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The decline step-down test measuring the maximum pain-free flexion angle: a reliable and valid performance test in patients with patellofemoral pain

Brief summary, from the abstract

In patients with patellofemoral pain, the decline step-down test used to measure the maximum pain-free knee flexion angle was found to be reliable and valid.

  • Reliability was good both within and between raters: intra-observer ICC2,1 = 0.83 and inter-observer ICC2,1 = 0.85.
  • The test scores showed a positive correlation with the Anterior Knee Pain Scale (Dutch version), rs = 0.31, p = 0.030, supporting validity.
  • Agreement was wide despite good ICCs: 95% limits of agreement spanned 27.56 degrees within raters and 24.42 degrees between raters, so individual measurements can vary considerably.
  • Evidence comes from a single reliability and validity study of 32 participants (48 knees).
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