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Table 3 Validity, reliability and responsiveness of clinical assessments of lower limb functions and activities

From: Robot-aided assessment of lower extremity functions: a review

Measure Instrument/test Properties Study
   Validity Inter-rater reliability Intra-rater reliability Responsiveness  
pROM Universal goniometer Knee angle : ICC ≥ 0.98 [219] Hip flex: 0.56 ≤ ICC ≥ 0.91, SEM = 6.16° [32, 220, 221]
Hip ext: 0.20 ≤ ICC ≥ 0.68, SEM = 4.45° [32, 220, 221]
Hip abduction: 0.45 ≤ ICC ≥ 0.63, SEM = 6.08°[220, 221]
Hip adduction: 0.14 ≤ ICC ≥ 0.65, SEM = 4.4° [220, 221]
Knee flex: 0.84 ≤ ICC ≤ 0.93, SEM = 8.21° [32, 220]
Knee ext: 0.59 ≤ ICC ≤ 0.86, SEM = 3.48° [32, 220]
Ankle DF: 0.26 ≤ ICC ≤ 0.87 [32]
Ankle PF: ICC = 0.74 [32]
Knee flex: 0.97 ≤ ICC ≥ 0.99
Knee ext: 0.91 ≤ ICC ≥ 0.98
[222, 223]
Hip sagittal angle: 0.51 ≤ ICC ≥ 0.54, SEM = 4° [224]
Ankle DF: 0.72 ≤ ICC ≥ 0.89 [34]
- [32, 34, 219224]
aROM Universal goniometer Knee flex: r ≥ 0.975
Knee ext: r ≥ 0.390
Knee flex: ICC ≥ 0.977
Knee ext: ICC ≥ 0.893
Knee flex: ICC = 0.997
Knee ext: ICC ≥ 0.972
- [29]
End-feel Manual examination - Hip flex: 0.21 ≤ k ≤ 0.41
Hip ext: k = − 0.13
Knee flex: − 0.01 ≤ k ≤ 0.31
Knee ext: 0.25 ≤ k ≤ 0.43
Knee flex: k = 0.76
Knee ext: k = 1.00
- [32], [225]
Muscle strength MMT Knee flex (vs isokinetic dynamometer): ρ = 0.74
Knee ext: r = 0.70
[11]
Lower extremities: 0.66 ≤ ICC ≤ 1 [226]
MRC score: 0.62 ≤ ICC ≤ 0.88 [227]
Lower extremities: 0.77 ≤ ρ ≤ 0.99 [228] External resp.: Sensitivity: 60.9 % to 70.3 % [77] [11, 77, 226228]
HHD Knee ext: 0.43 ≤ r ≤ 0.99
Knee flex: 0.83 ≤ ICC ≤ 0.85
Ankle PF: r = 0.93
Ankle DF: r = 0.60 [79]
Knee flex: ICC = 0.95
Knee ext: ICC = 0.88
Ankle DF: ICC = 0.69 [78]
Hip: ICC = 0.82 (belt), ICC = 0.80 (therapist) [229]
Knee flex: ICC = 0.97
Knee ext: ICC = 0.93
Ankle DF: ICC = 0.91 [78]
95 % CI = 32.5 N (72 %)
95 % CI = 57.1 N (79 %) [229]
[78, 79, 230]
Proprioception Romberg test - - - -  
Toe-test - - - -  
Joint impedance MAS vs ankle measurement device: r = 0.09
vs H-reflex: r = 0.47
vs Pendulum test: r = − 0.69
0.16 ≤ k ≤ 0.61
Ankle PF: r = 0.727
0.4 ≤ ICC ≤ 0.75 - [230]
Pendulum test vs MAS: − 0.63 ≤ ρ ≤ −0.89 - 0.651 ≤ ICC ≤ 0.844 - [153]
Walking function/Gait pattern WISCI II Construct validity:
vs TUG: r = −0.76
vs 10MWT: r = −0.68
vs 6MWT: r = 0.60
0.98 ≤ ICC ≤ 1 ICC = 1 MDC: 1 level
Effect size 2.05, moderate change – discrimination between 1 and 3 months post injury
Effect size 0.73, small change – discrimination between 3 and 6 months post injury
[230]
10MWT vs TUG: ρ = 0.89
vs 6MWT: ρ = − 0.95
vs WISCI II: ρ = 0.795
r = 0.97
LOA = ± 7.0 s
r = 0.98
LOA = ± 6.0 s
Effect size: 0.92 - discrimination between 1 and 3 months post injury
Effect size: 0.47 - discrimination between 3 and 6 months post injury
[181, 230, 231]
  1. ρ indicates Spearman rank correlation, r Pearson’s correlation, k Cohen’s Kappa, CI confidence intervals, DF dorsiflexion, PF plantarflexion