title: Physiotherapists can identify female football players with high knee valgus angles during vertical drop jumps using real-time observational screening.
abstract: METHODS
  Clinical measurement, controlled laboratory study.
  
  
  OBJECTIVE
  To assess the relationships among real-time observational screening of frontal plane knee control and knee valgus angles and abduction moments calculated from 3-D motion analysis during a vertical drop jump. A secondary purpose was to investigate interrater agreement for 3 independent physiotherapists.
  
  
  BACKGROUND
  Current approaches to screen for anterior cruciate ligament injury risk are based on complex biomechanical analyses or 2-dimensional video reviews. There is a need for simple and efficient, low-cost screening methods.
  
  
  METHODS
  Sixty Norwegian elite female football (soccer) players performed a vertical drop-jump task. Using real-time observational screening, 3 physiotherapists independently scored each participant's frontal plane knee control as good, reduced, or poor, based on specific criteria. Screening test scores were correlated to frontal plane knee kinematics and kinetics using 3-D motion analysis. Interrater agreement was determined using kappa correlation coefficients.
  
  
  RESULTS
  Knee valgus angles differed significantly among players rated as having poor, reduced, or good knee control (10.3° ± 3.4°, 5.4° ± 4.1°, and 1.9° ± 4.3°, respectively). The correlation between the observation test scores and valgus angles was moderate for all raters (0.54-0.60, P≤.001), but the observation scores correlated poorly with abduction moments (0.09-0.11, P>.05). The highest discriminative accuracy was found for knee valgus angles across all raters (area under the receiver-operating-characteristic curve, 0.85-0.89). The interrater agreement between the physiotherapists was substantial to almost perfect, with percentage agreement and kappa coefficients ranging from 70% to 95% and 0.52 to 0.92, respectively.
  
  
  CONCLUSIONS
  Physiotherapists can reliably identify female athletes with high knee valgus angles in a vertical drop-jump landing using real-time observational screening.
authors.affiliation: Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
authors.forename: Agnethe
authors.initials: A
authors.lastname: Nilstad
authors.forename: Thor Einar
authors.initials: TE
authors.lastname: Andersen
authors.forename: Eirik
authors.initials: E
authors.lastname: Kristianslund
authors.forename: Roald
authors.initials: R
authors.lastname: Bahr
authors.forename: Grethe
authors.initials: G
authors.lastname: Myklebust
authors.forename: Kathrin
authors.initials: K
authors.lastname: Steffen
authors.forename: Tron
authors.initials: T
authors.lastname: Krosshaug
mesh_terms: D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis; D007719:Knee Joint / Q000503:physiopathology*; D015588:Observer Variation; D059825:Physical Therapists; D018570:Risk Assessment / Q000379:methods; D012916:Soccer / Q000293:injuries*; D013647:Task Performance and Analysis; D055815:Young Adult