Hansen Rudi, Lundgaard-Nielsen Mathilde, Henriksen Marius
Department of Physical and Occupational Therapy, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark.
The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark.
PeerJ. 2021 Oct 19;9:e12203. doi: 10.7717/peerj.12203. eCollection 2021.
Assessment of knee kinematics plays an important role in the clinical examination of patients with patellofemoral pain (PFP). There is evidence that visual assessments are reliable in healthy subjects, but there is a lack of evidence in injured populations. The purpose of this study was to examine the intra- and interrater agreement in the visual assessment of dynamic knee joint alignment in patients with PFP.
The study was a cross-sectional agreement study. Sixty participants (42 females) were included. We assessed the intra- and interrater agreement of two functional tests: The single leg squat (SLS) and the forward lunge (FL). One investigator scored the movement according to preset criteria while video recording the movement for retest. Moreover, the performance was scored by another investigator using the video recording. Agreement was assessed using weighted kappa statistics.
The intrarater agreement ranged from moderate to good (Kappa 0.58 (FL) to 0.70 (SLS)) whereas the interrater agreement ranged from fair to moderate (Kappa 0.22 (SLS) to 0.50 (FL)).
The agreement within raters was better than between raters, which suggests that assessments should preferably be performed by the same tester in research and in a clinical setting, e.g., to evaluate any treatment effect. We promote FL as a reliable clinical tool for evaluating dynamic knee alignment, since it shows equally good intra- and interrater agreement, and it is an inexpensive and easy method to use.
膝关节运动学评估在髌股关节疼痛（PFP）患者的临床检查中起着重要作用。有证据表明，视觉评估在健康受试者中是可靠的，但在受伤人群中缺乏相关证据。本研究的目的是检验PFP患者动态膝关节对线视觉评估中的评分者内和评分者间一致性。
本研究为横断面一致性研究。纳入60名参与者（42名女性）。我们评估了两项功能测试的评分者内和评分者间一致性：单腿深蹲（SLS）和前弓步（FL）。一名研究者根据预设标准对动作进行评分，同时对动作进行录像以便重新测试。此外，另一名研究者使用录像对表现进行评分。使用加权kappa统计量评估一致性。
评分者内一致性从中度到良好（kappa值为0.58（FL）至0.70（SLS）），而评分者间一致性从一般到中度（kappa值为0.22（SLS）至0.50（FL））。
评分者内一致性优于评分者间一致性，这表明在研究和临床环境中，例如评估任何治疗效果时，评估最好由同一名测试者进行。我们推荐FL作为评估动态膝关节对线的可靠临床工具，因为它在评分者内和评分者间一致性方面表现同样良好，并且是一种廉价且易于使用的方法。
