Abstract
This systematic review and meta-analysis aimed to synthesize the validity and reliability of the AST and explore its measurement precision through standard error of measurement (SEM) and minimal detectable change (MDC). A systematic search of PubMed, Scopus, and Web of Science databases was conducted to identify studies evaluating the AST's psychometric properties. Studies reporting quantitative validity or reliability data (e.g., correlation coefficients, ICC) were included. A random-effects meta-analysis was performed to pool validity and reliability estimates, with heterogeneity assessed using I(2) and Tau(2). SEM and MDC values were systematically reviewed to evaluate measurement precision. Seven studies were included in the systematic review, with five studies (42 validity estimates) and six studies (35 reliability estimates) contributing to the meta-analysis. The AST demonstrated promising levels of validity (pooled r = 0.923) and reliability (pooled r = 0.958), although substantial heterogeneity was observed (I(2) > 85%) and should be considered when interpreting these findings. No significant publication bias was detected. SEM ranged from 0.85 - 20.43 N, and MDC from 2.37 - 56.63 N, indicating variable measurement precision. Overall, the AST appears to be a potentially useful tool for assessing shoulder function, with relevance for clinical and research applications.