Moderate reliability of the lateral step down test amongst experienced and novice physical therapists.
Cody Mansfield, Claire Spech, Katherine Rethman and 7 others
PMID 33956559WHAT IT FOUND
Experienced and novice physical therapists showed similar moderate reliability when scoring the lateral step down test.
Agreement was poorest for 'fair' movement, and simplifying the categories to just 'good' or 'moderate' did not improve reliability.
Key findings
01Reliability between experienced and novice therapists was moderate and statistically similar for both inter-rater and intra-rater scores.
02Therapists agreed substantially on 'good' and 'poor' movement but showed only slight to fair agreement on 'fair' movement.
03Collapsing the three categories into two did not improve reliability, yielding moderate scores only.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study used video recordings rather than live clinical assessments, which may not reflect real-world practice. The step height was fixed at 20 cm for all participants, regardless of their height. The sample size was small (22 patients, 6 raters).
Declared interests
The authors declare no conflict of interest.
The easy way to misread this
Do not interpret the improved reliability at one week as evidence that the test is highly reliable in clinical practice. The overall reliability remained only moderate, and the study used video ratings rather than live patient assessments.