Measurement properties of visual rating of postural orientation errors of the lower extremity - a systematic review and meta-analysis

Objectives:To systematically review measurement properties of visual assessment and rating of PosturalOrientation Errors (POEs) in participants with or without lower extremity musculoskeletal disorders.Methods:A systematic review according to the PRISMA guidelines was conducted. The search wasperformed in Medline (Pubmed), CINAHL and EMBASE (OVID) databases until August 2016. Studiesreporting measurement properties for visual rating of postural orientation during the performance ofweight-bearing functional tasks were included. No limits were placed on participant age, sex or whetherthey had a musculoskeletal disorder affecting the lower extremity.Results:Twenty-eight articles were included, 5 of which included populations with a musculoskeletaldisorder. Visual rating of the knee-medial-to-foot position (KMFP) was reliable within and betweenraters, and meta-analyses showed that this POE was valid against 2D and 3D kinematics in asymptomaticpopulations. Other segment-specific POEs showed either poor to moderate reliability or there were toofew studies to permit synthesis. Intra-rater reliability was at least moderate for POEs within a taskwhereas inter-rater reliability was at most moderate.Conclusions:Visual rating of KMFP appears to be valid and reliable in asymptomatic adult populations.Measurement properties remain to be determined for POEs other than KMPF.