Department of Physiotherapy, Ariel University Center, Israel.
J Orthop Sports Phys Ther. 2010 Dec;40(12):792-800. doi: 10.2519/jospt.2010.3424. Epub 2010 Oct 22.
Cross-sectional.
To determine the association between hip and ankle range-of-motion measures, as well as measures of hip muscle strength, with measures of quality of lower extremity movement, as assessed visually during the lateral step-down test in healthy women.
Altered lower extremity movement pattern consisting of excessive femoral adduction and internal rotation, leading to excessive knee valgus alignment, is associated with increased risk of knee ligament injury, as well as patellofemoral pain syndrome. Previous investigations of lower extremity kinematics, using 3-dimensional motion analysis systems, document an inconsistent association between hip muscle strength and lower extremity movement pattern. Currently, it is unknown whether differences in hip muscle strength or other physical measures exist among women with differing quality of lower extremity movement as assessed by visual observation.
Two physical therapists assessed the quality of movement during the lateral step-down among 29 healthy women (mean ± SD age, 24.3 ± 3.2 years). Subjects were instructed on the optimal movement pattern prior to performing the test. The quality of movement was categorized as "good" or "moderate," based on a previously established 6-point scale. Several measures of hip strength (handheld dynamometer) and hip and ankle range of motion (fluid-filled inclinometer and universal goniometer) were also assessed. Differences in strength and range-of-motion measures between women with good and women with moderate quality of movement were assessed with a Mann-Whitney U test.
Both examiners found decreased ankle dorsiflexion range of motion, as measured with the knee bent (P<.05 and P<.01 for examiner 1 and 2, respectively) and in weight bearing (P<.001 and P<.01 for examiner 1 and 2, respectively) among women with a moderate quality of movement compared to women with a good quality of movement on the lateral step-down test.
Following receipt of instructions on optimal lower extremity movement pattern, women who demonstrate a moderate quality of movement, as assessed visually during the lateral step-down test, exhibit decreased ankle dorsiflexion range of motion compared to women with a good quality of movement. Clinicians should consider evaluating ankle dorsiflexion range of motion when observing an altered lower extremity movement pattern during the lateral step-down test.
横断面研究。
确定髋关节和踝关节活动范围的测量值，以及髋关节肌肉力量的测量值与健康女性在侧向下台阶测试中通过视觉评估的下肢运动质量的测量值之间的关系。
下肢运动模式的改变包括股骨过度内收和内旋，导致过度的膝关节外翻对线，与增加膝关节韧带损伤以及髌股疼痛综合征的风险相关。使用三维运动分析系统对下肢运动学的先前研究记录了髋关节肌肉力量与下肢运动模式之间的关联不一致。目前，尚不清楚在通过视觉观察评估下肢运动质量不同的女性中，是否存在髋关节肌肉力量或其他身体测量值的差异。
两位物理治疗师评估了 29 名健康女性（平均年龄 ± 标准差，24.3 ± 3.2 岁）在侧向下台阶测试中的运动质量。在进行测试之前，告知受试者最佳的运动模式。根据先前建立的 6 分制，运动质量分为“良好”或“中等”。还评估了几种髋关节力量（手持测力计）和髋关节及踝关节活动范围（充液测斜仪和通用量角器）的测量值。使用 Mann-Whitney U 检验评估具有良好和中等运动质量的女性之间的力量和活动范围测量值的差异。
两位评估者都发现，与在侧向下台阶测试中运动质量良好的女性相比，运动质量中等的女性在膝关节弯曲时（评估者 1 和 2 分别为 P<.05 和 P<.01）和负重时（评估者 1 和 2 分别为 P<.001 和 P<.01）的踝关节背屈活动范围减小。
在接受有关下肢最佳运动模式的指导后，在侧向下台阶测试中通过视觉评估运动质量为中等的女性与运动质量良好的女性相比，其踝关节背屈活动范围减小。当在侧向下台阶测试中观察到下肢运动模式改变时，临床医生应考虑评估踝关节背屈活动范围。
