assesses posture, muscle balance, and movement patterns in order to identify relevant musculoskeletal dysfunction in a clinical population.Purpose: The purposes of this study were to: (1) determine if raters with similar clinical experience and rating experience exhibit adequate agreement of the scoring for the SFMA during clinical use; (2) determine the reliability of the categorical scoring of the SFMA in a clinical population; (3) determine the reliability of the criterion checklist scoring of the SFMA in a clinical population; (4) compare the reliability of real-time assessment to recorded assessment.
Design: Inter-rater reliability studyMethods: 49 clinical subjects (20.7 years ± 1.6) were simultaneously assessed in real-time by two physical therapists and were recorded with digital video cameras in the sagittal and frontal view while they performed the fifteen component movement patterns that comprise the top-tier SFMA. The third physical therapist assessed the patterns from the video. Subjects were assessed using the SFMA categorical scoring and criterion checklist scoring tools.
Results:The two live clinical raters demonstrated the greatest Cohen's Kappa scores (10 of 15) with moderate or better interrater agreement (Kappa > 0.40) using the categorical scoring tool. The overall ICC [2,1] score indicated fair to moderate agreement between all raters for the criterion checklist scoring (ICC, SEM, p-value) (0.61, 8.23, p < 0.001). Real time clinical use was the most reliable method for using the criterion checklist scoring tool (0.72, 1.95, p=0.43).
Conclusions:Using the categorical and criterion checklist tools in a clinical population to score the fifteen component fundamental movements of the SFMA demonstrated moderate or better reliability when performed clinically by certified SFMA raters.
Level of Evidence: Reliability, Level 2
Context: Recently, blood flow restriction (BFR) training has gained popularity as an alternative to high-load resistance training for improving muscle strength and hypertrophy. Previous BFR studies have reported positive treatment effects; however, clinical benefits to using BFR following meniscal repair or chondral surgery are unknown. The purpose of this study was to determine the effect of resistance exercises with BFR training versus exercises alone on self-reported knee function, thigh circumference, and knee flexor/extensor strength postmeniscal or cartilage surgery. Design: Single-blinded randomized controlled trial in an outpatient military hospital setting. Twenty participants were randomized into 2 groups: BFR group (n = 11) and control group (n = 9). Methods: Participants completed 12 weeks of postoperative thigh strengthening. The BFR group performed each exercise with the addition of BFR. Both groups continued with the prescribed exercises without BFR from 12 weeks until discharged from therapy. Thigh circumference and self-reported knee function were measured at 1, 6, 12, and 24 weeks postoperatively along with knee extensor and flexor strength at 12 and 24 weeks. Change scores between time points were calculated for knee function. Limb symmetry indices (LSI) were computed for thigh circumference and knee strength variables. Results: Seventeen participants were included in the final analyses (BFR = 8 and control = 9) due to COVID-19 restrictions. There were no interactions or main effects for group. Time main effects were established for change in knee function scores, thigh circumference LSI, and knee extensor strength LSI. However, knee flexor strength LSI had no main effect for time. Conclusion: The outcomes of this trial suggest that resistance exercises with and without BFR training may result in similar changes to function, thigh atrophy, and knee extensor strength postmeniscus repair/chondral restoration, though further study with larger sample sizes is needed.
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