评估被动踝关节僵硬程度的临床测试的效度和信度。

Validity and reliability of clinical tests for assessing passive ankle stiffness.

作者信息

Araújo Vanessa L, Carvalhais Viviane O C, Souza Thales R, Ocarino Juliana M, Gonçalves Gabriela G P, Fonseca Sérgio T

机构信息

Physical Therapy Department, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

出版信息

Rev Bras Fisioter. 2011 Mar-Apr;15(2):166-73.

PMID:21789368

Abstract

BACKGROUND

The presence of inadequate levels of passive ankle stiffness have been associated with the occurrence of movement disorders, the development of pathological conditions and the reduction in the performance of functional activities such as walking, running and jumping. Therefore, clinical tests to evaluate ankle stiffness may be useful for the physical therapy assessment.

OBJECTIVES

To investigate the concurrent validity and the intra- and inter-examiner reliability of clinical measures developed to assess passive stiffness of the ankle joint during dorsiflexion movement.

METHODS

Fifteen healthy participants underwent to test-retest evaluations of their ankles by two examiners. Two clinical measures were performed: 'position of first detectable resistance' and 'change in passive resistance torque'. The results of these tests were compared to the passive stiffness measured with an isokinetic dynamometer, in which the electromyography activity of specific muscles was monitored to ensure that the test was performed passively (gold standard measure).

RESULTS

Pearson correlation coefficients ranged from r=-0.81 to -0.88 (p<0.001) for the correlation between the passive ankle stiffness measured with the isokinetic dynamometer and the results of the clinical measure 'position of the first detectable resistance'. For the measure of 'change in passive resistance torque', these coefficients ranged from r=0.72 to 0.83 (p<0.004). The Intraclass Correlation Coefficients (ICCs) for the intra- and inter-examiner reliability ranged from 0.75 to 0.98.

CONCLUSION

The clinical measures presented satisfactory validity and reliability to be used in clinical practice.

摘要

背景

被动踝关节僵硬度水平不足与运动障碍的发生、病理状况的发展以及行走、跑步和跳跃等功能活动表现的下降有关。因此，评估踝关节僵硬度的临床测试可能对物理治疗评估有用。

目的

研究为评估背屈运动时踝关节被动僵硬度而开发的临床测量方法的同时效度以及检查者内和检查者间的可靠性。

方法

15名健康参与者接受了两名检查者对其踝关节的重测评估。进行了两项临床测量：“首次可检测到阻力的位置”和“被动阻力扭矩变化”。将这些测试结果与用等速测力计测量的被动僵硬度进行比较，在测量过程中监测特定肌肉的肌电图活动以确保测试是被动进行的（金标准测量）。

结果

等速测力计测量的被动踝关节僵硬度与临床测量“首次可检测到阻力的位置”结果之间的Pearson相关系数范围为r = -0.81至-0.88（p < 0.001）。对于“被动阻力扭矩变化”的测量，这些系数范围为r = 0.72至0.83（p < 0.004）。检查者内和检查者间可靠性的组内相关系数（ICC）范围为0.75至0.98。