Test-retest and interrater reliability of the functional lower extremity evaluation

J Orthop Sports Phys Ther. 2014 Dec;44(12):947-54. doi: 10.2519/jospt.2014.4809. Epub 2014 Nov 13.


Study design: Repeated-measures clinical measurement reliability study.

Objectives: To establish the reliability and face validity of the Functional Lower Extremity Evaluation (FLEE).

Background: The FLEE is a 45-minute battery of 8 standardized functional performance tests that measures 3 components of lower extremity function: control, power, and endurance. The reliability and normative values for the FLEE in healthy athletes are unknown.

Methods: A face validity survey for the FLEE was sent to sports medicine personnel to evaluate the level of importance and frequency of clinical usage of each test included in the FLEE. The FLEE was then administered and rated for 40 uninjured athletes. To assess test-retest reliability, each athlete was tested twice, 1 week apart, by the same rater. To assess interrater reliability, 3 raters scored each athlete during 1 of the testing sessions. Intraclass correlation coefficients were used to assess the test-retest and interrater reliability of each of the FLEE tests.

Results: In the face validity survey, the FLEE tests were rated as highly important by 58% to 71% of respondents but frequently used by only 26% to 45% of respondents. Interrater reliability intraclass correlation coefficients ranged from 0.83 to 1.00, and test-retest reliability ranged from 0.71 to 0.95.

Conclusion: The FLEE tests are considered clinically important for assessing lower extremity function by sports medicine personnel but are underused. The FLEE also is a reliable assessment tool. Future studies are required to determine if use of the FLEE to make return-to-play decisions may reduce reinjury rates.

Keywords: ACL; anatomy/lower extremity; functional testing; hop test; injury; knee; return to play.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Athletic Injuries / diagnosis
  • Athletic Injuries / physiopathology
  • Exercise Test / methods*
  • Female
  • Humans
  • Knee Injuries / diagnosis
  • Knee Injuries / physiopathology
  • Lower Extremity / injuries
  • Lower Extremity / physiology*
  • Male
  • Muscle Strength / physiology
  • Physical Endurance / physiology
  • Reference Values
  • Reproducibility of Results
  • Young Adult