|
NUMBER OF TRIALS NECESSARY TO ACHIEVE PERFORMANCE STABILITY OF SELECTED
GROUND REACTION FORCE VARIABLES DURING LANDING
|
1Center for Rehabilitation Research, Texas Tech University Health Sciences
Center, Lubbock, Texas, USA
2Department of Health, Exercise, and Sport Sciences, Texas Tech University,
Lubbock, Texas, USA
3Department of Kinesiology, University of Nevada, Las Vegas, Las Vegas,
Nevada, USA
4Human Performance & Wellness, Inc., Henderson, Nevada, USA
| Received |
|
23 August 2006 |
| Accepted |
|
26
January 2007 |
| Published |
|
01
March 2007 |
©
Journal of Sports Science and Medicine (2007) 6, 126 - 134
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| ABSTRACT |
| The objectives were to determine the number of trials necessary
to achieve performance stability of selected ground reaction force
(GRF) variables during landing and to compare two methods of determining
stability. Ten subjects divided into two groups each completed a minimum
of 20 drop or step-off landings from 0.60 or 0.61 m onto a force platform
(1000 Hz). Five vertical GRF variables (first and second peaks, average
loading rates to these peaks, and impulse) were quantified during
the initial 100 ms post-contact period. Test-retest reliability (stability)
was determined using two methods: (1) intra-class correlation coefficient
(ICC) analysis, and (2) sequential averaging analysis. Results of
the ICC analysis indicated that an average of four trials (mean 3.8
± 2.7 Group 1; 3.6 ± 1.7 Group 2) were necessary to achieve maximum
ICC values. Maximum ICC values ranged from 0.55 to 0.99 and all were
significantly (p < 0. 05) different from zero. Results of the sequential
averaging analysis revealed that an average of 12 trials (mean 11.7
± 3.1 Group 1; 11.5 ± 4.5 Group 2) were necessary to achieve performance
stability using criteria previously reported in the literature. Using
10 reference trials, the sequential averaging technique required standard
deviation criterion values of 0.60 and 0.49 for Groups 1 and 2, respectively,
in order to approximate the ICC results. The results of the study
suggest that the ICC might be a less conservative, but more objective
method for determining stability, especially when compared to previous
applications of the sequential averaging technique. Moreover, criteria
for implementing the sequential averaging technique can be adjusted
so that results closely approximate the results from ICC. In conclusion,
subjects in landing experiments should perform a minimum of four and
possibly as many as eight trials to achieve performance stability
of selected GRF variables. Researchers should use this information
to plan future studies and to report the stability of GRF data in
landing experiments.
KEY
WORDS: Reliability, variability, sequential averaging, intra-class
correlation coefficient.
|
| INTRODUCTION |
|
Stability of a performance variable refers to the repeatability
of that variable across repeated trials (observed performances)
over time and can be evaluated using test-retest reliability methods
(Portney and Watkins, 2000).
The stability of a variable across trials influences the stability
of the mean value of the group of trials. When the mean value is
not stable, both the reliability of the mean and its ability to
represent a more generalized performance (validity) are limited.
The number of trials obtained from an individual in an experiment
is thought to influence stability (Bates et al., 1983;
Salo et al., 1997)
and thus is an important methodological consideration in the design
of landing experiments.
Except for unique circumstances (e.g., a single trial is the subject
of interest) several trials are thought to provide a more stable
and representative mean value (Bates et al., 1983).
Because variability is present in all human movement, using too
few trials may not represent the individual's long-term performance.
A single trial protocol has been suggested to be both invalid and
unreliable (Bates et al., 1992)
because of the potential inability of the single trial to represent
the generalized performance. By chance the single trial could represent
an average performance but also might be atypical. Greater movement
variability results in less stable data and a greater likelihood
of sampling an atypical performance from the population of all possible
performances. Stability may be particularly important when trials
are obtained in non-continuous activities (e.g., a discrete movement
such as a jump or landing) or in a nonconsecutive manner in continuous
activities (e.g., nonconsecutive strides in running). While, increasing
the number of trials is thought to increase performance stability
(Bates et al., 1983;
Salo et al., 1997),
how many trials are necessary to provide stable data? Although a
few studies have examined this issue for nonconsecutive trials during
the activities of running (Bates et al., 1983;
1992),
walking (Hamill and McNiven, 1990),
hurdling (Salo et al., 1997)
, and vertical jumping (Rodano and Squadrone, 2002),
little information is available about the number of trials necessary
to achieve performance stability for nonconsecutive trials during
landing. Moreover, different studies have used either different
arbitrary criteria or different methods for determining stability,
making comparisons among studies difficult.
Running (Bates et al., 1983),
walking (Hamill and McNiven, 1990),
and vertical jumping (Rodano and Squadrone, 2002)
all have been examined for performance stability of nonconsecutive
trials using a sequential averaging estimation technique (see Methods).
For running, results of the sequential averaging technique (using
10 reference trials and a 0.25 standard deviation criterion value)
demonstrated that eight nonconsecutive steps (trials) were necessary
to obtain stable data in 43 ground reaction force variables (Bates
et al., 1983).
Similar results were found when increasing the number of reference
trials from 10 to 20 (Bates et al., 1983).
For walking, the sequential averaging technique (using 20 reference
trials and a 0.25 standard deviation criterion value) was used to
determine that 10 nonconsecutive trials were necessary to reach
performance stability of selected ground reaction force variables
(Hamill and McNiven, 1990).
For vertical jumping, the sequential averaging technique (using
25 reference trials and a 0.30 standard deviation criterion value)
was used to determine that 12 trials were needed to establish performance
stability of selected joint kinetic variables (Rodano and Squadrone,
2002).
A limitation of the sequential averaging technique is that the number
of reference trials and the standard deviation criterion value both
influence the results, yet the values selected are arbitrary.
Other investigators have used a variety of methods for examining
the reliability, stability, and variability of gait variables both
within and between days (Belli et al., 1995;
Kadaba et al., 1989;
Owings and Grabiner, 2003;
Winter, 1984)
and for consecutive (Belli et al., 1995;
Owings and Grabiner, 2003)
and nonconsecutive (Kadaba et al., 1989;
Winter, 1984)
trials. For example, Kadaba and colleagues calculated the coefficient
of variation (CV) both within and between days to estimate the repeatability
of spatiotemporal gait parameters, while the repeatability of kinematic,
kinetic, and electromyographic wave forms were examined using an
adjusted coefficient of multiple determination method (Kadaba et
al., 1989).
They suggested that data obtained from nonconsecutive trials from
subjects walking at their preferred speeds were sufficiently repeatable
(Kadaba et al., 1989).
However, a limitation of their method was that the number of trials
used to calculate repeatability was selected arbitrarily (three
per session and nine per day). Conversely, Owings and Grabiner used
running mean and standard deviation functions similar to the sequential
averaging technique to examine the stability of selected gait variables
over consecutive trials during treadmill walking for the purpose
of calculating step variability (Owings and Grabiner, 2003).
They suggested that at least 400 steps were required for accurate
estimation of step kinematics (Owings and Grabiner, 2003).
However, a limitation of their method was that many criteria used
to establish stability across multiple steps of data also were selected
arbitrarily. Belli and colleagues examined the absolute variability
of total body vertical displacement and step time for consecutive
trials during treadmill running at different velocities (Belli et
al., 1995).
They demonstrated that variability was relatively low at sub-maximal
velocities, but increased at higher velocities (Belli et al., 1995).
The absolute variability of each parameter was calculated as the
standard deviation of each mean value, and was expressed as a percentage
of the mean. They suggested that 32-64 steps were required to obtain
better than 1% accuracy on the mean value (Belli et al., 1995).
However, a limitation of their method was that the percentage value
used to represent a desired accuracy was selected arbitrarily.
Using a more traditional statistical method for examining performance
stability, Salo and colleagues utilized the intra-class correlation
coefficient (ICC) to examine the stability of selected kinematic
variables in nonconsecutive trials during sprint hurdling (Salo
et al., 1997).
They predicted that as few as one to as many as 78 trials were necessary
to reach a reliability of 0.90, depending on the specific kinematic
variable examined. However, a limitation of this study was that
only eight trials were actually collected from subjects and evaluated
for reliability. Moreover, the value eight (i.e., eight trials)
was selected arbitrarily. Additionally, the number of trials predicted
to reach pre-determined reliability values was determined using
the Spearman-Brown Prophecy formula, which likely overestimated
the reliability values for large numbers of trials.
While the number of trials necessary to achieve performance stability
has been examined for a number of different locomotor tasks, the
activity of landing has not been evaluated. Landing is an activity
that has recently received much attention in the literature because
of its implicit link to many lower extremity injuries, especially
in female athletes (Griffin et al., 2000).
Because the number of trials necessary to achieve performance stability
during landing has not been established, the reliability (and consequently
validity) of many landing studies which have used too few trials
could be in question. Moreover, the method for establishing performance
stability should be objective and not based on arbitrary criteria.
While several statistical methods have been used to determine stability
during gait and other activities, there appears to be no comparisons
between methods. Therefore, the purpose of the current study was
to answer the following questions: (1) How many trials are necessary
to achieve performance stability during landing? (2) How do the
results obtained from different methods of calculating performance
stability compare to one another? It was hypothesized that similar
to other locomotor tasks several trials would be necessary to achieve
performance stability during landing. Additionally, it was hypothesized
that different methods for determining stability would provide dissimilar
results.
|
| METHODS |
|
Experimental
design
A test-retest design was used to examine the stability within a
single testing session of selected ground reaction force variables
during nonconsecutive landing trials.
Subjects
Data from ten recreationally-active college students (age range
22-31 yr; mass 73.6 ± 11.8 kg) who had no known pathologic ankle,
knee, hip, or spinal conditions were included in the study. Five
subjects (four men and one woman; Group 1) volunteered expressly
for the current study, while the data from five other subjects (five
men; Group 2) were originally obtained in a previous investigation
(James et al., 2006).
Each subject read and signed a written informed consent statement
approved by the Institutional Review Board at the affiliated university.
Subjects wore non-restrictive athletic clothing (i.e., shorts, t-shirt)
and standard laboratory shoes.
Protocol
Two landing protocols that are commonly used in landing research
were used to determine the stability of selected ground reaction
force variables obtained from multiple nonconsecutive landing trials.
The two protocols were step-off and drop landings, each performed
using different subjects (Groups 1 and 2), as previously described.
In each protocol, subjects completed a brief warm-up followed by
a few practice landings designed to acquaint the subjects to the
task. The specific details of each protocol are given below, but
data were obtained and analyzed beginning with the first non-practice
trial and in the order performed by the subjects.
Group
1
Prior to testing, individuals in landing Group 1 completed a five-minute
warm-up on a cycle ergometer at a self-selected speed and resistance.
Following the warm-up, subjects participated in a 60 minute session
consisting of three to five practice and 100 experimental step-off
landing trials. Subjects received a one-minute rest following every
10 trials. Only the first 20 usable trials were included in the
stability analysis in the current investigation. To perform the
experimental landings, an adjustable wooden platform (0.61 m) was
positioned and aligned so that subjects would step-off with their
right foot and land bilaterally with their right foot on a force
platform (Model OR-6-7-2000 and SGA-6 bridge amplifier; Advanced
Mechanical Technology Inc., Watertown, MA, USA) inset into the ground
and their left foot on the adjacent floor. Subjects were not given
explicit instructions about their landing technique, but were encouraged
to land consistently and in a sport-ready position. The force platform
was interfaced to an Ariel Performance Analysis System (analog module;
San Diego, CA, USA) and data were sampled at 1000 Hz for 10 ms prior
to and 190 ms following initial ground contact. Both the force platform
and surrounding floor were individually covered with a 2.5 cm thick
artificial turf surface that was affixed to the under-floor by adhesive
tape.
Group
2
The protocol for subjects in landing Group 2 has been described
elsewhere (James et al., 2006)
and the relevant parts are presented here briefly. Prior to testing,
subjects performed a self-directed warm-up consisting of light calisthenics
and stretching. Following the warm-up, subjects participated in
a testing session in which approximately 30 drop landing trials
(0.60 m landing height) were performed in each of two experimental
conditions, non-fatigued and fatigued. Only the first 20 usable
non-fatigued landings were included in the stability analysis in
the current investigation. In the earlier study (James et al., 2006),
the first 10 trials were designated as practice trials for the purposes
of that protocol. However, in the current study the first 10 trials
were included as trials of interest. Drop landings were initiated
by the subjects after hanging by their hands from an adjustable
overhead bar. Subjects landed bilaterally with each foot on separate
but adjacent force platforms (Model OR-6-5-1, Advanced Mechanical
Technology, Inc., Watertown, MA). Only left side ground reaction
force data were used in the current study. Similar to the subjects
in Group 1, subjects in Group 2 were not given explicit instructions
about their landing technique, but were encouraged to land consistently
and in a sport-ready position. Ground reaction force data were sampled
at 1000 Hz and recorded for 400 ms prior to and 200 ms following
initial ground contact. Data were sampled and stored using a Modular
Data Acquisition System (Model 7000, TransEra Corp., Orem, UT) interfaced
to a laptop computer.
Data
reduction
Vertical ground reaction force-time histories were reduced to five
discrete variables during the first 100 ms of ground contact using
a custom MatLab (v. 6.0, MathWorks, Inc., Natick, MA) program. The
discrete variables were the first (F1) and second (F2) peak force
magnitudes that occurred following contact, average loading rates
to each peak (F1LR and F2LR, respectively), and impulse (IMP; trapezoid
method) from 0-100 ms post-contact (Figure
1). F1LR was calculated as the slope of the line of the ground
reaction force-time history from initial contact to
F1. F2LR was calculated as the slope of the line of the ground reaction
force-time history from the minimum force value that occurred between
F1 and F2 to F2. These variables were selected because they represent
different characteristics of ground reaction force loading (peaks,
loading rates, total force), have been previously quantified in
landing studies examining ground reaction force variables (e.g.,
James et al., 2006),
and are analogous to many variables quantified in previous studies
examining the stability of ground reaction force data during running
(Bates et al., 1983)
and walking (Hamill and McNiven, 1990).
Statistical
analyses
Mean and standard deviation values were calculated for each ground
reaction force variable. Descriptive variables were reported in
multiples of body weight (BW). However, for the stability analyses,
ground reaction force variables were not normalized to body weight
because: (1) all stability evaluations were made within subject,
and (2) the ICC analysis is more sensitive when there is greater
variation between subjects in the numerical values of the dependent
variables (Portney and Watkins, 2000).
In order to test the experimental hypotheses, the performance stability
of each non-normalized ground reaction force variable across trials
was quantified for each subject group using two methods: (1) test-retest
intra-class correlation coefficient for single measures (ICC; Model
3, 1) (Portney and Watkins, 2000),
and (2) sequential averaging technique. The ICC was selected as
a traditional method for determining stability, while the sequential
averaging technique was used in order to facilitate comparison with
previous research that has reported the stability of selected variables
during running (Bates et al., 1983),
walking (Hamill and McNiven, 1990),
and vertical jumping (Rodano and Squadrone, 2002).
Both stability analysis methods were used to test the first (number
of trials necessary for stability) and second (comparison of methods)
hypotheses.
Intra-class
correlation coefficient analysis
The stability of each ground reaction force variable initially was
calculated for each subject group by using ICC (Model 3, 1) applied
to the first two landing trials. The ICC calculation was then iteratively
repeated in increments of one trial for combinations of trials ranging
from three to 20. The maximum ICC value for all iterations, the
number of trials needed to achieve the maximum ICC value, the probability
that the maximum ICC value was significantly different from zero,
and the ICC 95% confidence interval upper and lower limits were
determined. Additionally, the number of trials necessary to reach
ICC values of 0.80, 0.85, and 0.90 were calculated. All ICC procedures
were completed using SPSS v12. The criterion alpha-level for establishing
statistical significance was set to 0.05.
Sequential
averaging analysis
The ground reaction force variables also were examined for performance
stability across the first 20 landing trials for each subject in
each group using a sequential averaging technique as described in
the literature for running (Bates et al., 1983),
walking (Hamill and McNiven, 1990),
and vertical jumping (Rodano and Squadrone, 2002).
The process involved computing the mean, standard deviation, and
0.25 standard deviation values for the first 20 trials. Then, the
cumulative mean and mean deviation values were computed for each
of the 20 trials in the order that they were obtained experimentally.
A cumulative mean was calculated as the average of each trial with
all previous trials. This calculation was repeated in succession
for all trials from one to 20 for each subject and variable. Using
this procedure, the final cumulative mean value was identical to
the overall 20 trial mean. A mean deviation value was calculated
as the absolute difference between the cumulative mean of a corresponding
trial and the mean of all 20 trials. Finally, stability was estimated
as one greater than the smallest trial number for which all successive
mean deviations were smaller than the 0.25 standard deviation criterion
value for that particular subject and variable (Bates et al., 1983).
The 20 trial and 0.25 standard deviation criterion values were chosen
to facilitate comparison to previous results reported for running
(Bates et al., 1983)
and walking (Hamill and McNiven, 1990).
The sequential averaging procedure was repeated using a 10 reference
trial data set and a 0.25 standard deviation criterion value in
order to examine differences in stability that might result from
using a different number of reference trials. Additionally, the
sequential averaging procedure was repeated for the 10 reference
trial data set by iteratively varying the standard deviation criterion
value until the number of trials necessary for stability approximated
the results obtained from the ICC analysis.
|
| RESULTS |
|
Ground reaction force-time histories and the values of the selected
discrete variables normalized to body weight were typical of a vertical
landing task (Table 1).
Relative to the first hypothesis, results indicated that performance
stability of the ground reaction force variables was achieved after
several nonconsecutive discrete landing trials. For the ICC analysis,
the number of trials required for stability varied by group and
variable (Tables 2 and 3).
For the sequential averaging analysis, the number of trials required
for stability varied by subject, variable, and number of reference
trials used for the estimation (Tables 4
and 5).
For subject Group 1, the maximum ICC value was 0.98 for the IMP
variable, with an ICC range of 0.71 to 0.98 for all variables (Table
2). All maximum ICC values were significantly (p < 0.05)
different from zero and the number of trials needed to reach the
maximum ICC value ranged from two to eight (mean 3.8 ± 2.7 trials;
Table 2). The F1 and F1LR variables
never achieved an ICC of 0.80, but F2 achieved an ICC of 0.85 after
two trials and 0.90 after seven trials; F2LR achieved an ICC of
0.85 after two trials; and IMP reached an ICC of 0.90 after two
trials (Table 2). For the sequential
averaging analysis that used 20 reference trials and a 0.25 standard
deviation criterion value, subject Group 1 exhibited a five to 17
trial range (mean 11.7 ± 3.1 trials) to achieve stability across
all subjects and ground reaction force variables (Table
4). For the sequential averaging analysis that used 10 reference
trials and a 0.25 standard deviation criterion value, subject Group
1 exhibited a five to 10 trial range (mean 7.9 ± 1.5 trials) to
achieve stability across all subjects and ground reaction force
variables (Table 5).
For subject Group 2, the maximum ICC value was 0.99 for the IMP
variable, with an ICC range of 0.55 to 0.99 for all variables (Table
3). All maximum ICC values were significantly (p <
0.05) different from zero and the number of trials needed to reach
the maximum ICC value ranged from two to six (mean 3.6 ± 1.7 trials;
Table 3). The F2 and F2LR variables
never achieved an ICC of 0.80, but F1 achieved an ICC of 0.90 after
two trials; F1LR achieved an ICC of 0.80 after two trials, 0.85
after three trials, and 0.90 after four trials; and IMP reached
an ICC of 0.90 after two trials (Table
3). For the sequential averaging analysis that used 20 reference
trials and a 0.25 standard deviation criterion value, subject Group
2 exhibited a three to 17 trial range (mean 11.5 ± 4.5 trials) to
achieve stability across all subjects and ground reaction force
variables (Table 4). For the
sequential averaging analysis that used 10 reference trials and
a 0.25 standard deviation criterion value, subject Group 2 exhibited
a three to 9 trial range (mean 6.6 ± 1.9 trials) to achieve stability
across all subjects and ground reaction force variables (Table
5).
Relative to the second hypothesis, results indicated that the number
of trials necessary to achieve performance stability of the ground
reaction force variables differed between analysis methods. Fewer
trials were required for stability using the ICC analysis when compared
to the sequential averaging analysis (Tables 2,
3, 4 and 5).
On average, the ICC analysis required 3.7 ± 2.1 trials for stability
when data were collapsed across variables and subject groups (Tables
2 and 3).
Conversely, the sequential averaging analysis required 11.6 ± 1.2
trials for stability when using 20 reference trials and the 0.25
standard deviation criterion value (Table
4) and 7.2 ± 0.9 trials when using 10 reference trials and the
0.25 standard
deviation criterion value when data were averaged across subjects,
variables, and groups (Table 5).
Further dissimilarities between stability analysis methods were
revealed by the results of the sequential averaging analysis that
used 10 reference trials and iteratively varied the standard deviation
criterion value. These results indicated that standard deviation
criterion values less stringent than 0.25 were required to approximate
the ICC results. For Group 1, a standard deviation criterion value
of 0.60 resulted in an average of 3.8 ± 1.8 trials to reach stability,
compared to an average of 3.8 ± 2.7 trials for the ICC analysis.
For Group 2, a standard deviation criterion value of 0.49 (rounded
to two decimal places; actual value 0.4875) resulted in an average
of 3.6 ± 2.1 trials to reach stability, compared to an average of
3.6 ± 1.7 trials for the ICC analysis.
|
| DISCUSSION |
|
Performance
stability is the test-retest reliability of a variable measured
repeatedly over time. Stability is necessary for both the reliability
of the data the ability to generalize to a greater population of
trials. The number of trials obtained from an individual in an experiment
is thought to influence stability (Bates et al., 1983;
Salo et al., 1997)
and thus is an important methodological consideration in the design
of landing experiments. The number of trials needed for stability
of ground reaction force variables during nonconsecutive landings
has not been examined and is important for assessing the quality
of previous landing studies and planning future studies. Therefore,
one purpose of the study was to determine how many trials were necessary
to achieve performance stability during landing. Another purpose
was to compare two different methods of determining stability.
The first hypothesis was supported. Several trials were necessary
to achieve performance stability of the selected ground reaction
force variables during nonconsecutive discrete landing trials. Using
the ICC method, four trials (mean 3.8 ± 2.7 trials for Group 1;
3.6 ± 1.7 trials for Group 2) were needed to achieve the maximum
ICC values, which ranged from 0.55 to 0.99 across ground reaction
force variables. Additionally, four of ten variables across the
two subject groups failed to achieve an ICC value of 0.80, but only
one variable (Group 2, F2LR; ICC = 0.55) failed to reach an ICC
value 0.70. In comparison, the ICC value for the F2LR variable for
Group 1 was 0.87. The results of the ICC analysis suggest that the
test-retest reliability (stability) of landing trials is relatively
strong for most of the selected ground reaction force variables
and can be achieved within two to eight trials.
However, in contrast to the ICC analysis the sequential averaging
technique suggested that as many as 12 nonconsecutive
landing trials (11.7 ± 3.1 for Group 1; 11.5 ± 4.5 for Group 2)
might be necessary to achieve performance stability when using 20
reference trials and a 0.25 standard deviation criterion value.
Although landing, running, and walking were not compared statistically,
results of the sequential averaging analysis from the current study
suggest that more trials might be needed to achieve stability during
landing than during either running or walking. In running, it was
reported that eight nonconsecutive trials were necessary to achieve
stability of the mean values of selected ground reaction force variables
when using the 0.25 standard deviation criterion value and either
10 or 20 reference trials (Bates et al., 1983).
During walking, stability of selected ground reaction force variables
were reported following 10 nonconsecutive trials when using 20 reference
trials and the 0.25 standard deviation criterion value (Hamill and
McNiven, 1990).
The current results for landing are similar to a previous report
for vertical jumping, which used the sequential averaging technique
(25 reference trials and a 0.30 standard deviation criterion value)
to conclude that 12 trials were necessary to achieve performance
stability in lower extremity joint kinetic parameters (Rodano and
Squadrone, 2002).
Collectively, results from the investigations which have used the
sequential averaging technique suggest that 8-12 trials might be
necessary to achieve performance stability in ground reaction force
and lower extremity kinetic variables during various locomotor tasks,
but results differ slightly among activities. Results from the current
study suggest that the number of trials required for stability during
landing is slightly greater than the number of trials reported for
running and walking, but within the range of values reported for
running, walking, and vertical jumping when using similar criterion
values.
The second hypothesis also was supported. Different methods for
determining stability provided dissimilar results. The ICC and sequential
averaging methods were compared, but other methods for assessing
reliability, stability, and variability as reported in the literature
(Belli et al., 1995;
Kadaba et al., 1989;
Owings and Grabiner, 2003)
were not examined. As previously stated, the ICC analysis on the
current data revealed that an average of four trials were necessary
to achieve stability, while 12 trials were needed using the sequential
averaging technique when using the selected criteria. These values
differ substantially from each other and the decision to follow
one recommendation over the other could have important implications
relative to the time and financial investment in an experiment.
Logically, the best method would minimize the need to arbitrarily
determine criteria for establishing stability, would be easy to
implement, and would be familiar to most researchers. Therefore,
the ICC method would seem to provide an objective means for determining
performance stability. In comparing the two methods, the sequential
averaging technique (using the selected values) would appear to
provide a conservative estimate of the number of trials to achieve
stability. Hamill and McNiven, 1990
characterized 0.25 as a conservative standard deviation criterion
value. Greater standard deviation criterion values would result
in a fewer number of trials to achieve stability. In the current
study, the standard deviation criterion value necessary to approximate
the ICC results also was investigated. Using 10 reference trials,
standard deviation criterion values of 0.60 (Group 1) and 0.49 (Group
2) provided results comparable to the ICC analysis. Therefore, the
smaller standard deviation criterion values reported in the literature
(e.g., 0.25, 0.30) appear to provide conservative estimates of stability.
While a primary result of the current study suggests that a minimum
of four trials (ICC analysis) might be necessary to achieve performance
stability during nonconsecutive landing trials, this result should
be evaluated in context with the delimitations and limitations of
the study. Delimitations included the age (22-31 yrs), sex (nine
male, one female), and activity level (recreationally active) of
the subjects. Because it is unknown how widely the current results
can be generalized to subjects with different characteristics, generalization
to different populations should be made with caution. Future research
could examine if the current results are robust and applicable to
subjects who have different characteristics.
The main limitations of the study involved factors associated with
the landing task, variables selected for analysis, and interpretation
of the ICC values. First, the landing task (0.60 and 0.61 m discrete
landing) was not necessarily representative of landings that occur
during most functional activities. The landing height was greater
than typically would be performed. Additionally, in most functional
activities a landing would be preceded by a jump and followed by
another task such as a jump or a cutting maneuver thus potentially
altering feed forward or feedback control of the landing. Another
limitation was the absence of kinematic and joint kinetic variables
in the analysis. While the aim of the current study was to examine
the stability of ground reaction force variables, inclusion of kinematic
and joint kinetic variables could have provided additional insight
about the stability of trials during the selected landing task.
Future research could address these issues. Finally, determining
the number of trials necessary for stability using the ICC analysis
is more objective than using the sequential averaging technique
because it requires fewer arbitrary decisions. However, the interpretation
of the quality of an ICC value also is arbitrary. Portney and Watkins
suggested that reliability coefficients below 0.50 represent poor
reliability, values between 0.50 and 0.75 suggest moderate reliability,
and values above 0.75 indicate good reliability (Portney and Watkins,
2000).
Furthermore, they suggest that these categories are arbitrary and
that the reliability tolerance should be determined based on the
precision of the measured variables and the application of the results
(Portney and Watkins, 2000).
In the current study, no ICC values were less than 0.50 (poor reliability),
two ICC values were between 0.50 and 0.75 (moderate reliability),
and eight ICC values were greater than 0.75 (good reliability).
Moreover, of the eight ICC values greater than 0.75, five of these
were greater than 0.90. Additionally, in the current study the number
of trials needed for stability was based on the greatest ICC value
observed and not one of the arbitrary criterion values or qualitative
categories.
|
| CONCLUSION |
|
In
conclusion, landing performance stabilized after several trials.
Additionally, the methods for determining stability provided different
results. An average of four trials was required for stability when
using the ICC analysis and 12 trials was required when using the
sequential averaging technique with the selected criteria. As determined
by the ICC, some of the ground reaction force variables achieved
their maximum test-retest reliability (stability) after only two
trials, while other variables required six to eight trials each.
Additionally, some variables never achieved an ICC of 0.80, regardless
of the number of trials performed, while other variables achieved
ICC values greater than 0.95. The ICC analysis provided a traditional
statistical method for objective determination of stability, while
the sequential averaging technique was more subjective, but conservative
when using the criteria previously reported in the literature. Based
on the current results, it is recommended that a minimum of four
trials, and possibly as many as eight trials (the upper limit of
the ICC analysis), should be obtained from each subject in a single
session during an experiment involving 0.60 m drop or 0.61 m step-off
landings. Additionally, researchers should be aware of the reliability
of landing data in their investigations and could easily calculate
the ICC using traditional methods and report these values post hoc.
|
| KEY
POINTS |
- The
number of trials obtained from a subject in an experiment influences
the stability (test-retest reli-ability) and thus validity of
the data.
- One
trial might not be representative of a subject's more general
performance.
- Multiple-trial
protocols have been recommended by several researchers for a variety
of activities, but the number of trials necessary to achieve stabil-ity
of ground reaction force variables during land-ing has not been
examined.
- Researchers
have used different criteria and meth-odologies for determining
stability, making com-parisons among studies and activities difficult.
- In
the current study, test-retest intra-class correla-tion coefficient
revealed that on average four trials were necessary for stability,
while the more con-servative sequential averaging analysis suggested
that 12 trials were necessary for stability.
- Researchers
should be aware of the stability of landing data and collect enough
trials from each subject within a single testing session to maximize
reliability of their data.
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| AUTHORS
BIOGRAPHY |
C.
Roger JAMES
Employment: Director of the Center for Rehabilitation Research
and Associate Professor in the Department of Rehabilitation
Sciences in the School of Allied Health Sciences at Texas Tech
University Health Sciences Center.
Degree: PhD.
Research interests: Lower extremity biomechanics and
injury mechanisms; experimental and statistical design issues
in biomechanics research.
E-mail: roger.james@ttuhsc.edu |
|
Joseph A. HERMAN
Employment: Regional Medical Practice Administra-tor with
Abrazo Health Care located in Phoenix, AZ. Recently accepted
a position as Chief Operations Officer with SMI Radiology located
in Sun City West, AZ.
Degree: MS, MBA.
Research interests: Biomechanics of human movement
E-mail: jaherman@abrazohealth.com;jhermanbiomech@msn.com |
|
Janet
S. DUFEK
Employment: Visiting Research Associate Professor in the
Department of Kinesiology in the School of Allied Health Sciences
at the University of Nevada, Las Vegas.
Degree: PhD.
Research interests: Lower extremity function, variability
and human performance, single subject methodology
E-mail: jdufek@unlv.nevada.edu
|
|
Barry
T. BATES
Employment: Senior Scientist at Human Performance &
Wellness, Inc. in Henderson, Nevada.
Degree: PhD.
Research interests: Lower extremity function, human performance
and forensic (personal injury) biomechanics
E-mail: hpw@mail.com |
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