Griffiths Ian B, McEwan Islay M
Sports Podiatry Info Ltd, Brentwood Medical Centre, Brentwood, Essex, England, UK.
J Am Podiatr Med Assoc. 2012 Jul-Aug;102(4):278-89. doi: 10.7547/1020278.
Kinematic observations are inconsistent in predicting lower-extremity injury risk, and research suggests that kinetic variables may be more important in this regard. Before kinetics can be prospectively investigated, we need reliable ways of measuring them clinically. A measurement instrument was manufactured that closely mirrors a manual test used to clinically estimate supination resistance force. The reliability of the instrument and the validity of the clinical test were investigated.
The left feet of 26 healthy individuals (17 men and 9 women; mean ± SD age, 25.9 ± 9.2 years; mean ± SD weight, 77.7 ± 13.3 kg) were assessed. Foot Posture Index (FPI-6), manual supination resistance, and machine supination resistance were measured. Intrarater and interrater reliability of all of the measurements were calculated. Correlations of the supination resistance measured by the device with FPI-6, the manual supination resistance test, and body weight were investigated.
Interrater reliability of all of the measurements was generally poor. The supination resistance machine correlated highly with the manual supination test for the rater experienced with its use. Supination resistance measurements correlated poorly with the FPI-6 and weakly with body weight.
The supination resistance machine was shown to have sufficient limits of agreement for the study, but improvements need to be made for more meaningful research going forward. In this study, the force required to supinate a foot was independent of its posture, and approximately 12% of it was explained by body weight. Further work is required with a much larger sample size to build regression models that sufficiently predict supination resistance force and that will be of clinical use. The manual supination test is a valid clinical test for clinicians experienced in its use.
运动学观察在预测下肢损伤风险方面并不一致,并且研究表明动力学变量在这方面可能更为重要。在对动力学进行前瞻性研究之前,我们需要临床上可靠的测量方法。制造了一种测量仪器,该仪器紧密模仿用于临床评估旋后阻力的手动测试。研究了该仪器的可靠性以及临床测试的有效性。
对26名健康个体(17名男性和9名女性;平均±标准差年龄,25.9±9.2岁;平均±标准差体重,77.7±13.3千克)的左脚进行评估。测量足部姿势指数(FPI-6)、手动旋后阻力和机器旋后阻力。计算所有测量值的评估者内和评估者间可靠性。研究该设备测量的旋后阻力与FPI-6、手动旋后阻力测试和体重之间的相关性。
所有测量值的评估者间可靠性总体较差。对于熟悉其使用的评估者,旋后阻力机器与手动旋后测试高度相关。旋后阻力测量值与FPI-6的相关性较差,与体重的相关性较弱。
旋后阻力机器在本研究中显示出有足够的一致性界限,但为了未来进行更有意义的研究还需要改进。在本研究中,使足部旋后的所需力量与其姿势无关,并且其中约12%可由体重解释。需要使用更大的样本量进行进一步研究,以建立能够充分预测旋后阻力并具有临床用途的回归模型。对于熟悉其使用的临床医生而言,手动旋后测试是一项有效的临床测试。