Measurement Properties of a Test Battery to Assess Postural Orientation During Functional Tasks in Patients Undergoing ACL Injury Rehabilitation

Abstract Objective Undesirable postural orientation may be a risk factor for a second anterior cruciate ligament (ACL) injury. The purpose of this study was to evaluate face validity, internal consistency, and interrater reliability of an extended version of a previous test battery for visual assessment of postural orientation errors (POEs) in patients during the late phase of rehabilitation following ACL reconstruction (ACLR) (ie, when they have initiated jumping exercises). Methods This study used a cross-sectional design. Fifty-three patients (45% women) in the late phase of ACLR rehabilitation performed 5 functional tasks of varying difficulty. POEs of the lower extremity and trunk were visually assessed from video and scored on a scale from 0 (good) to 2 (poor). Results The side-hop and 2 new POEs (femur medial to shank, femoral valgus) were added to the test battery after expert focus group discussions. Internal consistency was calculated for all tasks (α = .712–.823). Interrater reliability showed fair to substantial agreement for femur medial to shank and femoral valgus during all tasks (K = 0.31–0.815) and almost perfect agreement for side-hop (intraclass correlation coefficient = 0.88). Conclusions The good internal consistency and reliability after adding side-hop, femur medial to shank, and femoral valgus suggests that this test battery is a suitable tool to quantify postural orientation throughout ACLR rehabilitation. Impact This test battery for visual assessment of POEs was evaluated in a heterogeneous group of patients in different phases of ACLR battery and can be used in clinical practice to measure POEs in patients with ACLR, including in the late phase of rehabilitation to return to sport. This study encourages research on more demanding tasks and additional POEs to cover the entire rehabilitation period after ACL injury or reconstruction.

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Postural orientation in subjects with anterior cruciate ligament injury: development and first evaluation of a new observational test battery

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-009-0959-x ◽

2009 ◽

Vol 18 (6) ◽

pp. 814-823 ◽

Cited By ~ 24

Author(s):

Anna Trulsson ◽

Martin Garwicz ◽

Eva Ageberg

Keyword(s):

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Injury ◽

Cruciate Ligament ◽

Test Battery ◽

Ligament Injury ◽

Observational Test ◽

Postural Orientation ◽

Anterior Cruciate

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A Study on the Role of Proprioceptive Training in Non Operative ACL Injury Rehabilitation

Indian Journal of Physiotherapy and Occupational Therapy - An International Journal ◽

10.5958/0973-5674.2015.00128.8 ◽

2015 ◽

Vol 9 (3) ◽

pp. 226

Author(s):

Salil Saha ◽

Bibek Adhya ◽

M S Dhillon ◽

Ashish Saini

Keyword(s):

Acl Injury ◽

Injury Rehabilitation ◽

Proprioceptive Training

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Evaluation of multiple sclerosis disability outcome measures using pooled clinical trial data

Neurology ◽

10.1212/wnl.0000000000008519 ◽

2019 ◽

Vol 93 (21) ◽

pp. e1921-e1931 ◽

Cited By ~ 10

Author(s):

Myla D. Goldman ◽

Nicholas G. LaRocca ◽

Richard A. Rudick ◽

Lynn D. Hudson ◽

Peter S. Chin ◽

...

Keyword(s):

Multiple Sclerosis ◽

Outcome Measures ◽

Performance Measures ◽

Performance Test ◽

Short Form ◽

Performance Measure ◽

Test Battery ◽

Measurement Properties ◽

Sf 36 ◽

Clinical Meaningfulness

ObjectiveWe report analyses of a pooled database by the Multiple Sclerosis Outcome Assessments Consortium to evaluate 4 proposed components of a multidimensional test battery.MethodsStandardized data on 12,776 participants, comprising demographics, multiple sclerosis disease characteristics, Expanded Disability Status Scale (EDSS) score, performance measures, and Short Form–36 Physical Component Summary (SF-36 PCS), were pooled from control and treatment arms of 14 clinical trials. Analyses of Timed 25-Foot Walk (T25FW), 9-Hole Peg Test (9HPT), Low Contrast Letter Acuity (LCLA), and Symbol Digit Modalities Test (SDMT) included measurement properties; construct, convergent, and known group validity; and longitudinal performance of the measures individually and when combined into a multidimensional test battery relative to the EDSS and SF-36 to determine sensitivity and clinical meaningfulness.ResultsThe performance measures had excellent test–retest reliability and showed expected differences between subgroups based on disease duration and EDSS level. Progression rates in detecting time to 3-month confirmed worsening were lower for T25FW and 9HPT compared to EDSS, while progression rates for LCLA and SDMT were similar to EDSS. When the 4 measures were analyzed as a multidimensional measure rather than as individual measures, progression on any one performance measure was more sensitive than the EDSS. Worsening on the performance measures analyzed individually or as a multidimensional test battery was associated with clinically meaningful SF-36 PCS score worsening, supporting clinical meaningfulness of designated performance test score worsening.ConclusionThese results support the use of the 4 proposed performance measures, individually or combined into a multidimensional test battery as study outcome measures.

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The development of an outcome measures toolkit for spinal cord injury rehabilitation

Canadian Journal of Occupational Therapy ◽

10.1177/0008417417690170 ◽

2017 ◽

Vol 84 (2) ◽

pp. 119-129 ◽

Cited By ~ 3

Author(s):

Christie W. L. Chan ◽

William C. Miller ◽

Matthew Querée ◽

Vanessa K. Noonan ◽

Dalton L. Wolfe ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Clinical Practice ◽

Outcome Measures ◽

Best Practice ◽

Outcome Measure ◽

Medical Condition ◽

Measurement Properties ◽

Injury Rehabilitation ◽

Cord Injury

Background. Spinal cord injury (SCI) is a complex medical condition that can be difficult to monitor. Purpose. This study aimed to establish a common set of validated outcome measures specifically for SCI clinical practice. Method. In a three-round online Delphi process, experts in SCI care across Canada suggested and ranked outcome measures for clinical practice. The facilitators provided feedback between rounds and determined if consensus (at least 75% agreement) was reached on a single outcome measure per clinical area. Findings. One hundred and forty-eight outcome measures were initially considered for inclusion. After three rounds, consensus was reached for 23 out of 30 clinical areas. In the remaining seven, more than one outcome measure was recommended. The final toolkit comprises 33 outcome measures with sufficient measurement properties for use with a SCI population. Implications. An outcome measures toolkit validated specifically for SCI should lead to improved identification of best practice and enable clinicians to monitor client progress effectively.

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ACL Injury Rehabilitation: A Psychological Case Study of a Professional Rugby Union Player

Journal of Clinical Sport Psychology ◽

10.1123/jcsp.2.1.71 ◽

2008 ◽

Vol 2 (1) ◽

pp. 71-90 ◽

Cited By ~ 25

Author(s):

Fraser Carson ◽

Remco C. J. Polman

Keyword(s):

Coping Strategies ◽

Cruciate Ligament ◽

Methodological Approach ◽

Acl Injury ◽

Rugby Union ◽

Self Report ◽

Injury Rehabilitation ◽

Rehabilitation Process ◽

Anterior Cruciate

The aim of this case study was to investigate the emotional factors and coping strategies used by a professional rugby union player during rehabilitation from anterior cruciate ligament (ACL) injury. A dominant (qualitative) - less dominant (quantitative) mixed methodological approach was established concurrent with the athlete’s rehabilitation. Twice monthly interviews and a self-report diary were completed throughout the rehabilitation process. Six questionnaires were used to assess specific aspects of injury rehabilitation identified from previous literature, including emotional response, coping, social support, and perceived autonomy. Content analysis of each phase of the rehabilitation process established 34 higher-order themes split into two general dimensions: Influential Emotions or Coping Strategies. Findings highlight the benefit of problem-focused coping to improve autonomy and confidence. A sequential movement through a series of emotions (shock, depression, relief, encouragement, and confidence building) was also identified.

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