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Physiotherapist agreement when visually rating movement quality during lower extremity functional screening tests
Chris Whatman1, Wayne Hing, Patria Hume
1Health and Rehabilitation Research Centre, Faculty of Health and Environmental Sciences, AUT University, Auckland, New Zealand. chris.whatman@aut.ac.nz
Summary
Physiotherapists showed fair to good agreement when rating lower extremity functional tests. Agreement improved with experience and using a dichotomous scale for movement quality assessment.
Area of Science:
- Biomechanics and Motor Control
- Clinical Assessment and Measurement
- Physical Therapy and Rehabilitation
Background:
- Assessing movement quality in lower extremity functional tests is crucial for physical therapy.
- Variability in visual rating can impact the reliability of movement quality assessments.
- Understanding factors influencing physiotherapist agreement is essential for standardized clinical practice.
Purpose of the Study:
- To evaluate the agreement among physiotherapists in visually rating movement quality during lower extremity functional tests.
- To compare the reliability of two distinct visual rating methods.
- To investigate the influence of clinical experience on rating agreement.
Main Methods:
- A clinical measurement design involving 44 physiotherapists with varying experience levels.
- Video recordings of six healthy individuals performing four functional tests were rated.
- Two rating methods (overall/segment) and two scales (dichotomous/ordinal) were used on two separate occasions, analyzed using Overall Percentage Agreement (OPA) and Agreement Coefficient (AC1).
Main Results:
- Intra-rater agreement varied from slight to almost perfect (AC1: 0.01-0.96).
- Inter-rater agreement ranged from fair to good (AC1: 0.22-0.71).
- Agreement, particularly intra-rater, was better with dichotomous rating and in experienced physiotherapists.
Conclusions:
- Physiotherapists exhibit moderate reliability in visually assessing movement quality during functional tests.
- The use of a dichotomous rating scale and higher clinical experience enhance agreement.
- Standardized rating methods are recommended to improve consistency in movement quality evaluation.
