Intrarater Reliability of Selected Clinical Outcome Measures Following Anterior Cruciate Ligament Reconstruction

Abstract

Objectives: The purpose of this study was to evaluate the intrarater reliability of selected clinical outcome measures in patients having ACL reconstruction. Background: Several investigations have reported the reliability of isokinetic testing and knee ligament arthrometry. Fewer studies have examined the reliability of lower extremity functional tests, with most of these studies evaluating normal subjects. Methods and Measures: Fifteen physically active males with unilateral ACL-reconstructed knees were evaluated with the KT-1000, Biodex isokinetic dynamometer, and 3 functional hop tests on 5 occasions. Results: lntraclass correlation coefficients (ICCs) revealed good to high intrarater reliability (ICC >0.80) of the functional hop tests and isokinetic peak torque values. KG were higher for the involved limb than the uninvolved limb using the scores from the KT-1000 Manual Maximum Test. Conclusions: The outcome measures examined in this investigation have been shown to be reliable in patients with ACL reconstructions, and support previous investigations in nonimpaired populations. Further research is needed to examine the validity of these postoperative outcome measures in patients with ACL reconstructions. ) . . -Greater demands are being placed on sports physical therapists to improve the measurement and documentation of clinical outcomes following rehabilitation programs of injured athletes. Success is often determined by a return to the same or better level of functional performance than before the injury. The final phase in the management of an injured athlete requires the timely and safe transition from the rehabilitation environment to actual competition. Although physical characteristics such as range of motion, girth, isokinetic strength, and static ligamentous laxity tests provide useful information about an athlete's postinjury or postoperative Isokinetic testing, commonly used by sports medicine clinicians to assess strength and muscle performance, has been determined to be safe17 and reliableS.19.40.P9.S8.~~41~45~~52P58~74~~ with reported intraclass coefficients (ICCs) ranging from 0.72 to 0.99.Many functional tests have been reported to identi-Q, assess, and evaluate knee stability and function following ACL injury or reconstruction. Some of the more commonly used functional tests reported in the literature include the single-leg hop(s), figure 8 run, shuttle run, vertical jump, joint position reproduction, and a crossover cutting maneu~er.~J~v~~.~2. M.75.76 These research investigations provided useful information regarding assessment following ACL injury or reconstruction, but the investigators declined to report on the reliability of the functional tests examined. A recent investigation by Risberg and Ekeland62 examined 6 functional tests performed by patients after ACL reconstruction, but did not report on the tests' reliability. Lephart et a14S.M suggested that the best assessment of functional capacity in athletes with ACL insufficiency is achieved through the use of 3 "functional perfor...

The Ability of 4 Single-Limb Hopping Tests to Detect Functional Performance Deficits in Individuals With Functional Ankle Instability

“…Other research using the single-limb hop for distance, 30-meter agility hop, and 6-meter timed hop also confirms that limb dominance does not affect performance. [3][4][5][6]17,22,24,30,31 Clinically, this finding may eliminate the need for pretest scores as a baseline, because the uninjured limb may be used for comparison.…”

“…4,12,16,20,[24][25][26]28,29,34,37 Functional performance tests range from general lower extremity tests to unilateral hopping tests. 1,2,4,6,12,[16][17][18]20,22,24,[29][30][31][32][33]37 Limited studies exist evaluating the presence of functional deficits in patients with FAI. 7,9,10,21,27,39 Even with the small amount of research available, the studies present with conflicting results, adding to the confusion regarding the nature of this condition.…”

Safety, Feasibility, and Efficacy of Negative Work Exercise Via Eccentric Muscle Activity Following Anterior Cruciate Ligament Reconstruction

“…This test is 1 of the most widespread performance measures conducted after ACL-R and has been shown to have good reliability. 8,43 After a 3-to 5-minute warm-up on a stationary bike, subjects were asked to stand on 1 leg, hop as far as possible, subsequently landing on the same leg. Arm position was self-selected, and swinging of the arms was permitted.…”

“…The KT-1000 is a commonly used instrument to evaluate knee stability and has good reliability and validity. 8,11,22,41 The difference in laxity between the involved and uninvolved knees was recorded. Good intratester reliability (ICC = 0.84) was achieved using the KT-1000 in this study.…”

“…Isokinetic strength testing has been a common outcome measure after ACL-R, and good reliability has been established. 8,40 Subjects were tested concentrically at 60° ≈ s -1 in a seated position, with the hips and knees at 90° flexion and the thighs, pelvis, and upper body firmly strapped to the seat of the dynamometer. Prior to testing, a warm-up consisting of 3 repetitions at 50%, 75%, and 100% intensity was completed.…”