Reliability and validity of two square agility test and workability rate of manipulation in adults with musculoskeletal disorders.

The sample was small and recruited from one outpatient physical therapy clinic, so the results may not hold in other settings or with other patient groups. Most participants identified as Caucasian, and the group was drawn from people just finishing a course of physical therapy rather than the broader population living with musculoskeletal disorders. The study did not test whether the tests detect change over time, and no minimum clinically important difference could be worked out, so it cannot tell you whether a patient has genuinely improved. Giving several performance tests in the same session may have caused practice or fatigue effects that influenced the scores. The comparison between upper-body and lower-body problems rested on small groups, with 10 people reporting upper-body-only problems and 28 lower-body-only while 17 reported both, so that comparison had little power to find a difference. Everyone could walk independently and had resting pain of 6/10 or less, so the findings do not apply to patients who are more disabled or in more pain.

The lead author designed the agility and manipulation tests and supplies the manipulation equipment and reporting software through a commercial method he teaches, so he has a financial interest in these tests performing well. The second author declared no conflict of interest.

Do not read this as evidence that these tests measure change in your patients. The study only repeated the tests three weeks apart in people who were not in active therapy, and the authors did not test whether the scores respond to rehabilitation or work out how much change matters to a patient.