Test-retest, intra-and inter-rater reliability of the reactive balance test in patients with chronic ankle instability –Implications for ankle injury prevention

ABSTRACT
Background:
The RBT could be a valuable addition to research on CAI and clinical practice, but it needs to be reliable before it can be used in clinical practice. It has already been proven reliable in healthy recreational athletes but not yet in patients with CAI.
Objective:
The study aimed to determine the test-retest, intra-, and inter-rater reliability of the Reactive Balance Test (RBT) in patients with chronic ankle instability (CAI) and the test-retest and inter-rater reliability of the newly developed RBT score sheet.
Design:
This is a repeated-measures, single-group reliability study.
Setting
Controlled laboratory study
Participants
We included 27 participants with CAI using the International Ankle Consortium guidelines.
Interventions
The independent variables in this study are the test-retest, intra-rater and inter-rater reliability of the RBT.
Main Outcome Measurements
The study used multiple reliability measures, including Pearson r, intra-class correlations (ICC), standard error of measurement (SEM), standard error of prediction (SEP), minimal detectable change (MDC), and Bland-Altman plots, to evaluate the reliability of the RBT's outcome measures (visuomotor response time and accuracy). It also assessed the test-retest and inter-rater reliability of the RBT score sheet using the same measures.
Results:
The ICC measures for test-retest reliability were similar for accuracy (0.609) and VMRT (0.594). Intra-rater reliability had high correlations and ICCs for accuracy (r=0.816, ICC=0.815) and VMRT (r=0.802, ICC=0.800). Inter-rater reliability had a higher ICC for VMRT (0.868) than for accuracy (0.690).
Conclusions
This study highlights the moderate to good reliability of the Reactive Balance Test (RBT) and its associated score sheet in assessing neurocognitive performance in patients with chronic ankle instability (CAI). These reliable assessments indirectly support athlete health and injury prevention by providing consistent tools for identifying individuals at risk, potentially aiding in targeted interventions to enhance athlete well-being and safety.