Mahar Shannon M, Livingston Lori A
School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada.
J Am Podiatr Med Assoc. 2009 May-Jun;99(3):198-205. doi: 10.7547/0980198.
Excessive calcaneal eversion and tibial varum are thought to predispose individuals to overuse injuries such as patellofemoral pain, yet investigations of this relationship have yielded equivocal results. Differences in the methods used, including stance position, may contribute to the observed differences.
Forty-six young adults (29 asymptomatic control patients and 17 patients with patellofemoral pain syndrome) participated. Resting calcaneal stance position and tibial varum were measured using a digital photographic-goniometric method while participants adopted three upright, weightbearing stance positions (self-selected, Romberg, and single-limb right or left). Data were collapsed and analyzed by group (asymptomatic, symptomatic) or limb status (uninjured, injured), stance, and limb (right, left).
Mean resting calcaneal stance position and tibial varum values differed significantly among the three stance conditions, whereas differences between groups, limb status, and limb were not observed. Pearson product moment correlations revealed no relationship between measures derived under the differing stance conditions (r = -0.08 to -0.37, P > .05) and only weak to moderate relationships in resting calcaneal stance position and tibial varum measures between the right and left limbs (r = 0.37 to 0.71, P < .01).
If differences in reported values for resting calcaneal stance position and tibial varum in an individual, between groups, or from study to study are to be interpreted as true differences or as products of the measurement method used, a standardized measurement method must be established and methods must be accurately reported.
跟骨过度外翻和胫骨内翻被认为会使个体易患髌股关节疼痛等过度使用性损伤，但对这种关系的研究结果并不明确。所使用方法的差异，包括站立姿势，可能导致了观察到的差异。
46名年轻成年人（29名无症状对照患者和17名髌股关节疼痛综合征患者）参与研究。当参与者采用三种直立、负重站立姿势（自我选择、Romberg姿势以及单腿右或左腿站立）时，使用数码摄影测角法测量静息跟骨站立姿势和胫骨内翻情况。数据按组（无症状、有症状）或肢体状态（未受伤、受伤）、站立姿势和肢体（右、左）进行汇总和分析。
三种站立姿势条件下的平均静息跟骨站立姿势和胫骨内翻值存在显著差异，而组间、肢体状态和肢体之间未观察到差异。Pearson积差相关分析显示，不同站立姿势条件下得出的测量值之间无相关性（r = -0.08至-0.37，P >.05），且左右肢体静息跟骨站立姿势和胫骨内翻测量值之间仅存在弱至中度相关性（r = 0.37至0.71，P <.01）。
如果个体、组间或不同研究中报告的静息跟骨站立姿势和胫骨内翻值的差异要被解释为真正的差异或所使用测量方法的产物，就必须建立标准化的测量方法，并且必须准确报告测量方法。
