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Table 1 Level of certainty evidence for each outcome from pooled data (GRADE approach)

From: Trunk Biomechanics in Individuals with Knee Disorders: A Systematic Review with Evidence Gap Map and Meta-analysis

Outcome

No of participants (studies)

SMD (95% CI)

Downgrading domains

Publication bias‡‡

Upgrading domain

Level of certainty

RoB*

Inconsistency†

Imprecision††

Indirectness‡

Large effect

Knee OA

 

Trunk flexion (walking)

233 (4)

0.40 (− 0.05, 0.84)

0

− 1

0

0

–

0

Moderate

Trunk flexion (sit-to-stand)

402 (4)

0.88 (0.58, 1.18)

0

0

0

0

–

+ 1

High

Trunk flexion (stepping tasks)

95 (2)

0.56 (0.13, 0.99)

0

0

− 1

0

–

0

Moderate

Ipsilateral trunk lean (walking)

643 (8)

1.36 (0.60, 2.11)

0

− 2

0

0

–

+ 1

Moderate

Contralateral trunk lean (sit-to-stand)

227 (2)

1.49 (0.90, 2.08)

0

− 1

0

0

–

+ 1

High

Ipsilateral trunk rotation (walking)

208 (3)

0.00 (− 0.28, 0.28)

0

0

0

0

–

0

High

TKA

 

Trunk flexion (walking)

95 (3)

0.09 (− 0.31, 0.50)

0

0

− 1

0

–

0

Moderate

Trunk flexion (stepping tasks)

116 (3)

− 0.15 (− 0.55, 0.25)

0

0

− 1

0

–

0

Moderate

Ipsilateral trunk lean (walking)

70 (2)

− 0.10 (− 0.57, 0.37)

0

0

− 1

0

–

0

Moderate

Contralateral trunk lean (walking)

70 (2)

0.06 (− 0.41, 0.53)

0

0

− 1

0

–

0

Moderate

Ipsilateral trunk lean (stepping tasks)

70 (2)

− 0.20 (− 0.67, 0.27)

0

0

− 1

0

–

0

Moderate

Contralateral trunk lean (stepping tasks)

70 (2)

− 0.07 (0.54, 0.40)

0

0

− 1

0

–

0

Moderate

Ipsilateral trunk rotation (walking)

70 (2)

0.52 (0.04, 0.99)

0

0

− 1

0

–

0

Moderate

Ipsilateral trunk rotation (stepping tasks)

70 (2)

0.00 (− 0.47, 0.47)

0

0

− 1

0

–

0

Moderate

PFP

 

Trunk flexion (running)

126 (3)

0.32 (− 0.15, 0.79)

0

0

− 1

0

–

0

Moderate

Trunk flexion (stepping tasks)

143 (2)

0.01 (− 0.32, 0.34)

0

0

− 1

0

–

0

Moderate

Trunk flexion (landing tasks)

70 (2)

0.56 (0.01, 1.12)

0

0

− 1

0

–

0

Moderate

Ipsilateral trunk lean (running)

158 (4)

0.20 (− 0.12, 0.52)

0

0

− 1

0

–

0

Moderate

Ipsilateral trunk lean (squatting tasks)

174 (3)

1.01 (0.33, 1.70)

0

− 1

− 1

0

–

+ 1

Moderate

Ipsilateral trunk lean (stepping tasks)

120 (2)

0.39 (− 0.13, 0.91)

0

0

− 1

0

–

0

Moderate

Contralateral trunk lean (stepping tasks)

108 (2)

0.09 (− 0.29, 0.47)

0

0

− 1

0

–

0

Moderate

Ipsilateral trunk lean (landing tasks)

70 (2)

1.12 (− 1.22, 3.47)

0

− 2

− 2

0

–

0

Very low

Ipsilateral trunk rotation (landing tasks)

70 (2)

− 0.63 (− 1.86, 0.61)

0

− 2

− 1

0

–

0

Very low

ACLR

 

Trunk flexion at IC (landing)

229 (3)

0.69 (0.38, 1.01)

0

0

− 1

0

–

0

Moderate

Trunk flexion (landing)

933 (13)

0.48 (0.21, 0.75)

0

− 1

0

0

0

0

Moderate

Trunk flexion (jumping)

312 (4)

− 0.76 (− 1.62, 0.10)

− 1

− 2

− 1

0

–

0

Very Low

Ipsilateral trunk lean at IC (landing)

180 (2)

− 0.01 (− 0.48, 0.46)

0

− 1

− 1

0

–

0

Low

Ipsilateral trunk lean (landing)

568 (6)

0.23 (− 0.05, 0.51)

0

− 1

0

0

–

0

Moderate

  1. ACLR anterior cruciate ligament reconstruction, IC initial contact, OA osteoarthritis, PFP patellofemoral pain, RoB risk of bias, SMD standardized mean differences, TKA total knee arthroplasty
  2. Downgrading domains
  3. *More than 25% of participants from studies with a high risk of bias. Studies scoring as low quality in the Downs and Black checklist were rated as high risk of bias (− 1)
  4. †Substantial heterogeneity across the studies (− 1 for I2 > 50%; − 2 for I2 > 75%)
  5. ††Total sample size < 100 participants per group, large confidence intervals or confidence intervals that do not overlap (− 1)
  6. ‡Study population and outcome measures align with the purpose of the review
  7. ‡‡Evidence of publication bias by asymmetry of the funnel plot or Egger’s test P < 0.10
  8. Upgrading domain
  9. Large effect: upgrade (+ 1) if more than 50% of pooled studies had Cohen’s criteria ≥ 0.8
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