Are visual assessments of the single-leg squat valid to be used in clinical practice? A systematic review of measurement properties based on the COSMIN guideline

• Published in: Physical therapy in sport 2023-09, Vol.63, p.118-125
• Main Authors: Gomes, Diogo A., da Costa, Guilherme V., Martins, Eduardo Campos, Silva, Danilo De Oliveira, Haupenthal, Alessandro, Ruschel, Caroline, de Castro, Marcelo P., Fontana, Heiliane de Brito
• Format: Article
• Language: English
• Subjects: Asymptomatic; Biomechanics; Clinical medicine; Decision making; Hip; Hypotheses; Hypothesis testing; Injuries; Kinematics; Knee; Methods; Muscle strength; Outcome measures; Pain; Physical therapy; Sports medicine; Systematic review; Validity
• ISSN: 1466-853X; 1873-1600
• DOI: 10.1016/j.ptsp.2023.07.009

Evaluate the discriminative and convergent validity of visual scales for the assessment of movement quality in the single-leg squat. Searches performed in CINAHL, Cochrane, Embase, PubMed, SPORTDiscus and Web of Science databases. Studies evaluating discriminative and convergent validity of movement quality visual assessments in single-leg squats were included. The COSMIN risk of bias checklist was used to assess the risk of bias, and certainty of evidence was assessed by the GRADE modified version. Ten studies evaluating three different methods of visual assessment of the single-leg squat (Crossley scale; Whatman score and Medial knee displacement) were included. Very low certainty evidence suggests that the Crossley scale had sufficient discriminative validity for patient-centred outcomes. Very low to moderate certainty evidence suggests that the three visual methods of assessment of the single-leg squat had insufficient discriminative validity for surrogate outcomes and groups. None of the three methods had the convergent validity assessed. The Crossley scale exhibited sufficient discriminative validity for patient-centred outcomes, although the evidence supporting this conclusion is of very low certainty. Visual scales for the assessment of the single-leg squat movement quality should be used with caution in clinical practice as most methods had insufficient discriminative validity and no reports of convergent validity. •The Crossley scale had sufficient discriminative validity for patient-centred outcomes.•Findings were primarily derived from evidence with a very low degree of certainty.•The clinical utility of visual assessments of the single-leg squat is unclear.•No study analysed the convergent validity of single-leg squat visual assessment methods.