measurement (i.e., interrater), and across repeated scoring attempts (i.e., intrarater). Reliability is associated with an estimate of potential error in a score. Instruments with lower reliability are assumed to have more measurement error in a score. For a measure to produce valid scores, it must
Hyokju Maeng, E. Kipling Webster, E. Andrew Pitchford and Dale A. Ulrich
Marissa L. Mason, Marissa N. Clemons, Kaylyn B. LaBarre, Nicole R. Szymczak and Nicole J. Chimera
10 represents the poorest neuromuscular performance, with all flaws present, and a score of 0 represents the best performance, with no flaws present. 5 – 7 Focused Clinical Question Does the TJA demonstrate both interrater and intrarater reliability in healthy individuals? Summary of Search, Best
Derya Celik, Ahmet Dirican and Gul Baltaci
Context: Handheld dynamometry (HHD) is considered an objective method of measuring strength, but the reliability of the procedure can be compromised by inadequate tester strength and insufficient stabilization of the dynamometer especially, for the scapular muscles. Objective: Primarily, to determine the intrarater reliability of HHD when testing shoulder and scapular muscle strength, and secondarily, to report reliability when corrected for body-mass index (BMI). Design: Technical report. Setting: University physiotherapy department. Participants: 57 adults (17 men, 40 women; mean age = 35.05 ± 13.5 y), both healthy individuals and patients with shoulder impingement. Intervention: HHD. Main Outcome Variables: Muscle strength of the upper, middle, and lower trapezius; anterior deltoid; serratus anterior; supraspinatus; and latissimus dorsi determined by HHD. Each muscle was assessed 3 times, and the mean value was calculated. The subjects were divided into 3 groups according to BMI. Group 1: BMI ≤ 20 kg/m2 (n = 22); Group 2: BMI ≤ 24.9 kg/m2 (n = 54); and Group 3: BMI ≤ 29.9 kg/m2 (n = 38). Results: Correlations were calculated for each pair of strength scores. Intraclass correlation coefficients (ICCs) ranged from .77 to .99 in healthy subjects and from .75 to .99 in patients, for all muscle groups except the upper trapezius (P < .05). Reliability values ranged from good to high in healthy subjects but were less consistent for the upper trapezius (ICC .45-.65). The relationship with BMI and muscle strength illustrates that as BMI increases, there is a decrease in reliability values of the lower trapezius (ICC = .35-.65). Conclusion: The study demonstrates that evaluating the strength of scapular and shoulder muscles using HHD presents reliable results for both patients with impingement syndrome and healthy subjects. Reliability values were compressed when testing the trapezius in subjects with higher BMI. This is likely a result of the examiner's difficulty in overcoming the patients with this maneuver.
Eric A. Sorenson
The Functional Movement Screen (FMS) consists of a battery of seven tests that are widely used to systematically evaluate movement.
To evaluate the interrater agreement and intrarater reliability of FMS scores assigned by athletic trainers who reviewed video recordings of the movements.
Interrater agreement and test–retest intrarater reliability.
Eight athletic trainers rated the movements of 15 college-aged participants.
Component and composite FMS scores.
Median values for interrater agreement (0.90) and intrarater reliability (0.88) of the FMS composite score were acceptable. With the exception of the rotary stability test, all of the component scores demonstrated acceptable values for scoring consistency (> 0.80).
Both component and composite FMS scores assigned by athletic trainers were highly consistent, both in terms of scores assigned by different raters and scores assigned by the same raters on two different occasions.
Amir K. Vafadar, Julie N. Cote and Philippe S. Archambault
Context: Joint-position sense (JPS) plays a critical role in the stability of shoulder joint. Restoration of JPS is essential to improve rehabilitation outcomes in individuals with shoulder injury. However, the number of affordable and reliable shoulder-JPS measurement methods for everyday clinical practice is limited. Objective:To estimate reliability and validity of 3 simple shoulder-JPS measurement methods. Design: Cross-sectional study. Participants: 25 healthy men and women. Main Outcome Measure: Absolute-error scores of JPS in 3 ranges of shoulder flexion (low, mid, and high), measured with a laser pointer, an inclinometer, and a goniometer in 2 separate sessions (48 h apart). Results: Overall interrater and intrarater intraclass correlation coefficients were .86 and .78 for the laser pointer, .67 and .70 for the inclinometer, and .60 and .50 for the goniometer, respectively. There was excellent reliability in the low range for the laser pointer and inclinometer methods, but fair to good and poor reliability in mid- and high ranges, respectively. All methods showed strong validity. Conclusion: The laser pointer and inclinometer JPS measurement methods are reliable and can be used by clinicians during rehabilitation of shoulder injuries.
Jeremiah Tate, Hanna True, Barry Dale and Carrie Baker
The high rate of ACL injury has led to the need for large-scale injury risk screening to aid in prevention. Cost and time alternatives to three-dimensional assessments of knee injury risk factors are necessary for largescale, clinical use. The purpose of this study was to determine the expert versus novice interrater reliability and test-retest reliability of the frontal plane projection angle (FPPA) during the single-leg squat (SLS) test. Excellent interrater reliability was demonstrated for session 1 and session 2. Excellent intrarater (i.e., test-retest) reliability was demonstrated for both the novice and expert. The minimal training requirements and excellent reliability of the FPPA during the SLS test make it a key screening tool for large-scale assessment of injury risk.
Barbara C. Belyea, Ethan Lewis, Zachary Gabor, Jill Jackson and Deborah L. King
Context: Lower-extremity landing mechanics have been implicated as a contributing factor in knee pain and injury, yet cost-effective and clinically accessible methods for evaluating movement mechanics are limited. The identification of valid, reliable, and readily accessible technology to assess lower-extremity alignment could be an important tool for clinicians, coaches, and strength and conditioning specialists. Objective: To examine the validity and reliability of using a handheld tablet and movement-analysis application (app) for assessing lower-extremity alignment during a drop vertical-jump task. Design: Concurrent validation. Setting: Laboratory. Participants: 22 healthy college-age subjects (11 women and 11 men, mean age 21 ± 1.4 y, mean height 1.73 ± 0.12 m, mean mass 71 ± 13 kg) with no lower-extremity pathology that prevented safe landing from a drop jump. Intervention: Subjects performed 6 drop vertical jumps that were recorded simultaneously using a 3-dimensional (3D) motion-capture system and a handheld tablet. Main Outcomes Measures: Angles on the tablet were calculated using a motion-analysis app and from the 3D motion-capture system using Visual 3D. Hip and knee angles were measured and compared between both systems. Results: Significant correlations between the tablet and 3D measures for select frontal- and sagittal-plane ranges of motion and angles at maximum knee flexion (MKF) ranged from r = .48 (P = .036) for frontal-plane knee angle at MKF to r = .77 (P < .001) for knee flexion at MKF. Conclusion: Results of this study suggest that a handheld tablet and app may be a reliable method for assessing select lower-extremity joint alignments during drop vertical jumps, but this technology should not be used to measure absolute joint angles. However, sports medicine specialists could use a handheld tablet to reliably record and evaluate lower-extremity movement patterns on the field or in the clinic.
Marissa C. Gradoz, Lauren E. Bauer, Terry L. Grindstaff and Jennifer J. Bagwell
ROM positions may inform clinical practice. Previous studies have reported goniometric supine hip IR ROM interrater reliability ranging from fair to excellent (intraclass correlation coefficient [ICC] = .44–.75) 6 , 7 and excellent intrarater reliability (ICC = .88–.95). 3 , 7 Supine hip ER ROM
Richard A. Brindle, David Ebaugh and Clare E. Milner
is unclear whether the peak force during a hip abductor eccentric strength test occurs before or after the leg begins to lower. For measures to be useful in clinical decision making, they need to be both reliable and valid. Substantial intrarater reliability of a hip abductor eccentric strength test
Eoin Everard, Mark Lyons and Andrew J. Harrison
later by the first rater. Due to time restraints, only the first rater (chartered physiotherapist) undertook the intrarater reliability element of this study. The University of Limerick research ethics committee approved all procedures undertaken in this study. All participants received appropriate