
Table 1 Search Strategy and Eligibility Parameters for the Scoping Review
Parameter Specification
Design and
reporting
Scoping review following PRISMA-ScR (Tricco et al., 2018); methodological stages per
Arksey and O'Malley (2005) and Levac et al. (2010).
Source and
coverage
PubMed/MEDLINE only; single-database search treated as an explicit scope boundary. Last
search: July 15, 2026.
Period and
languages
January 2021 to July 15, 2026; English, Spanish, or Chinese.
Search design Three title-anchored concept blocks combined with AND (synonyms within each block with
OR); every block required in the record title. Block 1 (team sport): soccer, football, rugby,
futsal, flag football. Block 2 (level): amateur, recreational, semi-professional, sub-elite,
university, collegiate. Block 3 (assessment object): body composition, anthropometr*, injur*,
fitness.
Strengthening the Reporting of Observational Studies in Epidemiology statement in mind (von Elm et
al., 2007). No meta-analysis was planned, given the expected heterogeneity of sports, sexes, competitive
levels, and outcomes.
Information sources and search strategy
Records were identified in a single bibliographic database, PubMed/MEDLINE. The use of one
database is an explicit boundary of the review's scope and is acknowledged as a limitation; a fully
exhaustive map would additionally interrogate Scopus, Web of Science, SPORTDiscus, SciELO, and
Dialnet. The last search was executed on July 15, 2026.
The search used a title-anchored Boolean strategy composed of three concept blocks combined with the
AND operator: (a) team sport (soccer, football, rugby, futsal, or flag football), (b) competitive level
(amateur, recreational, semi-professional, sub-elite, university, or collegiate), and (c) the object of
assessment (body composition, anthropometry, injury, or fitness). Anchoring all three blocks in the title
field prioritized precision, so that sport, level, and object of study were simultaneously present in the
record title. The search was restricted by language to English, Spanish, and Chinese, and by publication
date to the period 2021 through 2026. The complete search string, field tags, filters, and eligibility
parameters are reported in Table 1. Indispensable methodological classics outside the temporal window
were admitted when justified, specifically the Yo-Yo intermittent recovery test protocol (Bangsbo et al.,
2008) and the rating of perceived exertion scale (Borg, 1998).
Table 1 Search Strategy and Eligibility Parameters for the Scoping Review
Parameter Specification
Design and
reporting
Scoping review following PRISMA-ScR (Tricco et al., 2018); methodological stages per
Arksey and O'Malley (2005) and Levac et al. (2010).
Source and
coverage
PubMed/MEDLINE only; single-database search treated as an explicit scope boundary. Last
search: July 15, 2026.
Period and
languages
January 2021 to July 15, 2026; English, Spanish, or Chinese.
Search design Three title-anchored concept blocks combined with AND (synonyms within each block with
OR); every block required in the record title. Block 1 (team sport): soccer, football, rugby,
futsal, flag football. Block 2 (level): amateur, recreational, semi-professional, sub-elite,
university, collegiate. Block 3 (assessment object): body composition, anthropometr*, injur*,
fitness.
pág. 5555
Parameter Specification
Boolean string (("soccer"[Title] OR "football"[Title] OR "rugby"[Title] OR "futsal"[Title] OR "flag
football"[Title]) AND ("amateur"[Title] OR "recreational"[Title] OR "semi-
professional"[Title] OR "sub-elite"[Title] OR "university"[Title] OR "collegiate"[Title]) AND
("body composition"[Title] OR anthropometr*[Title] OR injur*[Title] OR fitness [Title]))
Eligible
population
Team-sport athletes (soccer or football, flag football, rugby, futsal) at amateur, recreational,
university, collegiate, semi-professional, or sub-elite levels, including mixed samples
containing at least one eligible level.
Eligible
components
and sources
At least one component: (a) anthropometry and body composition, (b) functional and field
performance, or (c) preparticipation screening, injury, and prevention. Source types: primary
studies, systematic or scoping reviews, and consensus or position documents.
Exclusion
criteria
E1, wrong population; E2, outside the review axes; E3, ineligible publication type (editorial,
protocol without results, erratum, or abstract without analyzable data); E4, wrong outcome
(surgical treatment, postoperative rehabilitation, or diagnostic imaging without field
application); E5, non-retrievable source; E6, sport outside scope.
Screening Title and abstract screening against a fixed rubric via an artificial-intelligence-assisted
procedure tuned for sensitivity; full-text confirmation pending.
Yield 145 records identified and screened; no duplicates removed (single database); 119 provisionally
retained pending full-text confirmation.
Note. PRISMA-ScR = Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.
The asterisk denotes truncation (e.g., anthropometr* retrieves anthropometry and anthropometric; injur* retrieves injury and
injuries); the [Title] tag restricts each term to the record title. Methodological classics outside the temporal window (the Yo-
Yo intermittent recovery test protocol and the Borg rating of perceived exertion scale) support instrument interpretation and
are not part of the contemporary evidence count.
Eligibility criteria and study selection
Sources were eligible when they met all of the following criteria: a team-sport population (soccer or
football, flag football, rugby, or futsal) at an amateur, recreational, university, collegiate, semi-
professional, or sub-elite level, or a mixed sample including such athletes; assessment of at least one of
the three review components (anthropometry and body composition; functional and field performance;
or preparticipation, injury, and prevention); a primary study, review, or consensus document;
publication in English, Spanish, or Chinese; and publication between 2021 and 2026. Six predefined
exclusion categories were applied: wrong population (E1); topic outside the review axes (E2);
publication type without primary data, such as editorials, study protocols, or errata (E3); wrong
outcome, such as surgical management or diagnostic imaging (E4); non-retrievable records (E5); and
sport outside the review scope (E6).
Title and abstract screening were performed autonomously by a large language model applied against
the fixed eligibility rubric described above. This procedure is declared transparently as artificial-
intelligence-assisted screening; recent evidence indicates that such models can screen records against
Parameter Specification
Boolean string (("soccer"[Title] OR "football"[Title] OR "rugby"[Title] OR "futsal"[Title] OR "flag
football"[Title]) AND ("amateur"[Title] OR "recreational"[Title] OR "semi-
professional"[Title] OR "sub-elite"[Title] OR "university"[Title] OR "collegiate"[Title]) AND
("body composition"[Title] OR anthropometr*[Title] OR injur*[Title] OR fitness [Title]))
Eligible
population
Team-sport athletes (soccer or football, flag football, rugby, futsal) at amateur, recreational,
university, collegiate, semi-professional, or sub-elite levels, including mixed samples
containing at least one eligible level.
Eligible
components
and sources
At least one component: (a) anthropometry and body composition, (b) functional and field
performance, or (c) preparticipation screening, injury, and prevention. Source types: primary
studies, systematic or scoping reviews, and consensus or position documents.
Exclusion
criteria
E1, wrong population; E2, outside the review axes; E3, ineligible publication type (editorial,
protocol without results, erratum, or abstract without analyzable data); E4, wrong outcome
(surgical treatment, postoperative rehabilitation, or diagnostic imaging without field
application); E5, non-retrievable source; E6, sport outside scope.
Screening Title and abstract screening against a fixed rubric via an artificial-intelligence-assisted
procedure tuned for sensitivity; full-text confirmation pending.
Yield 145 records identified and screened; no duplicates removed (single database); 119 provisionally
retained pending full-text confirmation.
Note. PRISMA-ScR = Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.
The asterisk denotes truncation (e.g., anthropometr* retrieves anthropometry and anthropometric; injur* retrieves injury and
injuries); the [Title] tag restricts each term to the record title. Methodological classics outside the temporal window (the Yo-
Yo intermittent recovery test protocol and the Borg rating of perceived exertion scale) support instrument interpretation and
are not part of the contemporary evidence count.
Eligibility criteria and study selection
Sources were eligible when they met all of the following criteria: a team-sport population (soccer or
football, flag football, rugby, or futsal) at an amateur, recreational, university, collegiate, semi-
professional, or sub-elite level, or a mixed sample including such athletes; assessment of at least one of
the three review components (anthropometry and body composition; functional and field performance;
or preparticipation, injury, and prevention); a primary study, review, or consensus document;
publication in English, Spanish, or Chinese; and publication between 2021 and 2026. Six predefined
exclusion categories were applied: wrong population (E1); topic outside the review axes (E2);
publication type without primary data, such as editorials, study protocols, or errata (E3); wrong
outcome, such as surgical management or diagnostic imaging (E4); non-retrievable records (E5); and
sport outside the review scope (E6).
Title and abstract screening were performed autonomously by a large language model applied against
the fixed eligibility rubric described above. This procedure is declared transparently as artificial-
intelligence-assisted screening; recent evidence indicates that such models can screen records against
pág. 5556
explicit criteria with useful accuracy, while their performance depends on how precisely the criteria are
formulated and warrants human verification (Khraisha et al., 2024; Oami et al., 2024). Screening was
tuned to favor sensitivity. Intra-screener stability was estimated by re-adjudicating a reproducible
random subsample of 25 records (seed = 42), blind to the first pass, which yielded 96.0% agreement
(Cohen's kappa = 0.834). Because identification drew on a single database, no duplicate records
required removal. Of 145 records identified and screened, 26 were excluded (wrong population, n = 1;
outside the review axes, n = 15; publication type, n = 4; wrong outcome, n = 6), leaving 119 sources
provisionally included. Confirmation of these provisionally included records at the full-text level is
declared as a pending verification step rather than a completed stage. The selection process and the
corresponding counts are shown in Figure 2.
Figure 2 PRISMA-ScR Flow Diagram for Study Selection
Note. The diagram follows the flow of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension
for Scoping Reviews (Tricco et al., 2018). Identification was limited to a single database (PubMed/MEDLINE), declared as a
scope boundary; therefore, no duplicate records were removed. Title and abstract screening were artificial-intelligence-assisted
and tuned for sensitivity, with intra-screener stability of 96.0% (Cohen's kappa = 0.834) on a reproducible random subsample
of 25 records (seed = 42). The 119 sources are provisional inclusions; full-text confirmation constitutes the pending verification
step. E1 through E4 denote the predefined exclusion reasons applied at screening.
Data charting and synthesis
Data were charted into an evidence matrix capturing, for each source, the author and year, country and
context, study design, sport and sex, sample, variables, instruments, main findings, and limitations
(Table 2). The synthesis was narrative and thematic, organized by the three review components, with
each component addressing one subquestion.
explicit criteria with useful accuracy, while their performance depends on how precisely the criteria are
formulated and warrants human verification (Khraisha et al., 2024; Oami et al., 2024). Screening was
tuned to favor sensitivity. Intra-screener stability was estimated by re-adjudicating a reproducible
random subsample of 25 records (seed = 42), blind to the first pass, which yielded 96.0% agreement
(Cohen's kappa = 0.834). Because identification drew on a single database, no duplicate records
required removal. Of 145 records identified and screened, 26 were excluded (wrong population, n = 1;
outside the review axes, n = 15; publication type, n = 4; wrong outcome, n = 6), leaving 119 sources
provisionally included. Confirmation of these provisionally included records at the full-text level is
declared as a pending verification step rather than a completed stage. The selection process and the
corresponding counts are shown in Figure 2.
Figure 2 PRISMA-ScR Flow Diagram for Study Selection
Note. The diagram follows the flow of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension
for Scoping Reviews (Tricco et al., 2018). Identification was limited to a single database (PubMed/MEDLINE), declared as a
scope boundary; therefore, no duplicate records were removed. Title and abstract screening were artificial-intelligence-assisted
and tuned for sensitivity, with intra-screener stability of 96.0% (Cohen's kappa = 0.834) on a reproducible random subsample
of 25 records (seed = 42). The 119 sources are provisional inclusions; full-text confirmation constitutes the pending verification
step. E1 through E4 denote the predefined exclusion reasons applied at screening.
Data charting and synthesis
Data were charted into an evidence matrix capturing, for each source, the author and year, country and
context, study design, sport and sex, sample, variables, instruments, main findings, and limitations
(Table 2). The synthesis was narrative and thematic, organized by the three review components, with
each component addressing one subquestion.
pág. 5557
Consistent with the scoping design and the heterogeneity of the corpus, no statistical pooling was
undertaken; associations are reported in terms of direction and, where available, magnitude, and are
interpreted as associative rather than causal.
RESULTS
The 119 provisionally included sources were organized into the three review components. Their
provisional characteristics are summarized in Table 2. This section presents the synthesis of Component
I; Components II and III follow. Throughout, relationships are described as associations, and their
direction and heterogeneity are emphasized rather than any single summary estimate.
Table 2 Provisional Characteristics of Sources Extracted for the Narrative Synthesis
Study Setting and sample Design Contribution [role]
Milanese et al.
(2025)
Italy; 622 male
athletes
Cross-sectional,
multivariable
BMI classes vs. DXA adiposity; supports
cautious BMI thresholds [IT]
Campa et al. (2021) International; mixed
athletes
Narrative review DXA, BIA, BIVA, skinfolds not
interchangeable [SS]
Kasper et al. (2021) International; applied
sport
Narrative review Applied utility of methods; skinfolds
defensible if standardized [SS]
Mathisen et al.
(2023)
International; sport
populations
Critical
review/consensus
Best-practice, ethical, non-stigmatizing
assessment [SG]
Ben Brahim et al.
(2023)
Pending; young adult
men
Cross-sectional BMI vs. RPI vs. WHtR and fitness;
nonlinear [IT]
Samarein et al.
(2023)
Iran; 270 referees Cross-sectional,
correlational
Waist, WHtR, %fat, body-shape indices as
complementary [IT]
İlhan et al. (2023) Türkiye; 120 male
referees
Cross-sectional,
correlational
Body composition with sprint and field
endurance [IT]
Petri et al. (2024a) International; elite
M/F soccer
Normative cross-
sectional
Sex/position ISAK references; limits of
elite norms [IT]
Petri et al. (2024b) Italy; 88 elite (44 W,
44 M)
Longitudinal
observational
Anthropometry/BIA change during a
nutrition program [IT]
Toro-Román et al.
(2023)
Spain; 50 semipro (26
M, 24 W)
Comparative cross-
sectional
Anthropometry/fitness differ by sex and
position [TA]
Spehnjak et al.
(2021)
SE Europe; 394 U15–
senior
Comparative cross-
sectional
Body mass/composition across age and
category [IT]
Portella et al.
(2023)
Brazil; 206 M, 11–16 y Descriptive-
correlational
Maturation's contribution to
composition/fitness [IT]
Santos-Sánchez et
al. (2021)
Spain; 71 M U12 Cross-sectional Body composition by position and diet [IT]
Staśkiewicz et al.
(2022)
Poland; professional Longitudinal
observational
Composition over macrocycle; stable BMI
hides fat/FFM shifts [IT]
Staśkiewicz et al.
(2023)
Poland; 38
professional
Longitudinal
observational
Age-related composition and nutrition
awareness [IT]
Macuh et al. (2023) Slovenia; 23
professional (15
tested)
Cross-sectional
observational
Diet, composition, performance; no
causality [IT]
Consistent with the scoping design and the heterogeneity of the corpus, no statistical pooling was
undertaken; associations are reported in terms of direction and, where available, magnitude, and are
interpreted as associative rather than causal.
RESULTS
The 119 provisionally included sources were organized into the three review components. Their
provisional characteristics are summarized in Table 2. This section presents the synthesis of Component
I; Components II and III follow. Throughout, relationships are described as associations, and their
direction and heterogeneity are emphasized rather than any single summary estimate.
Table 2 Provisional Characteristics of Sources Extracted for the Narrative Synthesis
Study Setting and sample Design Contribution [role]
Milanese et al.
(2025)
Italy; 622 male
athletes
Cross-sectional,
multivariable
BMI classes vs. DXA adiposity; supports
cautious BMI thresholds [IT]
Campa et al. (2021) International; mixed
athletes
Narrative review DXA, BIA, BIVA, skinfolds not
interchangeable [SS]
Kasper et al. (2021) International; applied
sport
Narrative review Applied utility of methods; skinfolds
defensible if standardized [SS]
Mathisen et al.
(2023)
International; sport
populations
Critical
review/consensus
Best-practice, ethical, non-stigmatizing
assessment [SG]
Ben Brahim et al.
(2023)
Pending; young adult
men
Cross-sectional BMI vs. RPI vs. WHtR and fitness;
nonlinear [IT]
Samarein et al.
(2023)
Iran; 270 referees Cross-sectional,
correlational
Waist, WHtR, %fat, body-shape indices as
complementary [IT]
İlhan et al. (2023) Türkiye; 120 male
referees
Cross-sectional,
correlational
Body composition with sprint and field
endurance [IT]
Petri et al. (2024a) International; elite
M/F soccer
Normative cross-
sectional
Sex/position ISAK references; limits of
elite norms [IT]
Petri et al. (2024b) Italy; 88 elite (44 W,
44 M)
Longitudinal
observational
Anthropometry/BIA change during a
nutrition program [IT]
Toro-Román et al.
(2023)
Spain; 50 semipro (26
M, 24 W)
Comparative cross-
sectional
Anthropometry/fitness differ by sex and
position [TA]
Spehnjak et al.
(2021)
SE Europe; 394 U15–
senior
Comparative cross-
sectional
Body mass/composition across age and
category [IT]
Portella et al.
(2023)
Brazil; 206 M, 11–16 y Descriptive-
correlational
Maturation's contribution to
composition/fitness [IT]
Santos-Sánchez et
al. (2021)
Spain; 71 M U12 Cross-sectional Body composition by position and diet [IT]
Staśkiewicz et al.
(2022)
Poland; professional Longitudinal
observational
Composition over macrocycle; stable BMI
hides fat/FFM shifts [IT]
Staśkiewicz et al.
(2023)
Poland; 38
professional
Longitudinal
observational
Age-related composition and nutrition
awareness [IT]
Macuh et al. (2023) Slovenia; 23
professional (15
tested)
Cross-sectional
observational
Diet, composition, performance; no
causality [IT]
pág. 5558
Study Setting and sample Design Contribution [role]
Talavera-
Hernández et al.
(2025)
Pending; elite flag
football
Cross-sectional
normative
Kinanthropometric profile; modality-
specific transfer [IT]
Asimakidis et al.
(2024)
24 countries; 102
practitioners
Cross-sectional
survey
Test-selection practice, barriers, little error
use [IT]
Asimakidis et al.
(2025)
International; elite
male soccer
Systematic review Heterogeneity in aerobic/RSA testing
protocols [SS]
Zemková &
Pacholek (2023)
Pending Repeated-
measures
Learning effect across repeated Yo-Yo tests
[IT]
Ishida et al. (2021) USA; 23 M
intercollegiate
Cross-sectional,
correlational
Composition/strength/power with sprint,
jump, endurance [TA]
Leão et al. (2022) Portugal; 66 M youth Descriptive-
correlational
Composition with jump, strength,
intermittent endurance [IT]
Bustamante-
Garrido et al.
(2024)
Chile; 58 M cadets Cross-sectional,
regression
Anthropometric/mechanical contribution to
sprint by distance [IT]
França et al. (2024) Portugal (Madeira); 96
youth
Cross-sectional,
correlational
Composition, power, speed, agility
interrelated [IT]
Ciocca et al. (2022) Pending Repeated-trial,
fatigue
COD distinct from agility under fatigue
[IT]
Morral-Yepes et al.
(2023)
Pending Methodological,
correlational
COD speed vs. reactive agility distinction
[IT]
Gisladottir et al.
(2024)
Europe; 78 U14, 43
senior
Cross-sectional,
correlational
Shared/nonredundant traits of agility,
sprint, jump [IT]
Becerra-Patiño et
al. (2025)
Colombia; youth Cross-sectional,
PCA
Multidimensional fitness profiles by
playing role [IT]
Ramírez-Munera et
al. (2025)
Spain; 34 professional
women
Cross-sectional,
correlational
Preseason anthropometry with performance
[IT]
Hernandez-
Martinez et al.
(2024)
Chile; 160 amateur
women
Comparative cross-
sectional
Composition/performance by position,
amateur women [TA]
Li et al. (2025) China; male university
students
RCT 8-wk functional training; movement
quality/fitness [TA]
Weise et al. (2025) International; 35
documents, 305 recs
Systematic review
of guidelines
History, screening, risk-based testing,
referral [SG]
Balachandran et al.
(2025)
USA; women flag
football
10-yr
epidemiological
review
Injured regions and types, female flag
football [AP]
Barber Foss et al.
(2023)
USA; youth flag
football
Descriptive
epidemiology
Game-related injury patterns, youth flag
football [IT]
Mao et al. (2025) USA; female
American football
Age-stratified
epidemiology
Injury patterns by age, 2015–2024 [IT]
Prieto-González et
al. (2021)
Spain; adolescent
athletes
Injury surveillance Injury occurrence and candidate factors
[IT]
Sonesson et al.
(2023)
Sweden; amateur M/F
soccer
Prospective cohort Age and baseline injury as risk indicators
[TA]
Yeomans et al.
(2021)
Ireland; amateur M/F
rugby
Comparative
epidemiology
Injury patterns by sex, amateur rugby [TA]
Marrese et al.
(2025)
Brazil; rugby union Epidemiological Incidence, severity, mechanism, region
[AP]
Study Setting and sample Design Contribution [role]
Talavera-
Hernández et al.
(2025)
Pending; elite flag
football
Cross-sectional
normative
Kinanthropometric profile; modality-
specific transfer [IT]
Asimakidis et al.
(2024)
24 countries; 102
practitioners
Cross-sectional
survey
Test-selection practice, barriers, little error
use [IT]
Asimakidis et al.
(2025)
International; elite
male soccer
Systematic review Heterogeneity in aerobic/RSA testing
protocols [SS]
Zemková &
Pacholek (2023)
Pending Repeated-
measures
Learning effect across repeated Yo-Yo tests
[IT]
Ishida et al. (2021) USA; 23 M
intercollegiate
Cross-sectional,
correlational
Composition/strength/power with sprint,
jump, endurance [TA]
Leão et al. (2022) Portugal; 66 M youth Descriptive-
correlational
Composition with jump, strength,
intermittent endurance [IT]
Bustamante-
Garrido et al.
(2024)
Chile; 58 M cadets Cross-sectional,
regression
Anthropometric/mechanical contribution to
sprint by distance [IT]
França et al. (2024) Portugal (Madeira); 96
youth
Cross-sectional,
correlational
Composition, power, speed, agility
interrelated [IT]
Ciocca et al. (2022) Pending Repeated-trial,
fatigue
COD distinct from agility under fatigue
[IT]
Morral-Yepes et al.
(2023)
Pending Methodological,
correlational
COD speed vs. reactive agility distinction
[IT]
Gisladottir et al.
(2024)
Europe; 78 U14, 43
senior
Cross-sectional,
correlational
Shared/nonredundant traits of agility,
sprint, jump [IT]
Becerra-Patiño et
al. (2025)
Colombia; youth Cross-sectional,
PCA
Multidimensional fitness profiles by
playing role [IT]
Ramírez-Munera et
al. (2025)
Spain; 34 professional
women
Cross-sectional,
correlational
Preseason anthropometry with performance
[IT]
Hernandez-
Martinez et al.
(2024)
Chile; 160 amateur
women
Comparative cross-
sectional
Composition/performance by position,
amateur women [TA]
Li et al. (2025) China; male university
students
RCT 8-wk functional training; movement
quality/fitness [TA]
Weise et al. (2025) International; 35
documents, 305 recs
Systematic review
of guidelines
History, screening, risk-based testing,
referral [SG]
Balachandran et al.
(2025)
USA; women flag
football
10-yr
epidemiological
review
Injured regions and types, female flag
football [AP]
Barber Foss et al.
(2023)
USA; youth flag
football
Descriptive
epidemiology
Game-related injury patterns, youth flag
football [IT]
Mao et al. (2025) USA; female
American football
Age-stratified
epidemiology
Injury patterns by age, 2015–2024 [IT]
Prieto-González et
al. (2021)
Spain; adolescent
athletes
Injury surveillance Injury occurrence and candidate factors
[IT]
Sonesson et al.
(2023)
Sweden; amateur M/F
soccer
Prospective cohort Age and baseline injury as risk indicators
[TA]
Yeomans et al.
(2021)
Ireland; amateur M/F
rugby
Comparative
epidemiology
Injury patterns by sex, amateur rugby [TA]
Marrese et al.
(2025)
Brazil; rugby union Epidemiological Incidence, severity, mechanism, region
[AP]
pág. 5559
Study Setting and sample Design Contribution [role]
Yendluri et al.
(2024)
USA; M/F rugby Epidemiological
trend
Sex-specific rugby injury trends 2008–
2022 [IT]
Bellingan et al.
(2025)
International; women's
rugby
Scoping review Epidemiology, candidate risks, gaps in
women's rugby [SS]
Chia et al. (2022) International; team-
ball sports
SR + meta-analysis Noncontact ACL by sex, age, sport, level,
exposure [SS]
Collings et al.
(2022)
Australia; elite women
footballers
Prospective
observational
Strength/biomechanics as ACL-related
indicators [IT]
Achenbach et al.
(2024)
Germany; professional
women
Observational Movement/situational ACL injury patterns
[IT]
Mancino et al.
(2024)
UK; female athletes Narrative review Sex-related ACL risks and prevention [SS]
John et al. (2025) International; women's
football
Review Sex-specific injury and prevention [SS]
Liveris et al. (2025) Pending; male football Structural equation
modeling
Interdependent intrinsic factors, lower-limb
injury [AP]
Mandorino et al.
(2023)
International; youth
soccer
Systematic review Injury incidence and candidate factors [SS]
Martins et al.
(2022)
Portugal; elite football Predictive
modeling
Composition/fitness in injury-prediction
models [IT]
Lemes et al. (2021) International; 13,355
athletes
SR + meta-analysis Exercise-based prevention of noncontact
injury [SS]
Bullock et al.
(2025)
International; female
athletes
SR + consensus
framework
Lower-extremity prevention; adherence
matters [SS]
Liu et al. (2026) International; ages 10–
19
SR + meta-analysis Multicomponent prevention in adolescent
team sport [SS]
Jaskulski et al.
(2025)
Poland; women's
rugby
Intervention 8-Wk sensorimotor program;
neuromuscular outcomes [AP]
Cardoso-Marinho et
al. (2022)
International; football Systematic review Athletes' injury-risk perception and
behavior [SS]
Note. Role codes: TA = target-aligned primary evidence (amateur, collegiate, university, or semiprofessional contexts within
scope); IT = indirect-transfer primary evidence (elite, professional, youth, or referee populations, informative but not directly
representative of amateur adults); SS = secondary synthesis (systematic, scoping, or narrative review); SG = secondary
guidance (consensus or guideline synthesis); AP = alignment pending. "Pending" in setting denotes country, sample, or level
to be verified from the full text before publication. M = men; W = women; RPI = reciprocal ponderal index; WHtR = waist-
to-height ratio; BMI = body mass index; BIA = bioelectrical impedance analysis; BIVA = bioelectrical impedance vector
analysis; DXA = dual-energy X-ray absorptiometry; FFM = fat-free mass; ISAK = International Society for the Advancement
of Kinanthropometry; RSA = repeated-sprint ability; COD = change of direction; PCA = principal component analysis; RCT
= randomized controlled trial; SR = systematic review; ACL = anterior cruciate ligament.
Component I. Anthropometry and body composition
This component addresses the first subquestion, concerning what anthropometric and body-composition
indicators contribute, and what they fail to capture, when describing the amateur team-sport athlete.
The synthesis moves from the single most common indicator to the multidimensional profile that the
evidence supports, and the indicators and methods are summarized in Table 3.
Study Setting and sample Design Contribution [role]
Yendluri et al.
(2024)
USA; M/F rugby Epidemiological
trend
Sex-specific rugby injury trends 2008–
2022 [IT]
Bellingan et al.
(2025)
International; women's
rugby
Scoping review Epidemiology, candidate risks, gaps in
women's rugby [SS]
Chia et al. (2022) International; team-
ball sports
SR + meta-analysis Noncontact ACL by sex, age, sport, level,
exposure [SS]
Collings et al.
(2022)
Australia; elite women
footballers
Prospective
observational
Strength/biomechanics as ACL-related
indicators [IT]
Achenbach et al.
(2024)
Germany; professional
women
Observational Movement/situational ACL injury patterns
[IT]
Mancino et al.
(2024)
UK; female athletes Narrative review Sex-related ACL risks and prevention [SS]
John et al. (2025) International; women's
football
Review Sex-specific injury and prevention [SS]
Liveris et al. (2025) Pending; male football Structural equation
modeling
Interdependent intrinsic factors, lower-limb
injury [AP]
Mandorino et al.
(2023)
International; youth
soccer
Systematic review Injury incidence and candidate factors [SS]
Martins et al.
(2022)
Portugal; elite football Predictive
modeling
Composition/fitness in injury-prediction
models [IT]
Lemes et al. (2021) International; 13,355
athletes
SR + meta-analysis Exercise-based prevention of noncontact
injury [SS]
Bullock et al.
(2025)
International; female
athletes
SR + consensus
framework
Lower-extremity prevention; adherence
matters [SS]
Liu et al. (2026) International; ages 10–
19
SR + meta-analysis Multicomponent prevention in adolescent
team sport [SS]
Jaskulski et al.
(2025)
Poland; women's
rugby
Intervention 8-Wk sensorimotor program;
neuromuscular outcomes [AP]
Cardoso-Marinho et
al. (2022)
International; football Systematic review Athletes' injury-risk perception and
behavior [SS]
Note. Role codes: TA = target-aligned primary evidence (amateur, collegiate, university, or semiprofessional contexts within
scope); IT = indirect-transfer primary evidence (elite, professional, youth, or referee populations, informative but not directly
representative of amateur adults); SS = secondary synthesis (systematic, scoping, or narrative review); SG = secondary
guidance (consensus or guideline synthesis); AP = alignment pending. "Pending" in setting denotes country, sample, or level
to be verified from the full text before publication. M = men; W = women; RPI = reciprocal ponderal index; WHtR = waist-
to-height ratio; BMI = body mass index; BIA = bioelectrical impedance analysis; BIVA = bioelectrical impedance vector
analysis; DXA = dual-energy X-ray absorptiometry; FFM = fat-free mass; ISAK = International Society for the Advancement
of Kinanthropometry; RSA = repeated-sprint ability; COD = change of direction; PCA = principal component analysis; RCT
= randomized controlled trial; SR = systematic review; ACL = anterior cruciate ligament.
Component I. Anthropometry and body composition
This component addresses the first subquestion, concerning what anthropometric and body-composition
indicators contribute, and what they fail to capture, when describing the amateur team-sport athlete.
The synthesis moves from the single most common indicator to the multidimensional profile that the
evidence supports, and the indicators and methods are summarized in Table 3.
pág. 5560
Body mass index: usefulness and limits in athletic populations
Body mass index remained the most accessible anthropometric indicator in amateur settings, yet the
corpus consistently framed it as a measure of relative mass rather than of adiposity or its distribution.
Analyses in athletes indicated that conventional overweight and obesity cut-off points misclassify
muscular individuals and require revision or external validation before being applied to sporting
populations (Milanese et al., 2025). When body mass index was examined alongside complementary
indices, its association with fitness was weaker and less specific than that of measures incorporating
stature and fat distribution (Ben Brahim et al., 2023). Longitudinal observation across a competitive
macrocycle further showed that body mass index can remain stable while body composition shifts, so
that a single ratio may conceal meaningful compensatory changes in fat and fat-free mass (Staśkiewicz
et al., 2022). The evidence therefore supported treating body mass index as a continuous, context-
dependent descriptor rather than as a classificatory threshold.
Body composition: components and estimation methods
Body composition was most often described through a two-compartment logic separating fat mass from
fat-free mass, with the important caveat that fat-free mass is not equivalent to muscle mass. The
reviewed methods, including skinfolds, bioelectrical impedance and vector analysis, and dual-energy
X-ray absorptiometry, were not interchangeable, since each rest on distinct assumptions and is sensitive
to hydration status, the prediction equation, and technician standardization (Campa et al., 2021). No
single method emerged as universally superior; the applied literature argued that the appropriate choice
depends on the assessment purpose, the available resources, and the capacity to standardize procedures,
and it reappraised accessible field methods such as skinfolds as defensible when performed rigorously
(Kasper et al., 2021). Best-practice guidance emphasized that body-composition data should be
collected and interpreted to minimize health and performance risks and to avoid over-interpreting slight
changes (Mathisen et al., 2023).
Central adiposity: waist circumference and waist-to-height ratio
Indicators of central adiposity captured a dimension that body mass index does not, namely the
distribution of tissue. Waist circumference and the waist-to-height ratio were associated with fitness in
young adults in ways not fully reflected by body mass index alone, which supported their inclusion as
Body mass index: usefulness and limits in athletic populations
Body mass index remained the most accessible anthropometric indicator in amateur settings, yet the
corpus consistently framed it as a measure of relative mass rather than of adiposity or its distribution.
Analyses in athletes indicated that conventional overweight and obesity cut-off points misclassify
muscular individuals and require revision or external validation before being applied to sporting
populations (Milanese et al., 2025). When body mass index was examined alongside complementary
indices, its association with fitness was weaker and less specific than that of measures incorporating
stature and fat distribution (Ben Brahim et al., 2023). Longitudinal observation across a competitive
macrocycle further showed that body mass index can remain stable while body composition shifts, so
that a single ratio may conceal meaningful compensatory changes in fat and fat-free mass (Staśkiewicz
et al., 2022). The evidence therefore supported treating body mass index as a continuous, context-
dependent descriptor rather than as a classificatory threshold.
Body composition: components and estimation methods
Body composition was most often described through a two-compartment logic separating fat mass from
fat-free mass, with the important caveat that fat-free mass is not equivalent to muscle mass. The
reviewed methods, including skinfolds, bioelectrical impedance and vector analysis, and dual-energy
X-ray absorptiometry, were not interchangeable, since each rest on distinct assumptions and is sensitive
to hydration status, the prediction equation, and technician standardization (Campa et al., 2021). No
single method emerged as universally superior; the applied literature argued that the appropriate choice
depends on the assessment purpose, the available resources, and the capacity to standardize procedures,
and it reappraised accessible field methods such as skinfolds as defensible when performed rigorously
(Kasper et al., 2021). Best-practice guidance emphasized that body-composition data should be
collected and interpreted to minimize health and performance risks and to avoid over-interpreting slight
changes (Mathisen et al., 2023).
Central adiposity: waist circumference and waist-to-height ratio
Indicators of central adiposity captured a dimension that body mass index does not, namely the
distribution of tissue. Waist circumference and the waist-to-height ratio were associated with fitness in
young adults in ways not fully reflected by body mass index alone, which supported their inclusion as
pág. 5561
complementary descriptors (Ben Brahim et al., 2023). In officiating and playing populations,
anthropometric indices differed by competitive division and related to performance, although these
associations were sensitive to the anatomical measurement site and to standardization of the protocol
(İlhan et al., 2023; Samarein et al., 2023). The evidence thus positioned central adiposity as an
informative, low-cost addition to the field profile rather than as a redundant measure.
ISAK standardization and modulation by sex and playing position.
Comparability across athletes and studies depended on standardized measurement, and the corpus
repeatedly invoked the procedures of the International Society for the Advancement of
Kinanthropometry as the reference for consistent data collection, including the derivation of sex-
specific and position-specific reference values (Petri et al., 2024a). Anthropometry, body composition,
and fitness differed between sexes and playing positions in semi-professional players, which cautioned
against applying a single normative profile across roles (Toro-Román et al., 2023). The same logic
extended to flag football, where a proposed kinanthropometric profile for elite athletes offered a body
reference that helps contextualize the modality and bridges the anthropometric component to the
performance and injury axes (Talavera-Hernández et al., 2025). Because these profiles varied
systematically with sex, sport, and position, they are read here as modulated associations rather than
fixed standards, a point developed visually in Figure 3 and revisited in the Discussion.
Table 3 Anthropometric and Body-Composition Indicators and Measurement Methods
Indicator Definition / output Standardization and key caution Sources
Body mass Total, mass (kg) Calibrated scale, light clothing,
standard time of day; varies with
hydration and intake; no tissue
compartments
Petri et al. (2024a)
Stature Height to vertex (cm) Stadiometer, Frankfort plane, no
footwear; small diurnal variation
Petri et al. (2024a)
Body mass
index
Mass / height² (kg/m²) From standardized mass and stature,
ignores fat, FFM, and distribution;
cutoffs misclassify athletes; read as
continuous
Ben Brahim et al. (2023);
Milanese et al. (2025);
Staśkiewicz et al. (2022)
Waist
circumference
Abdominal perimeter
(cm)
Nonelastic tape at a fixed site, end-
expiration; site-, tension-, and
technique-sensitive; sites not
interchangeable
Samarein et al. (2023)
Waist-to-
height ratio
Waist / stature (same unit) From standardized waist and stature;
error transfers to the ratio;
associations may be nonlinear
Ben Brahim et al. (2023);
Samarein et al. (2023)
complementary descriptors (Ben Brahim et al., 2023). In officiating and playing populations,
anthropometric indices differed by competitive division and related to performance, although these
associations were sensitive to the anatomical measurement site and to standardization of the protocol
(İlhan et al., 2023; Samarein et al., 2023). The evidence thus positioned central adiposity as an
informative, low-cost addition to the field profile rather than as a redundant measure.
ISAK standardization and modulation by sex and playing position.
Comparability across athletes and studies depended on standardized measurement, and the corpus
repeatedly invoked the procedures of the International Society for the Advancement of
Kinanthropometry as the reference for consistent data collection, including the derivation of sex-
specific and position-specific reference values (Petri et al., 2024a). Anthropometry, body composition,
and fitness differed between sexes and playing positions in semi-professional players, which cautioned
against applying a single normative profile across roles (Toro-Román et al., 2023). The same logic
extended to flag football, where a proposed kinanthropometric profile for elite athletes offered a body
reference that helps contextualize the modality and bridges the anthropometric component to the
performance and injury axes (Talavera-Hernández et al., 2025). Because these profiles varied
systematically with sex, sport, and position, they are read here as modulated associations rather than
fixed standards, a point developed visually in Figure 3 and revisited in the Discussion.
Table 3 Anthropometric and Body-Composition Indicators and Measurement Methods
Indicator Definition / output Standardization and key caution Sources
Body mass Total, mass (kg) Calibrated scale, light clothing,
standard time of day; varies with
hydration and intake; no tissue
compartments
Petri et al. (2024a)
Stature Height to vertex (cm) Stadiometer, Frankfort plane, no
footwear; small diurnal variation
Petri et al. (2024a)
Body mass
index
Mass / height² (kg/m²) From standardized mass and stature,
ignores fat, FFM, and distribution;
cutoffs misclassify athletes; read as
continuous
Ben Brahim et al. (2023);
Milanese et al. (2025);
Staśkiewicz et al. (2022)
Waist
circumference
Abdominal perimeter
(cm)
Nonelastic tape at a fixed site, end-
expiration; site-, tension-, and
technique-sensitive; sites not
interchangeable
Samarein et al. (2023)
Waist-to-
height ratio
Waist / stature (same unit) From standardized waist and stature;
error transfers to the ratio;
associations may be nonlinear
Ben Brahim et al. (2023);
Samarein et al. (2023)
pág. 5562
Indicator Definition / output Standardization and key caution Sources
Sum of
skinfolds
Sum of skinfold
thicknesses (mm)
Calibrated caliper, fixed sites, side,
and sequence; assessor- and TEM-
dependent; keep the protocol constant
Campa et al. (2021);
Kasper et al. (2021)
Body-fat
percentage
Estimated % fat mass From a skinfold equation, BIA, or
DXA; method-, equation-, and
device-dependent; not
interchangeable
Campa et al. (2021);
Kasper et al. (2021);
Milanese et al. (2025)
Fat mass Estimated fat
compartment (kg)
Derived from % fat or system output;
estimated and model-sensitive
Campa et al. (2021);
Kasper et al. (2021)
Fat-free mass Estimated nonfat mass
(kg)
From skinfolds, BIA, BIVA, or DXA;
not equal to skeletal muscle mass;
affected by hydration, glycogen, and
algorithm
Campa et al. (2021);
Kasper et al. (2021)
ISAK-
standardized
anthropometry
Standardized landmarks,
masses, circumferences,
breadths, skinfolds
Trained anthropometrist, standard
sites, sequence, and repeats; report
TEM; elite norms are not amateur
standards; consider sex, age, position,
level
Petri et al. (2024a)
Skinfold-
caliper
assessment
Skinfolds, sums,
equation-derived
estimates
Calibrated caliper, standard
landmarking, consistent assessor,
side, and timing; equation- and
population-dependent; quantify TEM
Campa et al. (2021);
Kasper et al. (2021)
Bioelectrical
impedance
analysis (BIA)
Compartments from
tissue impedance via
device equations
Constant device, electrodes, posture,
hydration, and intake; devices and
equations not interchangeable
Campa et al. (2021)
Bioelectrical
impedance
vector analysis
(BIVA)
Resistance and reactance
as a stature-normalized
vector
Standard electrodes and posture;
needs a population reference ellipse;
the vector is not a direct muscle or fat
mass
Campa et al. (2021)
Dual-energy
X-ray
absorptiometry
(DXA)
Fat, lean soft tissue, and
bone (regional and whole-
body)
Standard scanner, calibration,
positioning, and software; high
reproducibility but costly, model-
dependent, low radiation
Kasper et al. (2021);
Milanese et al. (2025)
Note. FFM = fat-free mass; TEM = technical error of measurement; BIA = bioelectrical impedance analysis; BIVA =
bioelectrical impedance vector analysis; DXA = dual-energy X-ray absorptiometry; ISAK = International Society for the
Advancement of Kinanthropometry. Method selection should follow the assessment purpose, available resources, operator
competence, expected measurement error, and capacity to reproduce standardized conditions; methods and equations are not
interchangeable. Longitudinal assessments should retain the same device, equation, sites, assessor, sequence, and
premeasurement conditions, and should report TEM when feasible. Results are descriptive or estimative, not a clinical
diagnosis, and should be communicated confidentially and without stigmatizing language (Campa et al., 2021; Kasper et al.,
2021; Mathisen et al., 2023).
Indicator Definition / output Standardization and key caution Sources
Sum of
skinfolds
Sum of skinfold
thicknesses (mm)
Calibrated caliper, fixed sites, side,
and sequence; assessor- and TEM-
dependent; keep the protocol constant
Campa et al. (2021);
Kasper et al. (2021)
Body-fat
percentage
Estimated % fat mass From a skinfold equation, BIA, or
DXA; method-, equation-, and
device-dependent; not
interchangeable
Campa et al. (2021);
Kasper et al. (2021);
Milanese et al. (2025)
Fat mass Estimated fat
compartment (kg)
Derived from % fat or system output;
estimated and model-sensitive
Campa et al. (2021);
Kasper et al. (2021)
Fat-free mass Estimated nonfat mass
(kg)
From skinfolds, BIA, BIVA, or DXA;
not equal to skeletal muscle mass;
affected by hydration, glycogen, and
algorithm
Campa et al. (2021);
Kasper et al. (2021)
ISAK-
standardized
anthropometry
Standardized landmarks,
masses, circumferences,
breadths, skinfolds
Trained anthropometrist, standard
sites, sequence, and repeats; report
TEM; elite norms are not amateur
standards; consider sex, age, position,
level
Petri et al. (2024a)
Skinfold-
caliper
assessment
Skinfolds, sums,
equation-derived
estimates
Calibrated caliper, standard
landmarking, consistent assessor,
side, and timing; equation- and
population-dependent; quantify TEM
Campa et al. (2021);
Kasper et al. (2021)
Bioelectrical
impedance
analysis (BIA)
Compartments from
tissue impedance via
device equations
Constant device, electrodes, posture,
hydration, and intake; devices and
equations not interchangeable
Campa et al. (2021)
Bioelectrical
impedance
vector analysis
(BIVA)
Resistance and reactance
as a stature-normalized
vector
Standard electrodes and posture;
needs a population reference ellipse;
the vector is not a direct muscle or fat
mass
Campa et al. (2021)
Dual-energy
X-ray
absorptiometry
(DXA)
Fat, lean soft tissue, and
bone (regional and whole-
body)
Standard scanner, calibration,
positioning, and software; high
reproducibility but costly, model-
dependent, low radiation
Kasper et al. (2021);
Milanese et al. (2025)
Note. FFM = fat-free mass; TEM = technical error of measurement; BIA = bioelectrical impedance analysis; BIVA =
bioelectrical impedance vector analysis; DXA = dual-energy X-ray absorptiometry; ISAK = International Society for the
Advancement of Kinanthropometry. Method selection should follow the assessment purpose, available resources, operator
competence, expected measurement error, and capacity to reproduce standardized conditions; methods and equations are not
interchangeable. Longitudinal assessments should retain the same device, equation, sites, assessor, sequence, and
premeasurement conditions, and should report TEM when feasible. Results are descriptive or estimative, not a clinical
diagnosis, and should be communicated confidentially and without stigmatizing language (Campa et al., 2021; Kasper et al.,
2021; Mathisen et al., 2023).
pág. 5563
Figure 3 Conceptual Model of Relationships Among Body Profile, Field Performance, and Injury in
Amateur Team Sport
Note. The model depicts associative, bidirectional relationships among the three assessment components; it does not posit a
linear causal chain. Neuromuscular control is represented as a mediating pathway linking body profile, performance, and
injury. Double-headed arrows denote reciprocal association, not causal direction. Sex, sport and modality, playing position,
competitive level, exposure, and previous injury history operate as cross-cutting modulators (Objective 4). Own elaboration.
Functional and field performance
This component addresses the second subquestion, concerning which functional and field-performance
tests are valid, feasible, and safe in the amateur setting, and how they relate to the body profile. The
synthesis proceeds from the logic of battery selection to each performance quality and closes with the
notion of performance as a multidimensional profile; the tests, their outcomes, and their standardization
requirements are summarized in Table 4.
Selecting the battery: validity, reliability, feasibility, and non-redundancy.
Survey evidence on applied testing practice indicated that the choice of tests is driven as much by
feasibility, available time, the competitive calendar, and resources as by measurement properties, and
that the measurement error attached to each test is seldom addressed explicitly in practice (Asimakidis
et al., 2024). A systematic appraisal of aerobic-fitness and repeated-sprint protocols documented
substantial variability in how ostensibly similar tests are administered, which limits comparability
across studies and settings and underscores the need for explicit standardization of warm-up,
familiarization, number of trials, recovery, test order, timing method, and surface (Asimakidis et al.,
2025).
Figure 3 Conceptual Model of Relationships Among Body Profile, Field Performance, and Injury in
Amateur Team Sport
Note. The model depicts associative, bidirectional relationships among the three assessment components; it does not posit a
linear causal chain. Neuromuscular control is represented as a mediating pathway linking body profile, performance, and
injury. Double-headed arrows denote reciprocal association, not causal direction. Sex, sport and modality, playing position,
competitive level, exposure, and previous injury history operate as cross-cutting modulators (Objective 4). Own elaboration.
Functional and field performance
This component addresses the second subquestion, concerning which functional and field-performance
tests are valid, feasible, and safe in the amateur setting, and how they relate to the body profile. The
synthesis proceeds from the logic of battery selection to each performance quality and closes with the
notion of performance as a multidimensional profile; the tests, their outcomes, and their standardization
requirements are summarized in Table 4.
Selecting the battery: validity, reliability, feasibility, and non-redundancy.
Survey evidence on applied testing practice indicated that the choice of tests is driven as much by
feasibility, available time, the competitive calendar, and resources as by measurement properties, and
that the measurement error attached to each test is seldom addressed explicitly in practice (Asimakidis
et al., 2024). A systematic appraisal of aerobic-fitness and repeated-sprint protocols documented
substantial variability in how ostensibly similar tests are administered, which limits comparability
across studies and settings and underscores the need for explicit standardization of warm-up,
familiarization, number of trials, recovery, test order, timing method, and surface (Asimakidis et al.,
2025).
pág. 5564
Intermittent endurance
Because team play is intermittent rather than continuous, field tests that reproduce repeated high-
intensity efforts were favored, with the Yo-Yo intermittent recovery test as the reference instrument
(Bangsbo et al., 2008). A structured compendium of Yo-Yo results confirmed the test's usefulness while
cautioning that reference values vary markedly by version, sex, age, and competitive level, so that the
distance covered is best treated as a direct field outcome rather than converted into an estimate of
maximal oxygen uptake (Schmitz et al., 2018). Performance on the test was also shown to improve with
repeated administrations, which makes familiarization a prerequisite for valid interpretation (Zemková
& Pacholek, 2023). Intermittent endurance co-varied with body composition and with strength and
power characteristics in collegiate and youth players, although the associations were of moderate and
variable magnitude (Ishida et al., 2021; Leão et al., 2022).
Linear speed and change-of-direction speed
The corpus distinguished acceleration, maximal velocity, the ability to repeat sprints, and change-of-
direction speed, and it insisted on the conceptual separation between preplanned change of direction
and reactive agility, which involve different perceptual and coordinative demands (Ciocca et al., 2022;
Morral-Yepes et al., 2023). Sprint performance was associated with anthropometric and mechanical
factors, and these associations differed by distance, reflecting the distinct contributions of the
acceleration and maximal-velocity phases (Bustamante-Garrido et al., 2024). Lower-body power, body
composition, speed, and agility were interrelated in youth players, but no single measure accounted for
the others, which supports assessing speed and change of direction as related yet non-redundant
qualities (França et al., 2024).
Lower-limb explosive strength
Vertical and horizontal jumps served as accessible field indicators of lower-limb explosive strength
rather than as pure measures of mechanical power. Jump performance was associated with fat-free mass
and with relative strength, and it varied with playing role and developmental stage, so that it is most
informative as one element of a broader profile (Becerra-Patiño et al., 2025; França et al., 2024; Ishida
et al., 2021; Leão et al., 2022).
Intermittent endurance
Because team play is intermittent rather than continuous, field tests that reproduce repeated high-
intensity efforts were favored, with the Yo-Yo intermittent recovery test as the reference instrument
(Bangsbo et al., 2008). A structured compendium of Yo-Yo results confirmed the test's usefulness while
cautioning that reference values vary markedly by version, sex, age, and competitive level, so that the
distance covered is best treated as a direct field outcome rather than converted into an estimate of
maximal oxygen uptake (Schmitz et al., 2018). Performance on the test was also shown to improve with
repeated administrations, which makes familiarization a prerequisite for valid interpretation (Zemková
& Pacholek, 2023). Intermittent endurance co-varied with body composition and with strength and
power characteristics in collegiate and youth players, although the associations were of moderate and
variable magnitude (Ishida et al., 2021; Leão et al., 2022).
Linear speed and change-of-direction speed
The corpus distinguished acceleration, maximal velocity, the ability to repeat sprints, and change-of-
direction speed, and it insisted on the conceptual separation between preplanned change of direction
and reactive agility, which involve different perceptual and coordinative demands (Ciocca et al., 2022;
Morral-Yepes et al., 2023). Sprint performance was associated with anthropometric and mechanical
factors, and these associations differed by distance, reflecting the distinct contributions of the
acceleration and maximal-velocity phases (Bustamante-Garrido et al., 2024). Lower-body power, body
composition, speed, and agility were interrelated in youth players, but no single measure accounted for
the others, which supports assessing speed and change of direction as related yet non-redundant
qualities (França et al., 2024).
Lower-limb explosive strength
Vertical and horizontal jumps served as accessible field indicators of lower-limb explosive strength
rather than as pure measures of mechanical power. Jump performance was associated with fat-free mass
and with relative strength, and it varied with playing role and developmental stage, so that it is most
informative as one element of a broader profile (Becerra-Patiño et al., 2025; França et al., 2024; Ishida
et al., 2021; Leão et al., 2022).
pág. 5565
Mobility, balance, neuromuscular control, and movement quality
Beyond the classic performance qualities, the corpus extended the battery toward the functional and
preventive domain, incorporating mobility, static and dynamic balance, neuromuscular control, and
movement quality, which are particularly relevant in modalities that involve acceleration, deceleration,
and pivoting. A randomized controlled trial in university students showed that a functional training
program improved movement quality and physical fitness, indicating that these qualities are both
assessable and modifiable (Li et al., 2025). Postural control differed across collision, contact, and non-
contact sport athletes, which suggests that balance and control profiles are shaped by the demands of
the modality (Schleich, 2017). Strength and biomechanical characteristics were, in turn, linked to knee-
loading patterns in female footballers, connecting neuromuscular assessment to the injury component
treated in Section 3.3 (Collings et al., 2022).
Internal load and perceived exertion
Ratings of perceived exertion were used as a complement to internal-load monitoring rather than as a
substitute for test outcomes, and their interpretation was treated cautiously, since perceived effort
reflects but does not replace the objective result of a performance test (Borg, 1998).
Performance as a multidimensional profile
Taken together, the evidence indicated that no isolated test represents performance. Fitness profiles
derived through principal component analysis differed by playing role in youth players, which
discourages ranking athletes on any single measure and favors role- and stage-specific interpretation
(Becerra-Patiño et al., 2025). The heterogeneity of test protocols documented across the literature
reinforces the same conclusion, since comparisons are only meaningful when administration is
standardized (Asimakidis et al., 2025). The direction of these performance associations, and their
integration with the body profile and the injury component, are represented in Figure 3.
Mobility, balance, neuromuscular control, and movement quality
Beyond the classic performance qualities, the corpus extended the battery toward the functional and
preventive domain, incorporating mobility, static and dynamic balance, neuromuscular control, and
movement quality, which are particularly relevant in modalities that involve acceleration, deceleration,
and pivoting. A randomized controlled trial in university students showed that a functional training
program improved movement quality and physical fitness, indicating that these qualities are both
assessable and modifiable (Li et al., 2025). Postural control differed across collision, contact, and non-
contact sport athletes, which suggests that balance and control profiles are shaped by the demands of
the modality (Schleich, 2017). Strength and biomechanical characteristics were, in turn, linked to knee-
loading patterns in female footballers, connecting neuromuscular assessment to the injury component
treated in Section 3.3 (Collings et al., 2022).
Internal load and perceived exertion
Ratings of perceived exertion were used as a complement to internal-load monitoring rather than as a
substitute for test outcomes, and their interpretation was treated cautiously, since perceived effort
reflects but does not replace the objective result of a performance test (Borg, 1998).
Performance as a multidimensional profile
Taken together, the evidence indicated that no isolated test represents performance. Fitness profiles
derived through principal component analysis differed by playing role in youth players, which
discourages ranking athletes on any single measure and favors role- and stage-specific interpretation
(Becerra-Patiño et al., 2025). The heterogeneity of test protocols documented across the literature
reinforces the same conclusion, since comparisons are only meaningful when administration is
standardized (Asimakidis et al., 2025). The direction of these performance associations, and their
integration with the body profile and the injury component, are represented in Figure 3.
pág. 5566
Table 4 Functional and Field-Performance Tests Applicable to Amateur Team Sport
Test
(construct)
Field protocol
(brief)
Outcome (unit);
reading; tier
Standardization, safety, and
sequencing (key)
Sources
Yo-Yo IR1
(intermittent
high-intensity
endurance)
Repeated 2 × 20-
m shuttles,
audio-paced, 10-
s active recovery,
to exhaustion
Distance (m); more
= better; Tier 1
Familiarize; keep audio, surface,
footwear, turn, recovery,
environment, and stop criteria
constant; norms by version, sex, age,
level; do not replace distance with
estimated VO₂max; run late; stop for
chest pain, dyspnea, dizziness, ataxia
Asimakidis
et al. (2025);
Bangsbo et
al. (2008);
Schmitz et
al. (2018);
Zemková &
Pacholek
(2023)
30-15 IFT
(intermittent
capacity, peak
velocity)
30-s shuttle
stages,
increasing speed,
15-s recovery,
standard audio,
and course
Final velocity
(km·h⁻¹); higher =
better; Tier 1
Constant course, audio, turn,
recovery, stop; familiarize; not
interchangeable with Yo-Yo IR1; run
at end; same interruption criteria
Asimakidis
et al. (2025)
10- or 20-m
linear sprint
(acceleration,
speed)
Standard start
behind line; 2–3
maximal trials,
full recovery,
best trial; gates at
set distances
Time (s); shorter =
better; Tier 1
(stopwatch) / Tier 2
(gates)
Constant start, distance, instructions,
trials, recovery, surface, footwear,
timing; prefer gates; do not pool
manual and electronic times; after
warm-up, before endurance; clear
deceleration zone
Bustamante-
Garrido et al.
(2024);
França et al.
(2024)
Preplanned
change-of-
direction test
(decelerate,
reorient,
accelerate)
Fixed course
(505, modified T,
or Illinois);
familiarize; ≥2
valid trials, best
time
Time (s); shorter =
better; Tier 1
(stopwatch) / Tier 2
(gates)
Identify the protocol (courses not
interchangeable); standard cone
spacing, entry, side, trials, timing;
invalidate missed cones or slips;
nonslip surface; stop for pain or
instability
Ciocca et al.
(2022);
Gisladottir et
al. (2024);
Morral-
Yepes et al.
(2023)
Reactive-
agility test
(perceptual
decision plus
movement)
Short
multidirectional
course; direction
cued by an
unpredictable
stimulus after
start
Response/completi
on time (s); shorter
= better; Tier 2–3
Distinguish from preplanned COD;
constant stimulus type, timing,
alternatives, course, rules, timing;
total time mixes perception and
locomotion; stop for instability or
collision risk
Ciocca et al.
(2022);
Morral-
Yepes et al.
(2023)
Repeated-
sprint ability
test
(reproduce
sprints with
incomplete
recovery)
Set number of
short sprints,
fixed brief
recoveries;
specify distance,
reps, recovery,
timing
Best, mean, total
time and decrement
(s, %); shorter and
smaller decrement
= better; Tier 2
Protocols not interchangeable; report
distance, reps, work-to-rest,
turnaround, timing, decrement
method; mean time more stable than
fatigue %; only if sport-justified, after
speed and COD; stop for pain or
altered mechanics
Asimakidis
et al. (2025)
Standing
horizontal
jump (lower-
limb
horizontal
explosive
performance)
Two-foot take-
off behind line,
standard arm
action, controlled
landing, 2–3
valid trials
Distance (cm);
greater = better;
Tier 1
Constant start, arm action, take-off,
landing, measuring point, trials,
surface; reflects performance and
body mass, not direct power; after
warm-up, before sprint or endurance;
nonslip landing
França et al.
(2024);
Ishida et al.
(2021); Leão
et al. (2022)
Table 4 Functional and Field-Performance Tests Applicable to Amateur Team Sport
Test
(construct)
Field protocol
(brief)
Outcome (unit);
reading; tier
Standardization, safety, and
sequencing (key)
Sources
Yo-Yo IR1
(intermittent
high-intensity
endurance)
Repeated 2 × 20-
m shuttles,
audio-paced, 10-
s active recovery,
to exhaustion
Distance (m); more
= better; Tier 1
Familiarize; keep audio, surface,
footwear, turn, recovery,
environment, and stop criteria
constant; norms by version, sex, age,
level; do not replace distance with
estimated VO₂max; run late; stop for
chest pain, dyspnea, dizziness, ataxia
Asimakidis
et al. (2025);
Bangsbo et
al. (2008);
Schmitz et
al. (2018);
Zemková &
Pacholek
(2023)
30-15 IFT
(intermittent
capacity, peak
velocity)
30-s shuttle
stages,
increasing speed,
15-s recovery,
standard audio,
and course
Final velocity
(km·h⁻¹); higher =
better; Tier 1
Constant course, audio, turn,
recovery, stop; familiarize; not
interchangeable with Yo-Yo IR1; run
at end; same interruption criteria
Asimakidis
et al. (2025)
10- or 20-m
linear sprint
(acceleration,
speed)
Standard start
behind line; 2–3
maximal trials,
full recovery,
best trial; gates at
set distances
Time (s); shorter =
better; Tier 1
(stopwatch) / Tier 2
(gates)
Constant start, distance, instructions,
trials, recovery, surface, footwear,
timing; prefer gates; do not pool
manual and electronic times; after
warm-up, before endurance; clear
deceleration zone
Bustamante-
Garrido et al.
(2024);
França et al.
(2024)
Preplanned
change-of-
direction test
(decelerate,
reorient,
accelerate)
Fixed course
(505, modified T,
or Illinois);
familiarize; ≥2
valid trials, best
time
Time (s); shorter =
better; Tier 1
(stopwatch) / Tier 2
(gates)
Identify the protocol (courses not
interchangeable); standard cone
spacing, entry, side, trials, timing;
invalidate missed cones or slips;
nonslip surface; stop for pain or
instability
Ciocca et al.
(2022);
Gisladottir et
al. (2024);
Morral-
Yepes et al.
(2023)
Reactive-
agility test
(perceptual
decision plus
movement)
Short
multidirectional
course; direction
cued by an
unpredictable
stimulus after
start
Response/completi
on time (s); shorter
= better; Tier 2–3
Distinguish from preplanned COD;
constant stimulus type, timing,
alternatives, course, rules, timing;
total time mixes perception and
locomotion; stop for instability or
collision risk
Ciocca et al.
(2022);
Morral-
Yepes et al.
(2023)
Repeated-
sprint ability
test
(reproduce
sprints with
incomplete
recovery)
Set number of
short sprints,
fixed brief
recoveries;
specify distance,
reps, recovery,
timing
Best, mean, total
time and decrement
(s, %); shorter and
smaller decrement
= better; Tier 2
Protocols not interchangeable; report
distance, reps, work-to-rest,
turnaround, timing, decrement
method; mean time more stable than
fatigue %; only if sport-justified, after
speed and COD; stop for pain or
altered mechanics
Asimakidis
et al. (2025)
Standing
horizontal
jump (lower-
limb
horizontal
explosive
performance)
Two-foot take-
off behind line,
standard arm
action, controlled
landing, 2–3
valid trials
Distance (cm);
greater = better;
Tier 1
Constant start, arm action, take-off,
landing, measuring point, trials,
surface; reflects performance and
body mass, not direct power; after
warm-up, before sprint or endurance;
nonslip landing
França et al.
(2024);
Ishida et al.
(2021); Leão
et al. (2022)
pág. 5567
Test
(construct)
Field protocol
(brief)
Outcome (unit);
reading; tier
Standardization, safety, and
sequencing (key)
Sources
Countermove
ment jump
(vertical
explosive
performance,
stretch-
shortening)
Rapid
countermovemen
t to maximal
take-off;
standard arms
and depth; 2–3
valid trials
Height (cm), flight
time; force-time if
platform; greater
height = better;
Tier 1 (mat/app) /
Tier 3 (force
platform)
Constant arms, depth, take-off,
landing, device, trials, rest; height
alone is an explosive indicator; power
and force-time need instrumentation;
early in battery; postpone for acute
lower-limb pain
Gisladottir et
al. (2024);
Ishida et al.
(2021); Leão
et al. (2022)
Handgrip
strength
(maximal
isometric
hand-forearm
force)
Calibrated
dynamometer,
standard grip
span and
position,
maximal
contraction, 2–3
trials per hand
Force (kgf or N);
higher = better;
Tier 2
Constant device, grip, posture, hand,
encouragement, duration, trials;
general indicator, not sport-specific
strength; low demand but stop for
hand, wrist, elbow, or shoulder pain;
avoid breath holding
Asimakidis
et al. (2024)
Joint-mobility
assessment
(active/passiv
e ROM:
ankle, hip,
shoulder)
Joint-specific test
with standard
landmarks,
position,
instructions, and
device
Degrees, cm, or
score; higher not
always better; Tier
1 (field) / Tier 2
(goniometer)
Specify joint, plane, active/passive,
landmarks, device, assessor,
endpoint; sensitive to temperature,
prior activity, pain; stop before pain or
protective spasm; do not force end
range in acute injury
Li et al.
(2025)
Static or
dynamic
balance test
(postural
control)
Unipedal/bipedal
or dynamic-reach
task; set stance,
surface,
footwear, vision,
trials
Time, reach, errors,
or index; direction
depends on
protocol; Tier 1
(field) / Tier 2–3
(instrumented)
Constant type, stance, limb, surface,
vision, duration, normalization,
familiarization; static and dynamic are
not interchangeable; supervise and
protect against falls; stop for dizziness
or instability
Collings et
al. (2022); Li
et al. (2025)
Borg CR10
rating of
perceived
exertion
(perceived
exertion)
Explain and
anchor CR10
before testing;
administer at a
fixed moment,
often
immediately
after
Score 0–10; higher
= more exertion
(not performance);
Tier 1
Constant instructions, anchors,
timing, wording; complements but
does not replace objective data; no
physical risk, but extremely high RPE
relative to workload may prompt
observation or referral
Borg (1998)
Note. CMJ = countermovement jump; COD = change of direction; CR10 = Category-Ratio 10 scale;
ICC = intraclass correlation coefficient; IFT = intermittent fitness test; MDC = minimal detectable change; ROM = range of
motion; RPE = rating of perceived exertion; SEM = standard error of measurement; VO₂max = maximal oxygen uptake.
Resource tiers correspond to the decision algorithm in Figure 4 (Tier 1, minimal equipment; Tier 2, moderate or specialized
field instrumentation; Tier 3, advanced laboratory, or wearable technology). Test selection should balance construct validity,
reproducibility, feasibility, nonredundancy, measurement error, sport specificity, and safety. Neuromuscular tests should
precede fatiguing repeated-sprint and intermittent-endurance tests. Sequence, warm-up, instructions, trials, recovery,
equipment, surface, footwear, time-of-day window, and environmental conditions should remain constant across participants
and repeated assessments. Time-based outcomes are read inversely to distance-, velocity-, height-, or force-based outcomes.
Pre-window methodological references support administration but are not part of the contemporary evidence count.
Preparticipation, safety, injury, and prevention
This component addresses the third subquestion, concerning how amateur team-sport athletes are
screened before assessment, what is known about their musculoskeletal injuries, and how prevention
Test
(construct)
Field protocol
(brief)
Outcome (unit);
reading; tier
Standardization, safety, and
sequencing (key)
Sources
Countermove
ment jump
(vertical
explosive
performance,
stretch-
shortening)
Rapid
countermovemen
t to maximal
take-off;
standard arms
and depth; 2–3
valid trials
Height (cm), flight
time; force-time if
platform; greater
height = better;
Tier 1 (mat/app) /
Tier 3 (force
platform)
Constant arms, depth, take-off,
landing, device, trials, rest; height
alone is an explosive indicator; power
and force-time need instrumentation;
early in battery; postpone for acute
lower-limb pain
Gisladottir et
al. (2024);
Ishida et al.
(2021); Leão
et al. (2022)
Handgrip
strength
(maximal
isometric
hand-forearm
force)
Calibrated
dynamometer,
standard grip
span and
position,
maximal
contraction, 2–3
trials per hand
Force (kgf or N);
higher = better;
Tier 2
Constant device, grip, posture, hand,
encouragement, duration, trials;
general indicator, not sport-specific
strength; low demand but stop for
hand, wrist, elbow, or shoulder pain;
avoid breath holding
Asimakidis
et al. (2024)
Joint-mobility
assessment
(active/passiv
e ROM:
ankle, hip,
shoulder)
Joint-specific test
with standard
landmarks,
position,
instructions, and
device
Degrees, cm, or
score; higher not
always better; Tier
1 (field) / Tier 2
(goniometer)
Specify joint, plane, active/passive,
landmarks, device, assessor,
endpoint; sensitive to temperature,
prior activity, pain; stop before pain or
protective spasm; do not force end
range in acute injury
Li et al.
(2025)
Static or
dynamic
balance test
(postural
control)
Unipedal/bipedal
or dynamic-reach
task; set stance,
surface,
footwear, vision,
trials
Time, reach, errors,
or index; direction
depends on
protocol; Tier 1
(field) / Tier 2–3
(instrumented)
Constant type, stance, limb, surface,
vision, duration, normalization,
familiarization; static and dynamic are
not interchangeable; supervise and
protect against falls; stop for dizziness
or instability
Collings et
al. (2022); Li
et al. (2025)
Borg CR10
rating of
perceived
exertion
(perceived
exertion)
Explain and
anchor CR10
before testing;
administer at a
fixed moment,
often
immediately
after
Score 0–10; higher
= more exertion
(not performance);
Tier 1
Constant instructions, anchors,
timing, wording; complements but
does not replace objective data; no
physical risk, but extremely high RPE
relative to workload may prompt
observation or referral
Borg (1998)
Note. CMJ = countermovement jump; COD = change of direction; CR10 = Category-Ratio 10 scale;
ICC = intraclass correlation coefficient; IFT = intermittent fitness test; MDC = minimal detectable change; ROM = range of
motion; RPE = rating of perceived exertion; SEM = standard error of measurement; VO₂max = maximal oxygen uptake.
Resource tiers correspond to the decision algorithm in Figure 4 (Tier 1, minimal equipment; Tier 2, moderate or specialized
field instrumentation; Tier 3, advanced laboratory, or wearable technology). Test selection should balance construct validity,
reproducibility, feasibility, nonredundancy, measurement error, sport specificity, and safety. Neuromuscular tests should
precede fatiguing repeated-sprint and intermittent-endurance tests. Sequence, warm-up, instructions, trials, recovery,
equipment, surface, footwear, time-of-day window, and environmental conditions should remain constant across participants
and repeated assessments. Time-based outcomes are read inversely to distance-, velocity-, height-, or force-based outcomes.
Pre-window methodological references support administration but are not part of the contemporary evidence count.
Preparticipation, safety, injury, and prevention
This component addresses the third subquestion, concerning how amateur team-sport athletes are
screened before assessment, what is known about their musculoskeletal injuries, and how prevention
pág. 5568
connects back to the descriptive components. The synthesis moves from the safety gate to injury
epidemiology, then to associated factors, and finally to prevention.
Preparticipation screening and safety criteria
The reviewed guidance framed preparticipation screening as a preventive, non-diagnostic process
whose purpose is to identify conditions that warrant proceeding, adapting, postponing, or referring,
rather than to certify fitness or guarantee the absence of risk (Weise et al., 2025). Screening typically
combined personal and family medical history, current symptoms, and injury history, and it relied
heavily on consensus recommendations, including criteria for not initiating a test, interrupting an
ongoing test, and referring the athlete to an appropriate professional (Harmon et al., 2013; Weise et al.,
2025). These stages, decisions, and referral criteria are organized in Table 5.
Table 5 Preparticipation Screening, Safety, Test-Interruption, and Referral Criteria
Stage Criterion and indicators Decision Action (key) Sources
Before session Emergency preparedness:
written EAP, communication,
first aid, contacts, venue access,
assigned roles
Proceed only
if operational
Confirm emergency
pathway; postpone high-
intensity testing if
resources unavailable
Scarneo-Miller
et al. (2024)
Screening Informed participation:
understands purpose, exertion,
risks, confidentiality, right to
withdraw
Proceed /
postpone /
decline
Documented consent:
clarify screening is
preventive, not clearance
Weise et al.
(2025)
Screening Personal health history:
cardiovascular, respiratory,
neurological, metabolic, renal
condition; prior surgery;
adverse event; medication
Proceed /
adapt /
postpone /
refer
Structured questionnaire:
refer if it affects exercise
safety
Weise et al.
(2025)
Screening Family cardiovascular history:
premature sudden or
unexplained death, inherited
cardiac disease, arrhythmia
Refer before
maximal
testing
Recommend medical
evaluation; do not diagnose
or clear
Weise et al.
(2025)
Screening Cardio-respiratory warning
symptoms: exertional chest
pain, syncope, disproportionate
dyspnea, palpitations, cyanosis
Do not
initiate; refer;
EAP if acute
Postpone and recommend
timely evaluation; activate
EAP if emergency
Scarneo-Miller
et al. (2024);
Weise et al.
(2025)
Screening Acute systemic illness: fever,
infection, vomiting or diarrhea,
uncontrolled condition,
clinician restriction
Postpone;
refer if
unresolved
Do not begin strenuous
testing; reschedule after
recovery
Weise et al.
(2025)
Screening Musculoskeletal injury (current
or previous): pain, swelling,
instability, altered gait, recent
injury or surgery, unresolved
rehab, recurrent or same-region
injury
Proceed with
caution /
adapt /
postpone /
refer
Test only what is safe;
postpone loading the
affected region; use injury
history in interpretation,
not alone to predict injury;
refer beyond scope
Sonesson et al.
(2023); Weise
et al. (2025)
connects back to the descriptive components. The synthesis moves from the safety gate to injury
epidemiology, then to associated factors, and finally to prevention.
Preparticipation screening and safety criteria
The reviewed guidance framed preparticipation screening as a preventive, non-diagnostic process
whose purpose is to identify conditions that warrant proceeding, adapting, postponing, or referring,
rather than to certify fitness or guarantee the absence of risk (Weise et al., 2025). Screening typically
combined personal and family medical history, current symptoms, and injury history, and it relied
heavily on consensus recommendations, including criteria for not initiating a test, interrupting an
ongoing test, and referring the athlete to an appropriate professional (Harmon et al., 2013; Weise et al.,
2025). These stages, decisions, and referral criteria are organized in Table 5.
Table 5 Preparticipation Screening, Safety, Test-Interruption, and Referral Criteria
Stage Criterion and indicators Decision Action (key) Sources
Before session Emergency preparedness:
written EAP, communication,
first aid, contacts, venue access,
assigned roles
Proceed only
if operational
Confirm emergency
pathway; postpone high-
intensity testing if
resources unavailable
Scarneo-Miller
et al. (2024)
Screening Informed participation:
understands purpose, exertion,
risks, confidentiality, right to
withdraw
Proceed /
postpone /
decline
Documented consent:
clarify screening is
preventive, not clearance
Weise et al.
(2025)
Screening Personal health history:
cardiovascular, respiratory,
neurological, metabolic, renal
condition; prior surgery;
adverse event; medication
Proceed /
adapt /
postpone /
refer
Structured questionnaire:
refer if it affects exercise
safety
Weise et al.
(2025)
Screening Family cardiovascular history:
premature sudden or
unexplained death, inherited
cardiac disease, arrhythmia
Refer before
maximal
testing
Recommend medical
evaluation; do not diagnose
or clear
Weise et al.
(2025)
Screening Cardio-respiratory warning
symptoms: exertional chest
pain, syncope, disproportionate
dyspnea, palpitations, cyanosis
Do not
initiate; refer;
EAP if acute
Postpone and recommend
timely evaluation; activate
EAP if emergency
Scarneo-Miller
et al. (2024);
Weise et al.
(2025)
Screening Acute systemic illness: fever,
infection, vomiting or diarrhea,
uncontrolled condition,
clinician restriction
Postpone;
refer if
unresolved
Do not begin strenuous
testing; reschedule after
recovery
Weise et al.
(2025)
Screening Musculoskeletal injury (current
or previous): pain, swelling,
instability, altered gait, recent
injury or surgery, unresolved
rehab, recurrent or same-region
injury
Proceed with
caution /
adapt /
postpone /
refer
Test only what is safe;
postpone loading the
affected region; use injury
history in interpretation,
not alone to predict injury;
refer beyond scope
Sonesson et al.
(2023); Weise
et al. (2025)
pág. 5569
Stage Criterion and indicators Decision Action (key) Sources
Screening Suspected or unresolved
concussion: recent head impact,
LOC, confusion, headache,
dizziness, balance or visual
symptoms, persistent post-
concussion symptoms
Do not test;
remove and
refer
Remove-and-refer; no
same-day return; graduated
clinical progression
Patricios et al.
(2023)
Screening Medication or substance affects
heart rate, BP, alertness,
coordination, thermoregulation,
or pain; stimulants
Proceed /
adapt /
postpone /
refer
Record use without altering
treatment; seek guidance
for interactions
Weise et al.
(2025)
Pretest Inadequate recovery or
preparation: sleep loss, recent
strenuous exercise, fasting,
dehydration, alcohol, heat, or
cold outside protocol
Adapt /
postpone
Reschedule if safety or
comparability
compromised; document
deviations
Weise et al.
(2025)
Pretest Equipment, surface,
environment: damaged or
uncalibrated gear, unstable or
obstructed surface, insufficient
space, unsafe temperature or
lighting, wrong footwear
Do not
initiate until
corrected
Correct hazard, change
location, adapt, or postpone
Scarneo-Miller
et al. (2024);
Weise et al.
(2025)
Administration Expected exertional response
(no warning signs):
proportionate fatigue,
ventilation, sweating, resolving
in recovery
Proceed with
monitoring
Continue per protocol;
terminate at predefined
completion criteria
Weise et al.
(2025)
Interruption Cardiovascular warning signs:
chest pain, syncope, marked
dizziness, palpitations,
cyanosis, pallor, collapse
Stop
immediately;
EAP or refer
by severity
Terminate, position safely,
basic assessment, activate
EAP; do not resume in
session
Scarneo-Miller
et al. (2024);
Weise et al.
(2025)
Interruption Abnormal respiratory response:
severe dyspnea, wheeze with
compromise, cannot speak,
distress, oxygenation concern
Stop
immediately;
treat within
scope, refer
or EAP
Terminate exertion; follow
emergency pathway; do not
restart
Scarneo-Miller
et al. (2024);
Weise et al.
(2025)
Interruption Acute musculoskeletal
symptoms: sudden or increasing
pain, suspected strain or sprain,
joint giving way, swelling,
cannot bear weight
Stop the test;
assess and
refer
Discontinue loading;
immediate care within
competence; clinical
evaluation
Weise et al.
(2025)
Interruption Neurological or motor-control
signs: new confusion, ataxia,
visual disturbance, severe
headache, weakness, altered
responsiveness, seizure
Stop
immediately;
EAP or refer
Protect from further
activity; activate EAP; no
same-session return
Patricios et al.
(2023);
Scarneo-Miller
et al. (2024)
Interruption Volitional termination or unsafe
protocol: requests to stop,
cannot maintain pace or
technique, excessive fatigue,
unsafe mechanics
Stop the test Respect for withdrawal; no
pressure; judge result
validity
Weise et al.
(2025)
Stage Criterion and indicators Decision Action (key) Sources
Screening Suspected or unresolved
concussion: recent head impact,
LOC, confusion, headache,
dizziness, balance or visual
symptoms, persistent post-
concussion symptoms
Do not test;
remove and
refer
Remove-and-refer; no
same-day return; graduated
clinical progression
Patricios et al.
(2023)
Screening Medication or substance affects
heart rate, BP, alertness,
coordination, thermoregulation,
or pain; stimulants
Proceed /
adapt /
postpone /
refer
Record use without altering
treatment; seek guidance
for interactions
Weise et al.
(2025)
Pretest Inadequate recovery or
preparation: sleep loss, recent
strenuous exercise, fasting,
dehydration, alcohol, heat, or
cold outside protocol
Adapt /
postpone
Reschedule if safety or
comparability
compromised; document
deviations
Weise et al.
(2025)
Pretest Equipment, surface,
environment: damaged or
uncalibrated gear, unstable or
obstructed surface, insufficient
space, unsafe temperature or
lighting, wrong footwear
Do not
initiate until
corrected
Correct hazard, change
location, adapt, or postpone
Scarneo-Miller
et al. (2024);
Weise et al.
(2025)
Administration Expected exertional response
(no warning signs):
proportionate fatigue,
ventilation, sweating, resolving
in recovery
Proceed with
monitoring
Continue per protocol;
terminate at predefined
completion criteria
Weise et al.
(2025)
Interruption Cardiovascular warning signs:
chest pain, syncope, marked
dizziness, palpitations,
cyanosis, pallor, collapse
Stop
immediately;
EAP or refer
by severity
Terminate, position safely,
basic assessment, activate
EAP; do not resume in
session
Scarneo-Miller
et al. (2024);
Weise et al.
(2025)
Interruption Abnormal respiratory response:
severe dyspnea, wheeze with
compromise, cannot speak,
distress, oxygenation concern
Stop
immediately;
treat within
scope, refer
or EAP
Terminate exertion; follow
emergency pathway; do not
restart
Scarneo-Miller
et al. (2024);
Weise et al.
(2025)
Interruption Acute musculoskeletal
symptoms: sudden or increasing
pain, suspected strain or sprain,
joint giving way, swelling,
cannot bear weight
Stop the test;
assess and
refer
Discontinue loading;
immediate care within
competence; clinical
evaluation
Weise et al.
(2025)
Interruption Neurological or motor-control
signs: new confusion, ataxia,
visual disturbance, severe
headache, weakness, altered
responsiveness, seizure
Stop
immediately;
EAP or refer
Protect from further
activity; activate EAP; no
same-session return
Patricios et al.
(2023);
Scarneo-Miller
et al. (2024)
Interruption Volitional termination or unsafe
protocol: requests to stop,
cannot maintain pace or
technique, excessive fatigue,
unsafe mechanics
Stop the test Respect for withdrawal; no
pressure; judge result
validity
Weise et al.
(2025)
pág. 5570
Stage Criterion and indicators Decision Action (key) Sources
Post-test Immediate recovery: heart rate,
breathing, orientation, gait,
skin, or symptoms not
normalizing; delayed dizziness,
nausea, or pain
Observe /
stop session /
refer
Supervise recovery; do not
dismiss while symptoms
persist; EAP if
deterioration
Scarneo-Miller
et al. (2024);
Weise et al.
(2025)
Post-test Incident or adverse-event
reporting: unexpected
symptoms, injury, near miss,
emergency response, safety
interruption
Record and
review before
further
participation
Complete incident report,
protect confidentiality,
evaluate protocol change or
referral
Scarneo-Miller
et al. (2024)
Referral Findings outside scope:
persistent pain, unresolved
injury, concerning
cardiovascular, respiratory,
neurological, metabolic,
nutritional, or psychological
finding, abnormal recovery
Refer Direct to medicine,
physiotherapy,
rehabilitation, nutrition, or
psychology; avoid out-of-
scope diagnoses
Patricios et al.
(2023); Weise
et al. (2025)
Return Resolution or professional
management: symptoms
resolved, limitation addressed,
recommendation obtained,
meets pretest conditions
Resume /
adapt /
continue
postponement
Repeat readiness
screening; resume only
safe, permitted tests
Patricios et al.
(2023); Weise
et al. (2025)
Principle Preventive and non-diagnostic:
screening flags caution,
adaptation, postponement, or
referral; no diagnosis or
guarantee of safety
Apply
proportional
judgment
Communicate as screening
observations; avoid
"cleared" or "injury-proof"
claims; keep confidential
and non-stigmatizing
Weise et al.
(2025)
Note. Decision codes: proceed, continue under the standardized protocol; adapt, modify test or sequence without
compromising safety or interpretability; postpone, defer until the condition resolves; stop, terminate an ongoing test; refer,
indicate assessment by a qualified professional. EAP = emergency action plan; LOC = loss of consciousness; BP = blood
pressure. For every criterion, document the relevant finding, action, and disposition confidentially, without stigmatizing
language, and on a need-to-know basis, distinguishing observed data from clinical interpretation. Preparticipation screening is
a preventive decision-support process, not a diagnosis, a guarantee of safety, or unrestricted medical clearance; much of the
guidance remains consensus-based and requires proportionate interpretation. Weise et al. (2025) provide the principal synthesis
for general preparticipation evaluation; Patricios et al. (2023) support the concussion criteria; and Scarneo-Miller et al. (2024)
support emergency action planning and incident response.
Epidemiology of musculoskeletal injuries in amateur team sport.
Descriptive evidence indicated that reduced-contact modalities are not injury-free. In flag football,
reported injuries involved the hand and fingers, knee, and ankle, and included sprains, strains, and
fractures, which supports surveillance of both the upper and lower extremities despite the modality's
rules (Balachandran et al., 2025; Barber Foss et al., 2023). Injury patterns in female American football
varied by age group, and the differences in contact exposure, rules, and equipment caution against
transferring those findings directly to flag football (Mao et al., 2025). In soccer and rugby, amateur
cohorts documented meaningful injury occurrence, with sex-disaggregated patterns in rugby and
prospective injury occurrence in amateur soccer (Prieto-González et al., 2021; Sonesson et al., 2023;
Stage Criterion and indicators Decision Action (key) Sources
Post-test Immediate recovery: heart rate,
breathing, orientation, gait,
skin, or symptoms not
normalizing; delayed dizziness,
nausea, or pain
Observe /
stop session /
refer
Supervise recovery; do not
dismiss while symptoms
persist; EAP if
deterioration
Scarneo-Miller
et al. (2024);
Weise et al.
(2025)
Post-test Incident or adverse-event
reporting: unexpected
symptoms, injury, near miss,
emergency response, safety
interruption
Record and
review before
further
participation
Complete incident report,
protect confidentiality,
evaluate protocol change or
referral
Scarneo-Miller
et al. (2024)
Referral Findings outside scope:
persistent pain, unresolved
injury, concerning
cardiovascular, respiratory,
neurological, metabolic,
nutritional, or psychological
finding, abnormal recovery
Refer Direct to medicine,
physiotherapy,
rehabilitation, nutrition, or
psychology; avoid out-of-
scope diagnoses
Patricios et al.
(2023); Weise
et al. (2025)
Return Resolution or professional
management: symptoms
resolved, limitation addressed,
recommendation obtained,
meets pretest conditions
Resume /
adapt /
continue
postponement
Repeat readiness
screening; resume only
safe, permitted tests
Patricios et al.
(2023); Weise
et al. (2025)
Principle Preventive and non-diagnostic:
screening flags caution,
adaptation, postponement, or
referral; no diagnosis or
guarantee of safety
Apply
proportional
judgment
Communicate as screening
observations; avoid
"cleared" or "injury-proof"
claims; keep confidential
and non-stigmatizing
Weise et al.
(2025)
Note. Decision codes: proceed, continue under the standardized protocol; adapt, modify test or sequence without
compromising safety or interpretability; postpone, defer until the condition resolves; stop, terminate an ongoing test; refer,
indicate assessment by a qualified professional. EAP = emergency action plan; LOC = loss of consciousness; BP = blood
pressure. For every criterion, document the relevant finding, action, and disposition confidentially, without stigmatizing
language, and on a need-to-know basis, distinguishing observed data from clinical interpretation. Preparticipation screening is
a preventive decision-support process, not a diagnosis, a guarantee of safety, or unrestricted medical clearance; much of the
guidance remains consensus-based and requires proportionate interpretation. Weise et al. (2025) provide the principal synthesis
for general preparticipation evaluation; Patricios et al. (2023) support the concussion criteria; and Scarneo-Miller et al. (2024)
support emergency action planning and incident response.
Epidemiology of musculoskeletal injuries in amateur team sport.
Descriptive evidence indicated that reduced-contact modalities are not injury-free. In flag football,
reported injuries involved the hand and fingers, knee, and ankle, and included sprains, strains, and
fractures, which supports surveillance of both the upper and lower extremities despite the modality's
rules (Balachandran et al., 2025; Barber Foss et al., 2023). Injury patterns in female American football
varied by age group, and the differences in contact exposure, rules, and equipment caution against
transferring those findings directly to flag football (Mao et al., 2025). In soccer and rugby, amateur
cohorts documented meaningful injury occurrence, with sex-disaggregated patterns in rugby and
prospective injury occurrence in amateur soccer (Prieto-González et al., 2021; Sonesson et al., 2023;
pág. 5571
Yeomans et al., 2021). Additional rugby evidence characterized incidence, severity, mechanism, and
anatomical distribution, described temporal trends by sex, and mapped the gaps in women's rugby,
where epidemiological data remain comparatively scarce (Bellingan et al., 2025; Marrese et al., 2025;
Yendluri et al., 2024). A notable gap across the corpus is the limited adult amateur and Latin American
epidemiological evidence, especially for flag football, a point summarized in Table 6.
Intrinsic, biomechanical, and body-related associated factors
The literature examined factors associated with non-contact lower-limb injury, including strength,
biomechanics, inter-limb asymmetries, neuromuscular control, and previous injury, and it increasingly
framed these within multifactorial rather than single-factor models. Non-contact anterior cruciate
ligament injury in women served as a paradigmatic case, with syntheses and prospective work
identifying candidate strength and biomechanical indicators and recurring injury mechanisms, while
cautioning that such indicators are not validated individual predictors (Achenbach et al., 2024; Chia et
al., 2022; Collings et al., 2022; Mancino et al., 2024). Reviews of women's football reinforced sex-
specific considerations for injury and prevention (John et al., 2025), and a structural equation model of
male footballers represented intrinsic characteristics as interdependent rather than isolated predictors,
which supports a systems-oriented reading and cautions against single-test decisions (Liveris et al.,
2025). Consistent with the screening evidence, previous injury and higher age were prospectively
associated with subsequent injury in amateur players (Sonesson et al., 2023), and body-composition
and fitness variables have been combined within multivariable injury-prediction models, an approach
that bridges the descriptive components to the injury component while requiring independent validation
(Martins et al., 2022).
These associated factors are compiled in Table 6, and their bidirectional, non-causal relationship with
body profile and performance is represented in Figure 3.
Yeomans et al., 2021). Additional rugby evidence characterized incidence, severity, mechanism, and
anatomical distribution, described temporal trends by sex, and mapped the gaps in women's rugby,
where epidemiological data remain comparatively scarce (Bellingan et al., 2025; Marrese et al., 2025;
Yendluri et al., 2024). A notable gap across the corpus is the limited adult amateur and Latin American
epidemiological evidence, especially for flag football, a point summarized in Table 6.
Intrinsic, biomechanical, and body-related associated factors
The literature examined factors associated with non-contact lower-limb injury, including strength,
biomechanics, inter-limb asymmetries, neuromuscular control, and previous injury, and it increasingly
framed these within multifactorial rather than single-factor models. Non-contact anterior cruciate
ligament injury in women served as a paradigmatic case, with syntheses and prospective work
identifying candidate strength and biomechanical indicators and recurring injury mechanisms, while
cautioning that such indicators are not validated individual predictors (Achenbach et al., 2024; Chia et
al., 2022; Collings et al., 2022; Mancino et al., 2024). Reviews of women's football reinforced sex-
specific considerations for injury and prevention (John et al., 2025), and a structural equation model of
male footballers represented intrinsic characteristics as interdependent rather than isolated predictors,
which supports a systems-oriented reading and cautions against single-test decisions (Liveris et al.,
2025). Consistent with the screening evidence, previous injury and higher age were prospectively
associated with subsequent injury in amateur players (Sonesson et al., 2023), and body-composition
and fitness variables have been combined within multivariable injury-prediction models, an approach
that bridges the descriptive components to the injury component while requiring independent validation
(Martins et al., 2022).
These associated factors are compiled in Table 6, and their bidirectional, non-causal relationship with
body profile and performance is represented in Figure 3.
pág. 5572
Table 6 Epidemiology, Associated Factors, and Prevention of Musculoskeletal Injuries in Team Sports
Study Setting and
population
Design Domain and
main
contribution
Applied reading; caveat
Balachandran et al.
(2025)
USA;
women, flag
football
10-yr
epidemiological
review
Distribution and
type: hand,
fingers, knee,
ankle; sprains,
strains, fractures
Include upper- and lower-limb
surveillance despite reduced-contact
rules; caveat: level, exposure, injury
definition pending
Barber Foss et al.
(2023)
USA; youth
flag football
Descriptive
epidemiology
Game-related
injury occurrence
Reduced contact is not absence of
MSK risk; caveat: youth data not
transferable to adults
Mao et al. (2025) USA; female
American
football, age-
stratified
Age-stratified
epidemiology
Injury patterns
2015–2024 vary
by age
Age-specific surveillance and
prevention; caveat: American
football differs from flag football
Prieto-González et
al. (2021)
Spain;
adolescent
athletes
Injury
surveillance
Incidence,
location,
candidate factors
Interpret by age, exposure,
development; caveat: mixed-sport or
adolescent may not represent adult
amateurs
Sonesson et al.
(2023)
Sweden;
amateur M/F
soccer
Prospective
cohort
Higher age and
baseline injury
prospectively
associated with in-
season injury
Record current symptoms and prior
injury at screening; caveat:
association, not individual
prediction
Mandorino et al.
(2023)
International
; youth
soccer
Systematic
review
Incidence,
distribution,
candidate factors
Basis for age-appropriate
prevention; caveat: heterogeneous
definitions, exposure, quality
Chia et al. (2022) International
; team ball
sports
SR + meat-
analysis
Noncontact ACL
by sex, age, sport,
level, exposure
Sex- and sport-sensitive
interpretation; caveat: pooled
estimate is not modality-specific
individual risk
Collings et al.
(2022)
Australia;
elite women
footballers
Prospective
observational
Strength and
biomechanics as
candidate ACL
indicators
Neuromuscular assessment adds
context; caveat: elite female
surrogates, limited transfer
Achenbach et al.
(2024)
Germany;
professional
women
Observational
injury-pattern
Four recurring
ACL injury
patterns
Inform movement-specific
prevention and video analysis;
caveat: patterns are not a validated
screening tool
Mancino et al.
(2024)
UK; female
athletes
Narrative
review
Anatomical,
biomechanical,
hormonal,
training ACL
factors
Multifactorial, sex-informed
prevention; caveat: narrative bias, no
pooled estimate
John et al. (2025) International
; women's
football
Review Sex-specific
injury
considerations
Sex-adapted prevention; caveat:
review type and appraisal need
verification
Liveris et al.
(2025)
Pending;
male football
Structural
equation
modeling
Interrelated
intrinsic factors,
noncontact lower-
limb injury
Systems view; caution against
single-test decisions; caveat: model
fit is not causation, needs external
validation
Table 6 Epidemiology, Associated Factors, and Prevention of Musculoskeletal Injuries in Team Sports
Study Setting and
population
Design Domain and
main
contribution
Applied reading; caveat
Balachandran et al.
(2025)
USA;
women, flag
football
10-yr
epidemiological
review
Distribution and
type: hand,
fingers, knee,
ankle; sprains,
strains, fractures
Include upper- and lower-limb
surveillance despite reduced-contact
rules; caveat: level, exposure, injury
definition pending
Barber Foss et al.
(2023)
USA; youth
flag football
Descriptive
epidemiology
Game-related
injury occurrence
Reduced contact is not absence of
MSK risk; caveat: youth data not
transferable to adults
Mao et al. (2025) USA; female
American
football, age-
stratified
Age-stratified
epidemiology
Injury patterns
2015–2024 vary
by age
Age-specific surveillance and
prevention; caveat: American
football differs from flag football
Prieto-González et
al. (2021)
Spain;
adolescent
athletes
Injury
surveillance
Incidence,
location,
candidate factors
Interpret by age, exposure,
development; caveat: mixed-sport or
adolescent may not represent adult
amateurs
Sonesson et al.
(2023)
Sweden;
amateur M/F
soccer
Prospective
cohort
Higher age and
baseline injury
prospectively
associated with in-
season injury
Record current symptoms and prior
injury at screening; caveat:
association, not individual
prediction
Mandorino et al.
(2023)
International
; youth
soccer
Systematic
review
Incidence,
distribution,
candidate factors
Basis for age-appropriate
prevention; caveat: heterogeneous
definitions, exposure, quality
Chia et al. (2022) International
; team ball
sports
SR + meat-
analysis
Noncontact ACL
by sex, age, sport,
level, exposure
Sex- and sport-sensitive
interpretation; caveat: pooled
estimate is not modality-specific
individual risk
Collings et al.
(2022)
Australia;
elite women
footballers
Prospective
observational
Strength and
biomechanics as
candidate ACL
indicators
Neuromuscular assessment adds
context; caveat: elite female
surrogates, limited transfer
Achenbach et al.
(2024)
Germany;
professional
women
Observational
injury-pattern
Four recurring
ACL injury
patterns
Inform movement-specific
prevention and video analysis;
caveat: patterns are not a validated
screening tool
Mancino et al.
(2024)
UK; female
athletes
Narrative
review
Anatomical,
biomechanical,
hormonal,
training ACL
factors
Multifactorial, sex-informed
prevention; caveat: narrative bias, no
pooled estimate
John et al. (2025) International
; women's
football
Review Sex-specific
injury
considerations
Sex-adapted prevention; caveat:
review type and appraisal need
verification
Liveris et al.
(2025)
Pending;
male football
Structural
equation
modeling
Interrelated
intrinsic factors,
noncontact lower-
limb injury
Systems view; caution against
single-test decisions; caveat: model
fit is not causation, needs external
validation
pág. 5573
Study Setting and
population
Design Domain and
main
contribution
Applied reading; caveat
Yeomans et al.
(2021)
Ireland;
amateur M/F
rugby
Comparative
epidemiology
Injury patterns
differ by sex
Sex-disaggregated surveillance;
caveat: exposure, role, and reporting
differences
Marrese et al.
(2025)
Brazil; rugby
union
Epidemiologica
l
Incidence,
severity,
mechanism,
region
Prioritize prevention by common
sites and mechanisms; caveat: level,
definition, duration, denominator
pending
Yendluri et al.
(2024)
USA; M/F
rugby
Epidemiologica
l trend
Trends 2008–
2022; persistent
noncontact knee
injury in women
Continue sex-specific surveillance;
caveat: coding, participation, and
exposure limits
Bellingan et al.
(2025)
International
; women's
rugby
Scoping review Epidemiology,
factors, gaps
Priorities for future research; caveat:
maps breadth, no pooled effect
Martins et al.
(2022)
Portugal;
elite football
Predictive
modeling
Injury prediction
from body
composition and
fitness
Shows potential and limits of
combined field variables; caveat:
elite, overfitting, needs validation
Lemes et al.
(2021)
International
; 13,355
athletes
SR + meat-
analysis
Exercise-based
prevention of
noncontact MSK
injury
Structured preventive exercise helps
with delivery and adherence; caveat:
varied content, definitions,
adherence
Bullock et al.
(2025)
International
; female
athletes
SR + consensus
framework
Lower-extremity
prevention
Sex-informed multicomponent
programs; monitor fidelity; caveat:
separate consensus from
comparative evidence
Liu et al. (2026) International
; ages 10–19
SR + meat-
analysis
Multicomponent
prevention
Neuromuscular and multicomponent
prevention with sufficient dose and
adherence; caveat: adolescent, do
not overgeneralize
Jaskulski et al.
(2025)
Poland;
women's
rugby
8-wk
intervention
Sensorimotor and
knee injury-
related indicators
Sensorimotor training within
preparation; caveat: surrogate
outcomes are not reduced injury
incidence
Cardoso-Marinho
et al. (2022)
International
; football
Systematic
review
Injury-risk
perception and
preventive
behavior
Athlete beliefs and engagement
matter for adherence; caveat:
perception is not incidence or
susceptibility
Note. ACL = anterior cruciate ligament; MSK = musculoskeletal; M = men; W = women; SR = systematic review. The term
risk factor is reserved for longitudinal evidence in which an exposure precedes and predicts the injury; cross-sectional,
biomechanical, and model-derived variables are described more cautiously as associated factors, candidate indicators, or
injury-related characteristics. Improvements in strength, balance, movement quality, or neuromuscular control are not
interpreted as reductions in injury incidence unless actual injuries were measured over a defined exposure period. The evidence
base is concentrated in soccer and rugby, includes a substantial proportion of female and youth populations, and offers
comparatively limited epidemiological evidence for adult amateur flag football; this asymmetry is treated as a central finding
and a limitation of transferability. Preventive programs should be interpreted in relation to content, exposure, adherence,
implementation of fidelity, and injury definition.
Study Setting and
population
Design Domain and
main
contribution
Applied reading; caveat
Yeomans et al.
(2021)
Ireland;
amateur M/F
rugby
Comparative
epidemiology
Injury patterns
differ by sex
Sex-disaggregated surveillance;
caveat: exposure, role, and reporting
differences
Marrese et al.
(2025)
Brazil; rugby
union
Epidemiologica
l
Incidence,
severity,
mechanism,
region
Prioritize prevention by common
sites and mechanisms; caveat: level,
definition, duration, denominator
pending
Yendluri et al.
(2024)
USA; M/F
rugby
Epidemiologica
l trend
Trends 2008–
2022; persistent
noncontact knee
injury in women
Continue sex-specific surveillance;
caveat: coding, participation, and
exposure limits
Bellingan et al.
(2025)
International
; women's
rugby
Scoping review Epidemiology,
factors, gaps
Priorities for future research; caveat:
maps breadth, no pooled effect
Martins et al.
(2022)
Portugal;
elite football
Predictive
modeling
Injury prediction
from body
composition and
fitness
Shows potential and limits of
combined field variables; caveat:
elite, overfitting, needs validation
Lemes et al.
(2021)
International
; 13,355
athletes
SR + meat-
analysis
Exercise-based
prevention of
noncontact MSK
injury
Structured preventive exercise helps
with delivery and adherence; caveat:
varied content, definitions,
adherence
Bullock et al.
(2025)
International
; female
athletes
SR + consensus
framework
Lower-extremity
prevention
Sex-informed multicomponent
programs; monitor fidelity; caveat:
separate consensus from
comparative evidence
Liu et al. (2026) International
; ages 10–19
SR + meat-
analysis
Multicomponent
prevention
Neuromuscular and multicomponent
prevention with sufficient dose and
adherence; caveat: adolescent, do
not overgeneralize
Jaskulski et al.
(2025)
Poland;
women's
rugby
8-wk
intervention
Sensorimotor and
knee injury-
related indicators
Sensorimotor training within
preparation; caveat: surrogate
outcomes are not reduced injury
incidence
Cardoso-Marinho
et al. (2022)
International
; football
Systematic
review
Injury-risk
perception and
preventive
behavior
Athlete beliefs and engagement
matter for adherence; caveat:
perception is not incidence or
susceptibility
Note. ACL = anterior cruciate ligament; MSK = musculoskeletal; M = men; W = women; SR = systematic review. The term
risk factor is reserved for longitudinal evidence in which an exposure precedes and predicts the injury; cross-sectional,
biomechanical, and model-derived variables are described more cautiously as associated factors, candidate indicators, or
injury-related characteristics. Improvements in strength, balance, movement quality, or neuromuscular control are not
interpreted as reductions in injury incidence unless actual injuries were measured over a defined exposure period. The evidence
base is concentrated in soccer and rugby, includes a substantial proportion of female and youth populations, and offers
comparatively limited epidemiological evidence for adult amateur flag football; this asymmetry is treated as a central finding
and a limitation of transferability. Preventive programs should be interpreted in relation to content, exposure, adherence,
implementation of fidelity, and injury definition.
pág. 5574
Prevention programs and risk perception
Intervention evidence indicated that exercise-based neuromuscular and multicomponent programs are
associated with reduced non-contact musculoskeletal injury when they are adequately delivered and
adhered to (Lemes et al., 2021), and consensus-oriented syntheses for the female athlete emphasized
sex-informed, multicomponent prevention and the decisive role of implementation fidelity (Bullock et
al., 2025). Multicomponent programs were likewise associated with reduced injury in adolescent team-
sport participants when dosage and adherence were sufficient (Liu et al., 2026), and sensorimotor and
knee-focused training modified neuromuscular indicators, although surrogate improvements should not
be equated with reduced injury incidence unless injuries and exposure were measured (Jaskulski et al.,
2025).
Pragmatic implementation frameworks addressed how such programs are adopted and sustained in real
settings (Patterson et al., 2022), and functional training improved modifiable movement-quality and
fitness qualities that prevention programs target (Li et al., 2025). Because adherence depends on
athletes' beliefs and engagement, risk perception emerged as a relevant implementation outcome rather
than a measure of injury susceptibility (Cardoso-Marinho et al., 2022). Taken together with the
epidemiological synthesis (Mandorino et al., 2023), these findings close the analytic loop: prevention
presupposes a prior diagnostic phase, so that Components I and II are the descriptive basis on which
Component III acts, an articulation represented in the integrative framework (Figure 1).
DISCUSSION
Integrating the three components: a resource-proportional framework.
The central result of this review is not a list of indicators but an articulation among them.
Preparticipation screening, anthropometry, and functional performance behaved not as independent
checklists but as an ordered system, in which screening operates as the entry gate that authorizes
assessment, while anthropometry and functional performance act as descriptors that feed a resource-
proportional field-assessment battery serving two applied aims, training guidance and injury prevention.
Read this way, the body profile is informative only when interpreted purposefully and ethically rather
than as a verdict about an athlete's diet or worth, a stance that the applied literature on body composition
makes explicit (Mathisen et al., 2023).
Prevention programs and risk perception
Intervention evidence indicated that exercise-based neuromuscular and multicomponent programs are
associated with reduced non-contact musculoskeletal injury when they are adequately delivered and
adhered to (Lemes et al., 2021), and consensus-oriented syntheses for the female athlete emphasized
sex-informed, multicomponent prevention and the decisive role of implementation fidelity (Bullock et
al., 2025). Multicomponent programs were likewise associated with reduced injury in adolescent team-
sport participants when dosage and adherence were sufficient (Liu et al., 2026), and sensorimotor and
knee-focused training modified neuromuscular indicators, although surrogate improvements should not
be equated with reduced injury incidence unless injuries and exposure were measured (Jaskulski et al.,
2025).
Pragmatic implementation frameworks addressed how such programs are adopted and sustained in real
settings (Patterson et al., 2022), and functional training improved modifiable movement-quality and
fitness qualities that prevention programs target (Li et al., 2025). Because adherence depends on
athletes' beliefs and engagement, risk perception emerged as a relevant implementation outcome rather
than a measure of injury susceptibility (Cardoso-Marinho et al., 2022). Taken together with the
epidemiological synthesis (Mandorino et al., 2023), these findings close the analytic loop: prevention
presupposes a prior diagnostic phase, so that Components I and II are the descriptive basis on which
Component III acts, an articulation represented in the integrative framework (Figure 1).
DISCUSSION
Integrating the three components: a resource-proportional framework.
The central result of this review is not a list of indicators but an articulation among them.
Preparticipation screening, anthropometry, and functional performance behaved not as independent
checklists but as an ordered system, in which screening operates as the entry gate that authorizes
assessment, while anthropometry and functional performance act as descriptors that feed a resource-
proportional field-assessment battery serving two applied aims, training guidance and injury prevention.
Read this way, the body profile is informative only when interpreted purposefully and ethically rather
than as a verdict about an athlete's diet or worth, a stance that the applied literature on body composition
makes explicit (Mathisen et al., 2023).
pág. 5575
Nutrition enters the framework as a transversal dimension of body status rather than as a separate axis
of judgment, consistent with expert guidance on football nutrition and with descriptive work relating
nutritional status to performance in players (Collins et al., 2021; Oukheda et al., 2024). The empirical
practice of combining body-composition and fitness variables within multivariable injury-risk models
illustrates the same integration in miniature, since it links the descriptive components to the injury
component while still requiring independent validation (Martins et al., 2022). This articulation is
represented in the integrative framework shown in Figure 1.
A proposed field-assessment battery for amateur team sport
The second contribution is a minimum viable, resource-proportional battery. The reviewed evidence on
test selection and standardization supports a battery organized by an explicit administration order, in
which neuromuscular, jump, speed, and change-of-direction tests precede fatiguing repeated-sprint and
intermittent-endurance tests, and in which familiarization, standardized instructions, invalidation
criteria, and safety rules are specified in advance (Asimakidis et al., 2024, 2025; Bangsbo et al., 2008).
The battery is transferable across team modalities and is organized in three resource tiers, essential,
standard, and enhanced, so that a team can assess meaningfully with minimal equipment and scale up
only when resources and standardization capacity allow. Crucially, the highest tier is not automatically
superior; the battery must match the assessment question and the setting, and it must remain subordinate
to the safety gate described in the preparticipation evidence (Weise et al., 2025). This decision logic
consolidates the tests and safety criteria compiled in Tables 4 and 5 and is presented as an algorithm in
Figure 4.
Nutrition enters the framework as a transversal dimension of body status rather than as a separate axis
of judgment, consistent with expert guidance on football nutrition and with descriptive work relating
nutritional status to performance in players (Collins et al., 2021; Oukheda et al., 2024). The empirical
practice of combining body-composition and fitness variables within multivariable injury-risk models
illustrates the same integration in miniature, since it links the descriptive components to the injury
component while still requiring independent validation (Martins et al., 2022). This articulation is
represented in the integrative framework shown in Figure 1.
A proposed field-assessment battery for amateur team sport
The second contribution is a minimum viable, resource-proportional battery. The reviewed evidence on
test selection and standardization supports a battery organized by an explicit administration order, in
which neuromuscular, jump, speed, and change-of-direction tests precede fatiguing repeated-sprint and
intermittent-endurance tests, and in which familiarization, standardized instructions, invalidation
criteria, and safety rules are specified in advance (Asimakidis et al., 2024, 2025; Bangsbo et al., 2008).
The battery is transferable across team modalities and is organized in three resource tiers, essential,
standard, and enhanced, so that a team can assess meaningfully with minimal equipment and scale up
only when resources and standardization capacity allow. Crucially, the highest tier is not automatically
superior; the battery must match the assessment question and the setting, and it must remain subordinate
to the safety gate described in the preparticipation evidence (Weise et al., 2025). This decision logic
consolidates the tests and safety criteria compiled in Tables 4 and 5 and is presented as an algorithm in
Figure 4.
pág. 5576
Figure 4 Decision Algorithm for Selecting and Administering a Resource-Proportional Field-
Assessment Battery in Amateur Team Sport
Note. The algorithm proceeds from the assessment purpose through a preparticipation safety gate to the selection of a resource-
proportional battery organized in three tiers (essential, standard, and enhanced), followed by a standardized test-administration
sequence, quality control, and an integrated profile that informs purpose-driven outputs. Tier 3 is not automatically superior;
the battery must match the assessment question and the available resources. Association is not interpreted as causation, and no
single test predicts injury. Own elaboration, informed by the evidence synthesized in Tables 3 to 5.
Heterogeneity by sex, sport, and level as the interpretive axis
The third contribution is analytic rather than instrumental: the corpus is markedly asymmetric, and
asymmetric structures interpretation. The performance evidence was predominantly male and soccer-
based, whereas the injury evidence was predominantly female and concentrated in soccer and rugby,
and the epidemiological evidence for flag football was incipient and largely from the United States
(Bellingan et al., 2025; Hernandez-Martinez et al., 2024; Ramírez-Munera et al., 2025; Toro-Román et
al., 2023). This distribution means that a profile or a risk pattern established in one population cannot
be assumed to hold in another, and that reference values and injury priorities should be interpreted, and
reported, with stratification by sex, sport, and competitive level (Balachandran et al., 2025; John et al.,
2025; Mao et al., 2025). Treating these modulators as a central axis, rather than as a closing caveat, is
what protects the review's conclusions from over-generalization, and the modulated, bidirectional
character of the relationships among the components is represented in Figure 3 and summarized in the
source characteristics of Table 2.
Figure 4 Decision Algorithm for Selecting and Administering a Resource-Proportional Field-
Assessment Battery in Amateur Team Sport
Note. The algorithm proceeds from the assessment purpose through a preparticipation safety gate to the selection of a resource-
proportional battery organized in three tiers (essential, standard, and enhanced), followed by a standardized test-administration
sequence, quality control, and an integrated profile that informs purpose-driven outputs. Tier 3 is not automatically superior;
the battery must match the assessment question and the available resources. Association is not interpreted as causation, and no
single test predicts injury. Own elaboration, informed by the evidence synthesized in Tables 3 to 5.
Heterogeneity by sex, sport, and level as the interpretive axis
The third contribution is analytic rather than instrumental: the corpus is markedly asymmetric, and
asymmetric structures interpretation. The performance evidence was predominantly male and soccer-
based, whereas the injury evidence was predominantly female and concentrated in soccer and rugby,
and the epidemiological evidence for flag football was incipient and largely from the United States
(Bellingan et al., 2025; Hernandez-Martinez et al., 2024; Ramírez-Munera et al., 2025; Toro-Román et
al., 2023). This distribution means that a profile or a risk pattern established in one population cannot
be assumed to hold in another, and that reference values and injury priorities should be interpreted, and
reported, with stratification by sex, sport, and competitive level (Balachandran et al., 2025; John et al.,
2025; Mao et al., 2025). Treating these modulators as a central axis, rather than as a closing caveat, is
what protects the review's conclusions from over-generalization, and the modulated, bidirectional
character of the relationships among the components is represented in Figure 3 and summarized in the
source characteristics of Table 2.
pág. 5577
Association versus causation and the quality of the evidence
Two cautions temper every inference drawn here. First, the reviewed primary evidence was
predominantly cross-sectional and observational, which supports statements about how variables co-
vary but not about how one produces another; establishing that an exposure precedes and predicts an
injury requires prospective designs with adequate exposure follow-up, and pooled or model-derived
associations should not be read as modality-specific individual risk (Chia et al., 2022; Mandorino et al.,
2023; von Elm et al., 2007). The under-reporting of measurement error across applied testing further
limits how confidently slight differences can be interpreted (Asimakidis et al., 2024). Second, the
method of this review imposes its own limits: identification was restricted to a single database, and title
and abstract screening was artificial-intelligence-assisted and tuned for sensitivity, with full-text
confirmation still pending. These procedures are defensible and transparent, and recent evidence
supports the assisted screening of records against explicit criteria, but they warrant the same interpretive
prudence the review applies to its sources (Khraisha et al., 2024; Oami et al., 2024).
Applied and educational implications
For practitioners in amateur, university, and semi-professional settings, the framework and battery offer
a feasible path from observation to measurement without laboratory resources, if data are collected and
communicated confidentially and without stigmatizing language (Kasper et al., 2021; Mathisen et al.,
2023). The preparticipation gate provides a proportionate, non-diagnostic basis for deciding whether to
proceed, adapt, postpone, or refer, and it clarifies when a finding exceeds the assessor's scope and
warrants referral (Weise et al., 2025). Because the effectiveness of any preventive program depends on
adherence, and adherence depends on athletes' beliefs and engagement, the educational task of building
accurate risk perception is inseparable from the technical task of assessment (Cardoso-Marinho et al.,
2022). In this sense, the review's applied value lies less in any single test than in a coherent, safety-first,
resource-aware way of assessing amateur team-sport athletes.
Limitations
Several limitations qualify the scope and the conclusions of this review. First, the heterogeneity of the
corpus, spanning different sports, sexes, competitive levels, instruments, and outcomes, precluded any
statistical pooling, so the synthesis is descriptive and maps the direction and breadth of the evidence
Association versus causation and the quality of the evidence
Two cautions temper every inference drawn here. First, the reviewed primary evidence was
predominantly cross-sectional and observational, which supports statements about how variables co-
vary but not about how one produces another; establishing that an exposure precedes and predicts an
injury requires prospective designs with adequate exposure follow-up, and pooled or model-derived
associations should not be read as modality-specific individual risk (Chia et al., 2022; Mandorino et al.,
2023; von Elm et al., 2007). The under-reporting of measurement error across applied testing further
limits how confidently slight differences can be interpreted (Asimakidis et al., 2024). Second, the
method of this review imposes its own limits: identification was restricted to a single database, and title
and abstract screening was artificial-intelligence-assisted and tuned for sensitivity, with full-text
confirmation still pending. These procedures are defensible and transparent, and recent evidence
supports the assisted screening of records against explicit criteria, but they warrant the same interpretive
prudence the review applies to its sources (Khraisha et al., 2024; Oami et al., 2024).
Applied and educational implications
For practitioners in amateur, university, and semi-professional settings, the framework and battery offer
a feasible path from observation to measurement without laboratory resources, if data are collected and
communicated confidentially and without stigmatizing language (Kasper et al., 2021; Mathisen et al.,
2023). The preparticipation gate provides a proportionate, non-diagnostic basis for deciding whether to
proceed, adapt, postpone, or refer, and it clarifies when a finding exceeds the assessor's scope and
warrants referral (Weise et al., 2025). Because the effectiveness of any preventive program depends on
adherence, and adherence depends on athletes' beliefs and engagement, the educational task of building
accurate risk perception is inseparable from the technical task of assessment (Cardoso-Marinho et al.,
2022). In this sense, the review's applied value lies less in any single test than in a coherent, safety-first,
resource-aware way of assessing amateur team-sport athletes.
Limitations
Several limitations qualify the scope and the conclusions of this review. First, the heterogeneity of the
corpus, spanning different sports, sexes, competitive levels, instruments, and outcomes, precluded any
statistical pooling, so the synthesis is descriptive and maps the direction and breadth of the evidence
pág. 5578
rather than a summary effect. Second, identification was restricted to a single bibliographic database,
PubMed/MEDLINE; although the title-anchored strategy favored precision, this choice introduces a
coverage boundary, and a fully exhaustive map would additionally interrogate Scopus, Web of Science,
SPORTDiscus, SciELO, and Dialnet. Third, title and abstract screening was performed autonomously
with a large language model tuned for sensitivity, and full-text confirmation of the provisionally
included sources remains a pending verification step; while recent evidence supports artificial-
intelligence-assisted screening against explicit criteria, this procedure warrants human verification
before the corpus is considered final (Khraisha et al., 2024; Oami et al., 2024).
Fourth, the evidence base is markedly asymmetric, with performance data concentrated in male soccer,
injury data concentrated in female soccer and rugby, and only incipient, largely United States
epidemiological evidence for adult amateur flag football, which limits transferability to Latin American
and other underrepresented populations (Balachandran et al., 2025; Barber Foss et al., 2023; Bellingan
et al., 2025). Fifth, the language restriction to English, Spanish, and Chinese, together with variable
access to full texts, may have introduced language and availability bias. Sixth, most primary evidence
was cross-sectional and observational, so the associations reported here cannot establish causation, and
the proposed field-assessment battery, although grounded in the reviewed evidence, has not yet been
validated.
CONCLUSIONS
This scoping review mapped recent evidence on field-based anthropometric, functional, and
preparticipation assessment in amateur team-sport athletes and examined how these indicators relate to
physical performance and to musculoskeletal injury history and risk. In response to the review question,
the evidence supports assessing the amateur athlete through three articulated components rather than
isolated measurements: a preparticipation safety gate, a multidimensional body profile in which body
mass index is a limited indicator requiring complementary measures of central adiposity and body
composition, and a field battery of intermittent endurance, speed, change of direction, and explosive
strength interpreted alongside mobility, balance, and neuromuscular control. Addressing the
subquestions, the relationships among body profile, performance, and injury were consistently
rather than a summary effect. Second, identification was restricted to a single bibliographic database,
PubMed/MEDLINE; although the title-anchored strategy favored precision, this choice introduces a
coverage boundary, and a fully exhaustive map would additionally interrogate Scopus, Web of Science,
SPORTDiscus, SciELO, and Dialnet. Third, title and abstract screening was performed autonomously
with a large language model tuned for sensitivity, and full-text confirmation of the provisionally
included sources remains a pending verification step; while recent evidence supports artificial-
intelligence-assisted screening against explicit criteria, this procedure warrants human verification
before the corpus is considered final (Khraisha et al., 2024; Oami et al., 2024).
Fourth, the evidence base is markedly asymmetric, with performance data concentrated in male soccer,
injury data concentrated in female soccer and rugby, and only incipient, largely United States
epidemiological evidence for adult amateur flag football, which limits transferability to Latin American
and other underrepresented populations (Balachandran et al., 2025; Barber Foss et al., 2023; Bellingan
et al., 2025). Fifth, the language restriction to English, Spanish, and Chinese, together with variable
access to full texts, may have introduced language and availability bias. Sixth, most primary evidence
was cross-sectional and observational, so the associations reported here cannot establish causation, and
the proposed field-assessment battery, although grounded in the reviewed evidence, has not yet been
validated.
CONCLUSIONS
This scoping review mapped recent evidence on field-based anthropometric, functional, and
preparticipation assessment in amateur team-sport athletes and examined how these indicators relate to
physical performance and to musculoskeletal injury history and risk. In response to the review question,
the evidence supports assessing the amateur athlete through three articulated components rather than
isolated measurements: a preparticipation safety gate, a multidimensional body profile in which body
mass index is a limited indicator requiring complementary measures of central adiposity and body
composition, and a field battery of intermittent endurance, speed, change of direction, and explosive
strength interpreted alongside mobility, balance, and neuromuscular control. Addressing the
subquestions, the relationships among body profile, performance, and injury were consistently
pág. 5579
associative, non-linear, and bidirectional, and they were strongly modulated by sex, sport, and
competitive level.
The review's contribution is threefold: an integrative framework that orders these components (Figure
1), a resource-proportional and transferable field-assessment battery presented as a decision algorithm
(Figure 4), and a critical synthesis that foregrounds the heterogeneity and direction of the evidence
rather than a single estimate. These conclusions are offered with deliberate causal prudence: no single
test predicts injury, and description precedes prevention. Accordingly, the research agenda that follows
is clear. Future work should prioritize prospective designs with adequate exposure follow-up, stratified
by sex, sport, and competitive level, that report measurement error explicitly, complete full-text
verification of the provisional corpus, and validate the proposed battery locally, including in Mexican
and broader Latin American amateur populations, where the evidence remains scarcest.
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4
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The review's contribution is threefold: an integrative framework that orders these components (Figure
1), a resource-proportional and transferable field-assessment battery presented as a decision algorithm
(Figure 4), and a critical synthesis that foregrounds the heterogeneity and direction of the evidence
rather than a single estimate. These conclusions are offered with deliberate causal prudence: no single
test predicts injury, and description precedes prevention. Accordingly, the research agenda that follows
is clear. Future work should prioritize prospective designs with adequate exposure follow-up, stratified
by sex, sport, and competitive level, that report measurement error explicitly, complete full-text
verification of the provisional corpus, and validate the proposed battery locally, including in Mexican
and broader Latin American amateur populations, where the evidence remains scarcest.
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2023-107113
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International Journal of Social Research Methodology, 8(1), 19–32.
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https://doi.org/10.3390/jfmk10010040
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https://doi.org/10.1016/j.jsams.2025.09.009
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Borg, G. (1998). Borg's perceived exertion and pain scales. Human Kinetics.
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M., Bizzini, M., Bourne, M. N., Dijkstra, H. P., Dubé, M.-O., Hayden, A., Girdwood, M.,
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perception of injury risk and prevention among football players: A systematic review. Frontiers
in Sports and Active Living, 4, 1018752. https://doi.org/10.3389/fspor.2022.1018752
Chia, L., de Oliveira Silva, D., Whalan, M., McKay, M. J., Sullivan, J., Fuller, C. W., & Pappas, E.
(2022). Non-contact anterior cruciate ligament injury epidemiology in team-ball sports: A
systematic review with meta-analysis by sex, age, sport, participation level, and exposure type.
Sports Medicine, 52, 2447–2467. https://doi.org/10.1007/s40279-022-01697-w
Ciocca, G., Tessitore, A., & Tschan, H. (2022). Agility and change-of-direction speed are two different
abilities also during the execution of repeated trials and in fatigued conditions. PLOS ONE,
17(6), e0269810. https://doi.org/10.1371/journal.pone.0269810
Collings, T. J., Diamond, L. E., Barrett, R. S., Timmins, R. G., Hickey, J. T., du Moulin, W. S., Williams,
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