The validity and reliability of the Vail Sport Test™ as a measure of performance following anterior cruciate ligament reconstruction
Hannon, Joseph P
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Background: The purposes of this study were to determine the convergent construct and external validity of the Vail Sport Test™. An additional purpose of this study was to determine the between-day test-retest reliability of the Vail Sport Test™. Methods: Forty-eight participants who previously underwent anterior cruciate ligament reconstruction (ACL-R) and who were cleared by their surgeon completed this study. All participants performed the Vail Sport Test™ in a clinical laboratory setting while being graded by an experience rater. Simultaneously, their performance was recorded by an 8-camera three-dimensional (3D) motion capture system time-synchronized with two force plates. A subset of participants returned between 2-7 days to repeat the Vail Sport Test™. Construct validity was assessed by comparing the scores collected visually to those obtained by analyzing post-capture 3D kinematic data. Additionally, the visual scores were compared to the scores on the International Knee Documentation Committee short form (IKDC). External validity was assessed by comparison of both the operated and uninvolved limb scores between those individuals who passed the Vail Sport Test™ and those who failed. A score of 46 out of 54 was used as the cutoff score for pass or fail. Five separate Wilcoxon signed ranked tests ( = 0.01) were used for comparisons and Pearson correlation coefficients were calculated to determine the relationships. Lastly, between-day test-retest reliability was assessed by comparing the visual scores of the operated and uninvolved limb collected on two separate sessions using intraclass correlation (ICC). Results: There was no significant difference between the scores collected visually and those collected post capture for the operated limb (p = 0.013). There was a significant difference between scores for the uninvolved limb (p = 0.006). In addition, a moderate correlation was found between the scores collected visually and those determined post-capture on the operated limb (r = 0.55) and uninvolved limb (r = 0.46). Further, there was no significant difference between the scores collected visually and those of the IKDC (p = 0.814). However, a fair correlation was found between the two sets of the scores (r = 0.20). When comparing between limbs, there was no significant difference between the operated and uninvolved limb in the pass group (p = 0.173) or the fail group (p = 0.465). Lastly, good between-day test-retest reliability (ICC = 0.787) was found for the operated limb, but fair reliability (ICC = 0.485) for the uninvolved limb. Conclusion: The Vail Sport Test™ demonstrated good convergent construct validity on the operated limb, good external validity on both the operated and uninvolved limb, and good between-day reliability on the operated limb. From a clinical perspective, the results of this study partially support the validity and reliability of the Vail Sport Test as a measure of readiness to return to play following ACL-R when used to assess the operated limb.