INTER-RATER RELIABILITY OF THE SELECTIVE FUNCTIONAL MOVEMENT ASSESSMENT (SFMA) BY SFMA CERTIFIED PHYSICAL THERAPISTS WITH SIMILAR CLINICAL AND RATING EXPERIENCE

Abstract

The Selective Functional Movement Assessment (SFMA) assesses posture, muscle balance, and movement patterns in order to identify relevant musculoskeletal dysfunction in a clinical population. The purposes of this study were to: (1) determine if raters with similar clinical experience and rating experience exhibit adequate agreement of the scoring for the SFMA during clinical use; (2) determine the reliability of the categorical scoring of the SFMA in a clinical population; (3) determine the reliability of the criterion checklist scoring of the SFMA in a clinical population; (4) compare the reliability of real-time assessment to recorded assessment. Inter-rater reliability study. 49 clinical subjects (20.7 years ± 1.6) were simultaneously assessed in real-time by two physical therapists and were recorded with digital video cameras in the sagittal and frontal view while they performed the fifteen component movement patterns that comprise the top-tier SFMA. The third physical therapist assessed the patterns from the video. Subjects were assessed using the SFMA categorical scoring and criterion checklist scoring tools. The two live clinical raters demonstrated the greatest Cohen's Kappa scores (10 of 15) with moderate or better inter-rater agreement (Kappa > 0.40) using the categorical scoring tool. The overall ICC [2,1] score indicated fair to moderate agreement between all raters for the criterion checklist scoring (ICC, SEM, p-value) (0.61, 8.23, p < 0.001). Real time clinical use was the most reliable method for using the criterion checklist scoring tool (0.72, 1.95, p=0.43). Using the categorical and criterion checklist tools in a clinical population to score the fifteen component fundamental movements of the SFMA demonstrated moderate or better reliability when performed clinically by certified SFMA raters. Reliability, Level 2.