Agreement of an Evaluation of the Forward-Step-Down Test by a Broad Cohort of Clinicians With That of an Expert Panel

in Journal of Sport Rehabilitation
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The forward-step-down (FSD) test may be used to identify underlying pathologies related to lower-extremity injuries. However, research on its interrater reliability is limited.


To assess the interrater reliability of the FSD test with a broad cohort of clinicians and to compare the level of agreement with an expert panel.


Single-measure, interrater reliability.


Annual conference of the Israeli Physical Therapy Society.


15 healthy subjects who performed the FSD test and 142 physical therapists (PTs) who evaluated performance.


Each subject performed the FSD while being videoed. Six videos were selected by an expert panel for analysis. After viewing the videos, FSD performance was rated by 142 PTs, as well as by the expert panel, using a 3-level scale.

Main Outcome Measures:

Interrater reliability determined by intraclass correlation coefficient (ICC) and percentage of agreement with the expert panel.


Fair to good reliability and acceptable agreement were found for the entire sample of raters (ICC –.61, agreement 74%). The percentage of agreement was greater in the subgroup of raters who were familiar with the FSD than in those who were not (78.08% vs 69.32%, respectively, P = .004). Years of work experience did not affect the percentage of agreement (P = .141).


Fair to good interrater reliably of the FSD test was demonstrated by a broad cohort of PTs. The findings support the clinical utility of the FSD test as an assessment tool for quality of movement.

Herman and Nakdimon are with Physical Therapy Service, Maccabi Healthcare Services, Modi’in, Israel. Levinger is with the College of Sport and Exercise Science, Victoria University Melbourne, Melbourne, VIC, Australia. Springer is with the Dept of Physical Therapy, Ariel University, Ariel, Israel.

Address author correspondence to Shmuel Springer at