The Reliability and Discriminative Ability of the Overhead Squat Test for Observational Screening of Medial Knee Displacement

in Journal of Sport Rehabilitation

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Eric G. PostDept of Kinesiology, University of Wisconsin – Madison, Madison, WI.

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Matthew OlsonDept of Kinesiology, University of Wisconsin – Madison, Madison, WI.

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Stephanie TrigstedDept of Kinesiology, University of Wisconsin – Madison, Madison, WI.

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Scott HetzelDept of Biostatistics and Medical Informatics, University of Wisconsin – Madison, Madison, WI.

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David R. BellDept of Kinesiology, University of Wisconsin – Madison, Madison, WI.

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Context: The overhead squat test (OHS) is a functional screening exam that is used to identify high-risk movement profiles such as medial knee displacement (MKD). The reliability and discriminative ability of observational screening during the OHS to identify MKD have yet to be established. Objectives: To investigate the reliability and discriminative ability of observational screening for MKD during the OHS. Study Design: Clinical measurement, cross-sectional. Participants: 100 college students were video-recorded performing the OHS. Three certified athletic trainers classified the knee posture of each subject during the OHS on 2 different occasions using screening guidelines. Main Outcome Measures: Ratings were evaluated by calculating kappa coefficients for intra- and interrater levels of agreements. MKD was measured using motion analysis. Results: Intrarater reliability ranged from .60-.76 with an average value of .70. Interrater reliability was substantial (kappa > .60) for both observation sessions (Fleiss kappa session 1 = .69, session 2 = .70). Sensitivity ranged was .58-.83, while specificity ranged was .70-.88. The MKD group displayed significantly more displacement than the no-MKD group (P < .001). There was a moderate positive correlation (r = .48, P < .001) between knee-posture group and MKD assessed using motion analysis. Conclusion: The OHS has substantial reliability and is able to assess the presence of MKD. The OHS should be used as part of a comprehensive examination that evaluates multiple movement patterns and risk levels.

Address author correspondence to David R. Bell at drbell2@wisc.edu
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