Program in Physical Therapy, Mayo Clinic, Rochester, MN, USA.
J Sport Rehabil. 2011 Aug;20(3):333-44. doi: 10.1123/jsr.20.3.333.
Limited ankle DF (DF) range of motion (ROM) resulting from restricted gastrocnemius and soleus mobility is associated with a variety of lower extremity pathologies. Several techniques are used clinically to measure ankle DF.
To evaluate the reliability and minimal detectable change of DF ROM measurement, determine whether there is a difference in measured DF between techniques, and quantify the electromyographic (EMG) activity of the soleus and tibialis anterior muscles associated with the techniques.
Repeated measures.
Controlled laboratory setting.
39 healthy subjects, age 22-33.
DF measurements using 5 different techniques including active and passive DF with the knee extended and flexed to 90° and a modified lunge. EMG activity of the soleus and anterior tibialis muscles.
Intrarater reliability values (ICC3,1) ranged from .68 to .89. Interrater reliability (ICC2,1) ranged from .55 to .82. ICCs were the greatest with the modified lunge. The minimal detectable change (MDC95) ranged from 6° to 8° among the different techniques. A significant difference in DF ROM was found between all methods. Measurements taken with active DF were greater than the same measures taken passively. The lunge position resulted in greater DF ROM than both active and passive techniques. EMG activity of the soleus was greater with active DF and the lunge than with passive DF.
The modified lunge, which demonstrated excellent intrarater and interrater reliability, may best represent maximal DF. Active end-range DF was significantly greater than passive end-range DF when measured at either 0° or 90° knee flexion. Greater active DF was not explained by inhibition of the soleus. Finally, using the modified lunge, a difference between 2 measurements over time of 6° or more suggests that a meaningful change has occurred.
由于腓肠肌和比目鱼肌活动受限，导致踝关节背屈（DF）活动范围（ROM）有限，与多种下肢疾病有关。临床上有几种技术用于测量踝关节 DF。
评估 DF ROM 测量的可靠性和最小可检测变化，确定不同技术之间测量的 DF 是否存在差异，并量化与技术相关的比目鱼肌和胫骨前肌的肌电图（EMG）活动。
重复测量。
受控实验室环境。
39 名健康受试者，年龄 22-33 岁。
使用 5 种不同技术测量 DF，包括膝关节伸直和弯曲至 90°时的主动和被动 DF，以及改良的弓步。比目鱼肌和胫骨前肌的 EMG 活动。
内部测试者可靠性值（ICC3,1）范围为.68 至.89。外部测试者可靠性（ICC2,1）范围为.55 至.82。ICC 在改良弓步中最大。不同技术之间的最小可检测变化（MDC95）范围为 6°至 8°。在所有方法之间发现 DF ROM 存在显著差异。主动 DF 测量的 DF ROM 大于相同的被动测量。与主动和被动技术相比，弓步位置导致更大的 DF ROM。与被动 DF 相比，主动 DF 和弓步时比目鱼肌的 EMG 活动更大。
改良弓步表现出出色的内部和外部测试者可靠性，可能最能代表最大 DF。在 0°或 90°膝关节弯曲时测量，主动终末 DF 明显大于被动终末 DF。主动 DF 更大不能用比目鱼肌抑制来解释。最后，使用改良弓步，两次测量之间的差异超过 6°或更多表明发生了有意义的变化。
