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Updated: Jul 12, 2025
Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
Published on: March 1, 2024
The Reliability and Validity of the Modified Four Square Step Test in Individuals with Anterior Cruciate Ligament
Hikmet Kocaman1, Mehmet Canlı2, Halil Alkan3
1Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Karamanoglu Mehmetbey University, Karaman, Turkey.
Background:
The modified four square step test (mFSST) is frequently used in the evaluation of dynamic balance in individuals with balance problems. However, the reliability of the mFSST has not been examined in individuals undergoing anterior cruciate ligament reconstruction (ACLR) surgery.
Purpose:
The aim of this study was to examine the test-retest reliability of the mFSST in individuals undergoing ACLR surgery.
Methods:
Forty-eight patients who had ACLR surgery were included in this study. Patients performed a total of four mFSSTs, two times each, by two different raters over seven days.
Results:
In the current study, the mFSST demonstrated excellent test-retest and inter-rater reliability. The intraclass correlation coefficient for mFSST was 0.92. The standard error of measurement and minimal detectable change for mFSST were 0.15 and 0.41, respectively.
Conclusion:
The mFSST has excellent test-retest and inter-rater reliability in patients with ACLR. It is a valid and reliable tool for evaluating dynamic balance in patients with ACLR. We think that mFSST, which is a clinical evaluation test, can be preferred because it is easy to score and does not require special equipment.
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