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Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin
DOI: 10.1055/a-2546-9838
Original Article

Inter-Rater Reliability of the Qualitative Analysis of the One-Leg Squat Test in Adolescent Athletes

Interrater-Reliabilität bei der qualitativen Analyse des Einbein-Kniebeuge-Tests bei jugendlichen Sportlerinnen und Sportlern
Ebru Tekin 
1   Therapy and Rehabilitation, Balikesir University, Balıkesir, Turkey (Ringgold ID: RIN53003)
,
Fatma Unver
2   School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey (Ringgold ID: RIN52990)
,
Sibel Güven
3   Department of Sports Sciences, Pamukkale University, Denizli, Turkey (Ringgold ID: RIN52990)
,
Büşra Nur Orhan
4   Department of Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey (Ringgold ID: RIN52990)
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Abstract

Introduction

This study aimed to evaluate the inter-rater reliability of the qualitative analysis of the one-leg squat test in adolescent athletes.

Methods

The sample consisted of 20 adolescent athletes aged 10 to 18 years with no balance-affecting health issues. The athletes performed the one-leg squat test, and their performances were video recorded. Three raters—a senior physiotherapist, a junior physiotherapist, and a sports scientist—independently evaluated the videos using Lee Herringtonʼs qualitative analysis framework.

Results

Fleissʼ Kappa analysis showed no significant agreement among the three raters for the right leg, while a low but significant agreement was found for the left leg (k=0.159, p=0.003). Cohenʼs Kappa analysis indicated no significant agreement between the senior physiotherapist and the sports scientist (k=0.026, p=0.761) or between the junior physiotherapist and the sports scientist (k=0.059, p=0.509). However, a low yet statisticallysignificant agreement was observed between the senior and junior physiotherapists (k=0.250, p=0.008).

Conclusion

 The findings suggest that the qualitative analysis of the one-leg squat test does not show strong inter-rater reliability across different professional groups. The low agreement between physiotherapists, despite their experience differences, might be due to similar professional training and perspectives.

Zusammenfassung

Hintergrund und Ziel

Ziel der vorliegenden Studie war es, die Interrater-Reliabilität bei der qualitativen Analyse des Einbein-Kniebeuge-Tests (engl. One-Leg Squat Test bzw. Single-Leg Squat Test) bei jugendlichen Sportlerinnen und Sportlern zu prüfen.

Methode

Die Stichprobe bestand aus 20 jugendlichen Sportlerinnen und Sportlern im Alter von 10 bis 18 Jahren, bei denen keine mit Gleichgewichtsstörungen einhergehende Erkrankungen vorlagen. Die Sportlerinnen und Sportler absolvierten den Einbein-Kniebeuge-Test, wobei ihre Leistung auf Video aufgezeichnet wurde. Drei Rater (eine erfahrende Physiotherapeutin, eine weniger erfahrene Physiotherapeutin und ein Sportwissenschaftler) beurteilten die Videos unabhängig voneinander unter Verwendung des von Herrington vorgeschlagen Systems für die qualitative Bewegungsanalyse.

Ergebnisse

Die Fleiss Kappa-Analyse zeigte keine signifikante Übereinstimmung zwischen den drei Ratern für das rechte Bein, wohingegen für das linke Beineine geringe, aber signifikante Übereinstimmung festgestellt wurde (k=0,159, p=0,003). Die Cohen Kappa-Analyse ergab keine signifikante Übereinstimmung zwischen der erfahrenen Physiotherapeutin und dem Sportwissenschaftler (k=0,026, p=0,761) sowie zwischen der weniger erfahrenen Physiotherapeutin und dem Sportwissenschaftler (k=0,059, p=0,509). Eine geringe, aber statistisch signifikante Übereinstimmung wurde jedoch zwischen der erfahrenen und der weniger erfahrenen Physiotherapeutin festgestellt (k=0,250, p=0,008).

Schlussfolgerung

Die Ergebnisse deuten darauf hin, dass die qualitative Analyse des Einbein-Kniebeugen-Tests keine starke Interrater-Reliabilität zwischen verschiedenen Berufsgruppen aufweist. Dass die Physiotherapeutinnen trotz unterschiedlicher Berufserfahrung eine, wenn auch geringe, Übereinstimmung in der Beurteilung zeigten, könnte auf die ähnliche Berufsausbildung und eine gleiche Betrachtungsweise zurückzuführen sein.

Keywords

Qualitative - One-Leg Squat - Reliability

Schlüsselwörter

Qualitativ - Einbein-Kniebeuge - Reliabilität


Publication History

Received: 22 November 2024

Accepted: 26 February 2025

Article published online:
20 March 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

  • References

  • 1 Hewett TE, Myer GD, Ford KR. et al. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: A prospective study. Am J Sports Med 2005; 33: 492-501
    CrossrefPubMedSearch in Google Scholar
  • 2 Onate J, Cortes N, Welch C. et al. Expert versus novice interrater reliability and criterion validity of the landing error scoring system. J Sport Rehabil 2010; 19: 41-56
    CrossrefPubMedSearch in Google Scholar
  • 3 Crossley KM, Zhang WJ, Schache AG. et al. Performance on the single-leg squat task indicates hip abductor muscle function. Am J Sports Med 2011; 39: 866-873
    CrossrefPubMedSearch in Google Scholar
  • 4 Örtqvist M, Moström EB, Roos EM. et al. Reliability and reference values of two clinical measurements of dynamic and static knee position in healthy children. Knee Surg Sports Traumatol Arthrosc 2011; 19: 2060-2066
    CrossrefPubMedSearch in Google Scholar
  • 5 Bailey R, Selfe J, Richards J. The Single Leg Squat Test in the assessment of musculoskeletal function: A review. Physiotherapy Ireland 2011; 32: 14-20
    PubMedSearch in Google Scholar
  • 6 Räisänen AM, Belli P, Lacote M. Inter-rater reliability of the qualitative analysis of the single-leg squat test in adolescent athletes. J Sports Sci Med 2016; 15: 431-436
    PubMedSearch in Google Scholar
  • 7 Junge T, Runge L, Juul-Kristensen B. et al. Inter-tester reproducibility and inter-tester reliability of the Single Leg Squat Test in 9–10 and 12–14 year old children. BMC Musculoskelet Disord 2012; 13: 95
    CrossrefPubMedSearch in Google Scholar
  • 8 Al-Qahtani M, Smith TO, Kader DF. et al. Risk factors for lower extremity injuries in adolescent athletes: A systematic review. J Sports Med 2023; 57: 257-272
    CrossrefPubMedSearch in Google Scholar
  • 9 Herrington L, Munro A. A preliminary investigation to establish the criterion validity of a qualitative scoring system of limb alignment during single-leg squat and landing. J Exerc Sports Orthop 2014; 1: 1-6
    PubMedSearch in Google Scholar
  • 10 Schurr SA, Marshall AN, Resch JE. et al. Two-dimensional video analysis is comparable to 3D motion capture in lower extremity movement assessment. Int J Sports Phys Ther 2017; 12: 163-172
    PubMedSearch in Google Scholar
  • 11 Kiliç S. Kappa test. Psychiatry Behav Sci 2015; 5: 142
    PubMedSearch in Google Scholar
  • 12 Whatman C, Hing W, Hume P. Kinematic analysis of lower extremity movement during the single-leg squat. J Orthop Sports Phys Ther 2013; 43: 551-560
    CrossrefPubMedSearch in Google Scholar
  • 13 Barker-Davies RM, Hepper AE, Abt G. et al. Inter-rater reliability of the single-leg squat test in military personnel. J Athl Train 2018; 53: 657-663
    CrossrefPubMedSearch in Google Scholar
  • 14 Ressman J, Grooten WJA, Rasmussen-Barr E. Visual assessment of movement quality: A study on intra- and interrater reliability of a multi-segmental single-leg squat test. BMC Sports Sci Med Rehabil 2021; 13: 66
    CrossrefPubMedSearch in Google Scholar
  • 15 Powers CM. The influence of abnormal hip mechanics on knee injury: A biomechanical perspective. J Orthop Sports Phys Ther 2010; 40: 42-51
    CrossrefPubMedSearch in Google Scholar
  • 16 Padua DA, Marshall SW, Boling MC. et al. The Landing Error Scoring System (LESS) is a valid and reliable clinical assessment tool of jump-landing biomechanics: The JUMP-ACL study. Am J Sports Med 2011; 37: 1996-2002
    CrossrefPubMedSearch in Google Scholar
  • 17 Ressman J, Grooten WJA, Rasmussen-Barr E. Visual assessment of movement quality in the single-leg squat test: A review and meta-analysis of inter-rater and intra-rater reliability. BMJ Open Sport Exerc Med 2019; 5: e000541
    CrossrefPubMedSearch in Google Scholar
  • 18 Verhagen E, van Mechelen W, Finch CF. The pragmatic approach to sports injury prevention: How active implementation strategies can make a difference. Br J Sports Med 2018; 52: 877-878
    CrossrefPubMedSearch in Google Scholar
  • 19 Bahr R, Holme I. Risk factors for sports injuries—a methodological approach. Br J Sports Med 2003; 37: 384-392
    CrossrefPubMedSearch in Google Scholar
  • 20 Myer GD, Ford KR, Hewett TE. Methodological approaches and rationale for training to prevent anterior cruciate ligament injuries in female athletes. Scand J Med Sci Sports 2006; 14: 275-285
    CrossrefPubMedSearch in Google Scholar
  • 21 Miller R. Functional movement screening and injury prevention in young athletes. Sports Med 2018; 48: 567-578
    CrossrefPubMedSearch in Google Scholar