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Application of generalizability theory in estimating the reliability of ankle-complex laxity measurement
Robert J Heitman1, John E Kovaleski, Steven F Pugh
1University of South Alabama, Department of Health & Physical Education, 307 North University Boulevard, Mobile, AL 36688-0002, USA. bheitman@usouthal.edu
Context:
Generalizability theory is an appropriate method for determining the reliability of measurements obtained across more than a single facet. In the clinical and research settings, ankle-complex laxity assessment may be performed using different examiners and multiple trials.
Objective:
To determine the reliability of ankle-complex laxity measurements across different examiners and multiple trials using generalizability theory.
Design:
Correlational study.
Setting:
Laboratory.
Patients Or Other Participants:
Forty male university students without a history of ankle injury.
Main Outcome Measure(S):
Measures of right ankle-complex anteroposterior and inversion-eversion laxity were obtained by 2 examiners. Each examiner performed 2 anteroposterior trials, followed by 2 inversion-eversion trials for each ankle at 0 degrees of ankle flexion. Using generalizability theory, we performed G study and D study analyses.
Results:
More measurement error was found for facets associated with examiner than with trial for both anteroposterior and inversion-eversion laxity. Inversion-eversion measurement was more reliable than anteroposterior laxity measurement. Although 1 examiner and 1 trial had acceptable reliability (G coefficient >/= .848), increasing the number of examiners increased reliability to a greater extent than did increasing the number of trials.
Conclusions:
Within the range of examiner and trial facets studied, any combination of examiners or trials (or both) above 1 can change ankle laxity measurement reliability from acceptable (1 examiner, 1 trial) to highly reliable (3 examiners, 3 trials). Individuals may respond to examiners and their procedural nuances differently; thus, standardized procedures are important.
