Clinical Utility of Qualitative Change of Direction Movement Assessment in ACL Injury Risk Evaluation.
Evan Andreyo, Casey Unverzagt, Thomas Dos'Santos and 1 others
PMID 39371188WHAT IT FOUND
CMAS and E-CAST can score change-of-direction cuts on video, and have been compared with 3D movement analysis.
They may guide ACL screening, but no study has shown they predict injury.
Key findings
01CMAS and E-CAST are 2D video rubrics for change-of-direction cuts, with higher scores indicating more ACL-related movement faults.
02The tools show promising agreement with 3D movement analysis and can be scored consistently, but CMAS reliability is not uniform across studies.
03The authors recommend using these tools as part of screening or return-to-sport testing, but state there is no prospective evidence they predict ACL injury.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a narrative commentary, not an original trial or systematic review, so it does not provide new patient outcomes. There is no prospective evidence that CMAS or E-CAST scores predict ACL injury. Reliability is not uniform; one CMAS study reported poor inter-rater reliability, possibly because raters were insufficiently trained. Space, time, and equipment needs may prevent use in many clinics. Unplanned movement testing is ecologically useful but hard to standardize because stimulus timing and trajectory vary.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not treat a high CMAS or E-CAST score as proof an athlete will injure their ACL. The paper states there is no prospective evidence that these movement scores predict injury, so they are screening information, not a diagnosis of future risk.