Intra and inter-rater agreement of the Dynamic Movement Assessment ™ Agreement of the DMA™

Bunn, Priscila dos Santos; Costa, Hélcio Figueiredo da; Silva Júnior, Celso José da; Silva, Saulo de Almeida; Abrantes Júnior, Ricardo Costa; Silva, Elirez Bezerra da

doi:10.1590/S1980-65742020000400054

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Motriz: Revista de Educação Física

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Original Article (short paper) • Motriz: rev. educ. fis. 26 (4) • 2020 • https://doi.org/10.1590/S1980-65742020000400054 copy

Intra and inter-rater agreement of the Dynamic Movement Assessment ™ Agreement of the DMA™

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Aims:

To investigate the inter-and intra-rater agreement of the Dynamic Movement Assessment (DMA™) risk classification.

Method:

In this study, after the anthropometric measurements were made, 17 female soccer athletes were filmed performing the six DMA™ tests (full squat, step-up, single-leg squat, jump test, test plank, and side plank). Both, major and secondary deviations, were observed during the tests. Two experienced health professionals performed video analysis using Kinovea 8.15.0 (inter-rater agreement). To assess the intra-rater agreement, the same video analysis was performed two months later. Participants were rated from 0 to 21 points and at low, medium, moderate, and high risk of developing musculoskeletal injuries. To assess the reliability of the assessment of movement patterns of DMA, the intraclass correlation coefficient (ICC) was performed with a 2-way random-effects model with an absolute agreement (inter-rater) and a 2-way mixed-effects model and consistency (intra-rater). Weighted Kappa Agreement Analysis (kw) was performed with linear weights to assess the level of agreement related to the risk classification of DMA (high, moderate, medium, or minimum). The Analysis was performed with StatsDirect v.3 and SPSS (23.0).

Results:

Comparing the number of points between the inter-and intra-rater, the ICC was 0.91 (95% CI = 0.74-0.97) and 0.84 (95% CI = 0.59-0.94), respectively, with kw = 0.46 (P = 0.02) intra -rater and kw = 0.46 (P = 0.006) inter-rater (Table 9).

Conclusion:

DMA has excellent inter-and intra-rater reliability to evaluate movement patterns and classify the risk of musculoskeletal injuries.

Keywords:
movement; test reproducibility; athletic injuries

Variable		Result
Age years		26.7 ± 5.8
BMI (kg / m2)		23.2 ± 1.0
% C		25.6 ± 3.9
*QNSO - n (%)**	Neck	4 (23.5)
	Shoulders	3 (17.6)
	Back (top)	2 (11.7)
	Elbows	0 (0)
	Wrists/hands	2 (11.7)
	Back (lower)	5 (29.4)
	Hips/thighs	12 (70.6)
	Knee	6 (35.3)
	Ankle/foot	9 (52.9)

Participant	Evaluator 1 (phase 1)		Evaluator 1 (phase 2)		Evaluator 2
Participant	C	I	C	I	C	I
1	Moderate	17	Moderate	16	Medium	17
2	Moderate	17	Moderate	16	Medium	16
3	Moderate	14	High	14	High	14
4	Medium	20	Medium	20	Medium	17
5	Medium	19	Moderate	18	Medium	18
6	Moderate	19	Moderate	17	Moderate	17
7	Moderate	13	Moderate	14	Moderate	13
8	Moderate	15	Moderate	18	Moderate	17
9	Moderate	17	Moderate	17	Medium	18
10	Moderate	15	Medium	20	Moderate	16
11	Moderate	18	Medium	18	Medium	18
12	Medium	19	Moderate	17	Medium	19
13	Moderate	15	Moderate	14	Moderate	15
14	Medium	20	Medium	19	Medium	20
15	High	12	High	14	High	13
16	Moderate	18	Moderate	18	Moderate	15
17	Medium	14	Moderate	13	Moderate	13

Evaluator 1 (phase 1)
	Risk	Minimum	Medium	Moderate	High	Total
Evaluator 1 (phase 2)
	Minimum*	0	-	-	-	0
	Medium	-	2	2	1	5
	Moderate	-	3	8	-	11
	High	-	-	-	1	1
	Total	0	5	10	2	17

	Evaluator 1
	Risk	Minimum	Medium	Moderate	High	Total
Evaluator 2	Minimum*	0	-	-	-	0
	Medium	-	4	4	1	9
	Moderate	-	1	6		7
	High	-			1	1
	Total		5	10	2	17

Agreement	Number of points	A & B	ETM	ETM%	ICC	95%
			Intra-rater
Phase 1	16.6 ± 2.6	3.6 -3.5	1.0	0.1	0.84^a / (0.91) ^b	0.59 to 0.94 ^a/0.74 to 0.97 ^b
Phase 2	16.6 ± 2.3	3.6 -3.5	1.0	0.1	0.84^a / (0.91) ^b	0.59 to 0.94 ^a/0.74 to 0.97 ^b
			Inter-raters
Evaluator 1	16.6 ± 2.6	2.3 - 3.0	1.0	0.1	0.83 ^a /(0.91) ^b	0.59 to 0.93 ^a / 0.74 to 0.97 ^b
Evaluator 2	16.2 ± 2.1

Agreement	Number of concordant answers	Percentage of agreement	kw	95%	P
Intra-rater	11	64.70	0.46	0.05 to 0.86	0.02
Inter-raters	13	76.47	0.46	0.09 to 0.82	0.006

Risk	Minimum	Medium	Moderate	High
Minimum*	x	-	-	-
Medium	-	x	K = 0.35; P = 0.14 **	K = 1.0; P = 0.00 ***
Moderate	-	K = 0.35; P = 0.14 **	x	K = 0.60; P = 0.06 #
High	-	K = 1.0; P = 0.000 ***	K = 0.60; P = 0.06 #	x

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E-mail: motriz.rc@unesp.br

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[1] Corresponding author:
Priscila dos Santos Bunn, Avenida Brasil, 10.590, Penha, Rio de Janeiro, RJ, Brazil, CEP: 21.012-350. Email: priscilabunn@yahoo.com.br

Risk rating	Characteristics
4 - High	A collective score of 0-3 points on tests FST, SUT, and SLST + collective score of 3 points on tests PT, SPRT, and SPLT; and/or LOB in the tests FST and SUT;
3 - Moderate	A collective score of 4-5 points on tests FST, SUT, and SLST + collective score of 4 points or better on tests PT, SPRT, and SPLT; and/or LOB in two of the 3 test FST, SUT, or SLST;
2 - Medium	A collective score of 6-7 points on tests FST, SUT, and SLST + collective score of 5 points or better on tests PT, SPRT and SPLT; and/or LOB in one of the 3 test FST, SUT, or SLST;
1 - Minimum	A collective score of 8-9 points on tests FST, SU, T, and SLST + collective score of 6 points or better on tests PT, S P, T and SPLT; and/or LOB in one of the 3 test FST, S,UT or SLST;