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Consistency of clinical biomechanical measures between three different institutions: implications for multi-center biomechanical and epidemiological research.

Authors: Myer GD, Wordeman SC, Sugimoto D, Bates NA, Roewer BD, Medina McKeon JM, DiCesare CA, Di Stasi SL, Barber Foss KD, Thomas SM, Hewett TE

Multi-center collaborations provide an alternative to overcome the inherent limitations of single-center investigations. Specifically, multi-center projects can support large-scale prospective, longitudinal studies that investigate outcomes, such as those occurring after anterior cruciate ligament injury. This project was conceived to assess within- and between-center reliability of an affordable, clinical nomogram utilizing two-dimensional video methods to screen for risk of knee injury. The authors hypothesized that the two-dimensional screening methods would provide good-to-excellent reliability within and between institutions for assessment of frontal and sagittal plane biomechanics. Within-center reliability of the clinical nomogram variables was consistently excellent, but between-center reliability was fair-to-good. Within-center intra-class correlation coefficient for all nomogram variables combined was 0.98, while combined between-center inter-class correlation coefficient was 0.63. The authors concluded that injury risk screening protocols were reliable within and repeatable between centers. These results demonstrate the feasibility of multi-site biomechanical studies and establish a framework for further dissemination of injury risk screening algorithms. Specifically, multi-center studies may allow for further validation and optimization of two-dimensional video screening tools.

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