Beyer Emily B, Hale Rena F, Hellem Aaron R, Mumbleau Allison M, Schilaty Nathan D, Hewett Timothy E
Mayo Clinic Sports Medicine, Minneapolis, MN, USA.
Sparta Science, Menlo Park, CA, USA.
Int J Sports Phys Ther. 2020 Oct;15(5):770-775. doi: 10.26603/ijspt20200770.
Non-contact injuries are common in sports as abnormal lower extremity joint mechanics can place athletes at risk for injury. It is important to have reliable, feasible, cost-effective assessment tools to determine lower limb control and injury risk.
HYPOTHESIS/PURPOSE: The purpose of the study was to assess the intra- and inter-rater reliability of a three-tiered anterior cruciate ligament (ACL) injury risk rating assessment of the drop vertical jump using frontal plane, two-dimensional (2-D) motion capture.
Repeated measures.
Twenty male elite basketball athletes performed the drop vertical jump during a 2-D video assessment at Mayo Clinic Sports Medicine Center in Minneapolis, Minnesota. DVJ scores indicated the following: 1 no visible knee valgus, 2 slight wobble, inward motion of the knees, and 3 knee collision or large frontal plane knee excursion. Score assessment from video of the drop vertical jump was obtained by four independent investigators. The four raters then re-examined the same videos 1 month later, blinded to their original scores.
Intra-rater reliability Fleiss Kappa measure of agreement was substantial amongst all four raters at all scoring time points: initial contact (0.672), first landing (0.728), second landing (0.670), and peak valgus (0.662) ( < 0.001). The intra-rater ICC values were good at initial contact (0.809), second landing (0.874), and max valgus (0.885), however were excellent at first landing (0.914) ( < 0.001). Inter-rater reliability Fleiss Kappa measurement scores were slight at initial contact (0.173), fair at max valgus (0.343), and moderate at first landing (0.532) and second landing (0.514; < 0.001). Inter-rater ICC values were moderate at initial contact (0.588), excellent at first landing (0.919), and good at second landing (0.883) and max valgus (0.882; p<0.001).
When comparing scores of the drop vertical jump between four independent raters across two sessions, the study demonstrated substantial Kappa and good to excellent ICC intra-rater reliability. Inter-rater reliability demonstrated slight to moderate Kappa measurements of agreement and moderate to excellent ICC's. Thus, for excellent reliability using this assessment, patients should be scored by one individual. For moderate reliability between multiple raters, the first landing of the DVJ should be scored. Findings indicate that the proposed drop vertical jump assessment may be used for reliable identification of abnormal landing mechanics.
Level 3.
非接触性损伤在体育运动中很常见，因为下肢关节力学异常会使运动员面临受伤风险。拥有可靠、可行且具有成本效益的评估工具来确定下肢控制能力和受伤风险非常重要。
假设/目的：本研究的目的是使用额面二维（2-D）运动捕捉技术，评估三级前交叉韧带（ACL）损伤风险评级的下落垂直跳评估在评估者内和评估者间的可靠性。
重复测量。
20名男性精英篮球运动员在明尼苏达州明尼阿波利斯市梅奥诊所运动医学中心进行的二维视频评估中进行下落垂直跳。DVJ评分如下：1无明显膝外翻，2轻微晃动、膝盖向内运动，3膝盖碰撞或额面膝盖大幅偏移。四名独立研究人员从下落垂直跳的视频中获取评分评估。然后，这四名评估者在1个月后重新检查相同的视频，对他们原来的评分不知情。
在所有评分时间点，所有四名评估者的评估者内可靠性Fleiss Kappa一致性测量均为实质性：初始接触时（0.672）、首次着地时（0.728）、第二次着地时（0.670）和最大外翻时（0.662）（p<0.001）。评估者内ICC值在初始接触时良好（0.809）、第二次着地时良好（0.874）和最大外翻时良好（0.885），然而在首次着地时优秀（0.914）（p<0.001）。评估者间可靠性Fleiss Kappa测量分数在初始接触时为轻微（0.173）、最大外翻时为中等（0.343）、首次着地时为中等（0.532）和第二次着地时为中等（0.514；p<0.001）。评估者间ICC值在初始接触时为中等（0.588）、首次着地时优秀（0.919）、第二次着地时良好（0.883）和最大外翻时良好（0.882；p<0.001）。
在比较两次测试中四名独立评估者的下落垂直跳分数时，该研究证明了评估者内Kappa值为实质性，ICC值为良好至优秀的可靠性。评估者间可靠性证明了一致性的Kappa测量为轻微至中等，ICC值为中等至优秀。因此，为了使用此评估获得优秀的可靠性，应由一名个体对患者进行评分。对于多个评估者之间的中等可靠性，应评估DVJ的首次着地情况。研究结果表明，所提出的下落垂直跳评估可用于可靠识别异常着地力学。
3级。
