Reliability of the Expanded Cutting Alignment Scoring Tool (E-CAST) to Assess Trunk and Limb Alignment During a 45-Degree Side-Step Cut.
Lauren S Butler, Alexa R Martinez, Dai Sugimoto and 9 others
PMID 35391867WHAT IT FOUND
The E-CAST tool is reliable when a single physical therapist scores the same video twice.
However, agreement between two different therapists was only moderate. The added sagittal plane checks lowered this agreement, suggesting frontal plane views alone may be more consistent for screening ACL risk.
Key findings
01Inter-rater reliability was moderate, meaning two different therapists did not always agree on the score.
02Intra-rater reliability was good, meaning a single therapist gave consistent scores when re-evaluating the same videos.
03The addition of sagittal plane variables (knee flexion and plantarflexion) resulted in a decrease in inter-rater reliability.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study only tested reliability between two physical therapists, so it is unknown if coaches or other clinicians would get similar results. The participants performed a planned cut, which may not reflect the unpredictable nature of sport. The study did not test if the E-CAST actually predicts ACL injuries, only if it can be scored consistently. Definitions for the scoring criteria varied in specificity, which may have confused the raters.
The easy way to misread this
Do not assume the E-CAST predicts ACL injury risk. This study only tested whether physical therapists could score the videos consistently, not whether the movement faults identified actually lead to injury.