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Single leg squat ratings by clinicians are reliable and predict excessive hip internal rotation moment

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posted on 20.03.2018, 09:09 authored by Rob Barker-Davies, Andrew Roberts, Alexander N. Bennett, Daniel FongDaniel Fong, Patrick Wheeler, Mark LewisMark Lewis
Background - Single leg squats are commonly used subjective assessments of general biomechanical function, injury risk, as a predictor for recovery and as an outcome measure of rehabilitation. While 3D motion capture is a useful tool for elite sports performance and research it is impractical for routine clinical use. Research Question - This cross-sectional study aims to: assess reliability and validity of clinicians’ subjective ratings of single leg squats compared to 3D motion capture, and to identify whether performance predicts joint moments. Methods - 22 healthy military volunteers were simultaneously recorded on video and 3D motion capture performing single leg squats. Videos were reviewed twice by 5 physiotherapists rating performance on a 0–5 scale assessing squat depth, hip adduction, pelvic obliquity, pelvic tilt and trunk flexion summated into a composite score. Results - Hip adduction and trunk flexion exhibited moderate to substantial inter- and intra-rater reliability (range κ = 0.408–0.699) other individual criteria were mostly fair (κ ≤ 0.4). Composite scores for inter-rater reliability were ICC(1,1) = 0.419 and ICC(1,κ) = 0.783 and intra-rater reliability were ICC(1,1) = 0.672 and κ(w) = 0.526. Validity against 3D kinematics was poor with only 6/75 individually rated criteria reaching κ > 0.40. Correlation was found between composite scores and hip internal rotation moment (rs = 0.571, p = 0.009). Significance - Repeated use of single leg squats by a single practitioner is supported. Comparisons between clinicians are unreliable but improved by average measures from multiple raters. Heterogeneous reliability across scoring components suggests a qualitative description of the criteria scored is less ambiguous than using composite scores in a clinical setting. Composite scores may be more useful for analysis at a population level. Poor validity against kinematic data suggests clinicians use additional information upon which they find agreement such as estimating kinetics. Correlation between hip internal rotation moment and subjective ratings may be such an example of clinicians trying to identify excessive abnormal loading.

Funding

This study has been funded by a Higher Education Funding Council for England award to Loughborough University.

History

School

  • Sport, Exercise and Health Sciences

Published in

Gait and Posture

Citation

BARKER-DAVIES, R.M. ... et al, 2018. Single leg squat ratings by clinicians are reliable and predict excessive hip internal rotation moment. Gait and Posture, 61, pp.453-458.

Publisher

Elsevier (© Crown Copyright)

Version

VoR (Version of Record)

Publisher statement

This work is made available according to the conditions of the OGL licence. Full details of this licence are available at: http://creativecommons.org/licenses/OGL/3.0/.

Acceptance date

14/02/2018

Publication date

2018

Notes

This is an Open Access Article. It is published by Elsevier under the Open Government Licence 3.0. Full details of this licence are available at http://www.nationalarchives.gov.uk/doc/open-government-licence/.

ISSN

0966-6362

Language

en