Concurrent Validity and Reliability of Two-dimensional Frontal Plane Knee Measurements during Multi-directional Cutting Maneuvers

Dimas Sondang Irawan; Chantheng Huoth; Komsak Sinsurin; Pongthanayos Kiratisin; Roongtiwa Vachalathiti; Jim Richards

doi:10.26603/001c.31651

Concurrent Validity and Reliability of Two-dimensional Frontal Plane Knee Measurements during Multi-directional Cutting Maneuvers

Int J Sports Phys Ther. 2022 Feb 2;17(2):148-155. doi: 10.26603/001c.31651. eCollection 2022.

Authors

Dimas Sondang Irawan¹, Chantheng Huoth¹, Komsak Sinsurin¹, Pongthanayos Kiratisin¹, Roongtiwa Vachalathiti², Jim Richards³

Affiliations

¹ Biomechanics and Sports Research unit, Faculty of Physical Therapy, Mahidol University.
² Musculoskeletal Physical Therapy Research unit, Faculty of Physical Therapy, Mahidol University.
³ Allied Health Research unit, University of Central Lancashire.

Abstract

Background: Excessive knee valgus has been strongly suggested as a contributing key factor for anterior cruciate ligament (ACL) injuries. Three-dimensional (3D) motion analysis is considered the "gold standard" to assess joint kinematics, however, this is difficult for on-field assessments and for clinical setting.

Purpose: To investigate the concurrent validity of 2D measurements of knee valgus angle during cutting in different directions and to explore intra-rater and inter-rater reliability of the 2D measurements.

Study design: Descriptive laboratory study.

Method: Seven recreational soccer players participated in this study. Participants performed three trials of cutting maneuvers in three different directions (30º, 60º, and 90º) with the dominant leg. Cutting maneuvers were recorded simultaneously with a video camera and a Vicon^TM motion capture system. Knee valgus angle from 2D and 3D measurements at initial contact and at peak vertical ground reaction force (vGRF) were extracted. The Pearson's correlation was used to explore the relationship between the 2D and 3D measurements, and reliability of the 2D measurements were performed using intraclass correlation coefficients (ICC).

Result: Significant correlations between 2D and 3D knee valgus measurements were noted for 60º (r = 0.45) and 90º (r = 0.77) cutting maneuvers at initial contact. At peak vGRF, significant correlations between 2D and 3D knee valgus measurements were noted for 30º, 60º, and 90º cutting maneuvers (r=0.45, r=0.74, r=0.78), respectively. Good-to-excellent intra-rater and inter-rater reliability of the 2D knee valgus measurements was observed during cutting in all directions (ICCs: 0.821-0.997).

Conclusion: Moderate-to-strong correlation between 2D and 3D knee valgus measurements during 60°-90° cutting maneuvers, and good-to-excellent intra-rater and excellent inter-rater reliability for the 2D measurements in the present study supports the use of 2D knee valgus measurements in the evaluation of targeted interventions, although the limitations of examining cutting maneuvers using 2D measurement in complex movement still need to be considered.

Level of evidence: 3.

Keywords: acl injury; injury risk screening; knee valgus; side-step cutting; sport clinical tool.