title: Development of a novel rating system to assess lower-limb comfort.
abstract: BACKGROUND
  Comfort evaluation techniques are commonplace in medicine. However, measures of lower-limb comfort are infrequently used in the sporting environment. The purpose of this study was to develop an instrument for measuring lower-limb comfort, which will extend previous work in the field of injury awareness.
  
  
  METHODS
  A lower-limb comfort index (LLCI) was developed for use in the environment of elite sport. Forty professional footballers participated in development of the index. The study had three components. A critical appraisal of the literature established the need for an LLCI. The second phase involved 20 professional footballers establishing and testing the components of the comfort index as an instrument for measuring comfort.
  
  
  RESULTS
  Nonparametric statistics (the McNemar test) in phase 2 indicated that the LLCI demonstrated good responsiveness to suitability (P = .019) and ease of use (P < .01). After a high level of agreement for responses, the third stage required 20 players to pilot test the reliability of the LLCI in a controlled environment. Repeated measures of difference between two periods for sum comfort (intraclass correlation coefficient = 0.99) and individual anatomical segments (κ = 0.72-1) provided confidence that the comfort index was reliable.
  
  
  CONCLUSIONS
  The LLCI showed good trait construct to provide confidence to conduct a future study to investigate interrater consistency in a wider cohort of professional footballers under different conditions, such as match-day and training-week environments.
authors.affiliation: School of Sport and Exercise Science, Institute of Sport, Victoria University, Melbourne, Australia. michael.kinchington@live.vu.edu.au
authors.forename: Michael
authors.initials: M
authors.lastname: Kinchington
authors.forename: Kevin
authors.initials: K
authors.lastname: Ball
authors.forename: Geraldine
authors.initials: G
authors.lastname: Naughton
mesh_terms: D000328:Adult; D006305:Health Status Indicators; D006801:Humans; D007869:Leg Injuries / Q000175:diagnosis; D035002:Lower Extremity; D008297:Male; D010147:Pain Measurement / Q000379:methods*; D012775:Shoes; D012916:Soccer; D018709:Statistics, Nonparametric; D055815:Young Adult