Injury Risk Estimation Expertise: Interdisciplinary Differences in Performance on the ACL Injury Risk Estimation Quiz

Background: Simple observational assessment of movement is a potentially low-cost method for anterior cruciate ligament (ACL)
injury screening and prevention. Although many individuals utilize some form of observational assessment of movement, there are
currently no substantial data on group skill differences in observational screening of ACL injury risk.
Purpose/Hypothesis: The purpose of this study was to compare various groups’ abilities to visually assess ACL injury risk as well
as the associated strategies and ACL knowledge levels. The hypothesis was that sports medicine professionals would perform
better than coaches and exercise science academics/students and that these subgroups would all perform better than parents
and other general population members.
Study Design: Cross-sectional study; Level of evidence, 3.
Methods: A total of 428 individuals, including physicians, physical therapists, athletic trainers, strength and conditioning
coaches, exercise science researchers/students, athletes, parents, and members of the general public participated in the study.
Participants completed the ACL Injury Risk Estimation Quiz (ACL-IQ) and answered questions related to assessment strategy
and ACL knowledge.
Results: Strength and conditioning coaches, athletic trainers, physical therapists, and exercise science students exhibited consistently
superior ACL injury risk estimation ability (þ2 SD) as compared with sport coaches, parents of athletes, and members of
the general public. The performance of a substantial number of individuals in the exercise sciences/sports medicines (approximately
40%) was similar to or exceeded clinical instrument-based biomechanical assessment methods (eg, ACL nomogram).
Parents, sport coaches, and the general public had lower ACL-IQ, likely due to their lower ACL knowledge and to rating the
importance of knee/thigh motion lower and weight and jump height higher.
Conclusion: Substantial cross-professional/group differences in visual ACL injury risk estimation exist. The relatively profound
differences in injury risk estimation accuracy and their potential implications for risk screening suggest the need for additional
training and outreach.