Date of Completion


Embargo Period



Lindsay DiStefano, Douglas Casa, Thomas Trojian, Carl Maresh

Field of Study



Master of Science

Open Access

Open Access


Background: ACL injuries are a frequently talked about injury in sports and have a multitude of negative side effects. A majority of injuries occur during single-leg cutting motions. Clinical screening tools are an effective way to identify those demonstrating more ACL injury risk factors. Recent research has created a variety of clinical screening tools to identify ACL injury risk factors, however none screen athletes during a single-leg cutting motion.

Hypothesis: A clinical screening tool using a single-leg cutting motion (the Cutting Screening Tool, or CST) will reliably identify ACL injury risk factors when used by athletic trainers.

Methods: Six currently certified, licensed, and practicing athletic trainers (4 Female, 2 Male; 3 “Novice” with less than five years experience, 3 “Veteran” with more than 10 years experience) in the state of Connecticut were recruited to rate 20 subjects performing three trials of a single-leg cutting task from the frontal and sagittal planes. This data was used to determine inter-rater reliability. After a minimum waiting period of three days, the raters re-scored five subjects a second time to assess intra-rater reliability.

Results: The CST had overall poor inter-rater reliability (ICC(2,1) = 0.32, SEM = 1.42). Inter-rater reliability of specific items on the CST varied from poor to excellent. One system of data reduction (Cohen’s kappa statistic) occasionally had low inter-rater reliability because of high percentage of chance agreement. Intra-rater reliability was moderate when comparing Novice vs. Veteran raters (ICC(2,1) = 0.64, SEM = 0.69) Novice raters had excellent intra-rater reliability (ICC(2,1) = 0.99, SEM = .10) while Veteran raters had poor intra-rater reliability (ICC(2,1) = 0.38, SEM = 1.72). One Veteran rater was removed from certain calculations due to discrepancies in re-scoring subjects.

Conclusions: The CST is not currently ready for use as a clinical screening tool, however it will be a valuable method of identifying those at greater risk for ACL injury following further research.

Major Advisor

Lindsay DiStefano