Novice Inter-Rater Reliability on the Selective Functional Movement Assessment (SFMA) After a 4-Hour Training Session.
Brent Harper, Adrian Aron
PMID 37547829WHAT IT FOUND
After just four hours of training, physical therapy students scored the same patients very differently on the SFMA checklist, and both missed more movement problems than an expert.
A single short course does not make a clinician reliable at this screen.
Key findings
01Inter-rater agreement on the 50-point SFMA checklist was moderate overall, but the two students differed significantly from each other and from the certified expert, with large effect sizes.
02The expert identified a mean of 13.9 non-optimal movements out of 50, compared with 9.7 and 6.2 for the two students, meaning the students missed movement problems the expert found.
03Agreement on the categorical movement scores was only fair to moderate, and one student's scoring was notably less consistent with the others, suggesting four hours of training is not enough for reliable classification.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only three raters were studied, and two were students, so the results describe these specific individuals rather than all novice PTs. All participants were healthy volunteers with no pain, but the SFMA is designed for patients with musculoskeletal symptoms, so reliability in a clinical population may differ. The students had no clinical experience with the SFMA, though this mirrors a new graduate starting to use it. Participants were examined three times in succession, which could introduce a learning effect despite randomised order. The study measured agreement between raters, not whether the SFMA correctly identified real movement dysfunction.
Declared interests
The authors declared no conflicts of interest and the study received no specific grant funding.
The easy way to misread this
Do not read the moderate overall ICC of 0.60 as evidence that four hours of SFMA training is adequate. The two students disagreed significantly with each other and both missed more non-optimal movements than the expert, so this level of agreement does not mean the screen is reliable in novice hands.