Health and Rehabilitation Research Centre, AUT University, Auckland, New Zealand.
Phys Ther Sport. 2013 Aug;14(3):168-74. doi: 10.1016/j.ptsp.2012.07.001. Epub 2012 Oct 26.
To investigate visual rating of pelvis and knee position in young athletes during lower extremity functional tests.
Pelvis and knee alignment, in 23 athletes, was visually rated by 66 physiotherapists. Peak two-dimensional (2D) and three-dimensional (3D) kinematics were also quantified. Ratings were compared to consensus visual ratings of an expert panel. The consensus ratings were also compared to peak kinematics. Reliability was determined using percentage agreement (PA) and the first order agreement coefficient (AC1). Sensitivity, specificity, diagnostic odds ratio (DOR) and differences in kinematics between groups based on the expert visual ratings were calculated to assess rating validity.
Mean intra-rater agreement was substantial (PA: 79-88%, AC1: 0.60-0.78). Inter-rater agreement ranged from fair to substantial (PA: 67-80%; AC1: 0.37-0.61). Sensitivity (≥80%) and specificity (≥50%) were acceptable for all tests except the Drop Jump. Experience (DOR 1.6-2.8 times better) and slower movement (4.9 times better) improved rating accuracy. Peak 3D and 2D kinematics were different between groups rated as having good versus poor alignment by the experts.
Visual rating by physiotherapists is a valid tool for identifying young athletes with poor frontal plane dynamic pelvis and knee alignment.
研究下肢功能测试中年轻运动员骨盆和膝关节位置的目测评估。
23 名运动员的骨盆和膝关节对线情况由 66 名物理治疗师进行目测评估。还对二维（2D）和三维（3D）运动学的峰值进行了量化。评估结果与专家小组的共识视觉评估进行了比较。共识评估还与峰值运动学进行了比较。使用百分比一致性（PA）和一级一致性系数（AC1）来确定可靠性。根据专家的视觉评估，计算了敏感性、特异性、诊断优势比（DOR）和组间运动学差异，以评估评估的有效性。
平均组内评分者间一致性较高（PA：79-88%，AC1：0.60-0.78）。组间评分者间一致性从一般到较高（PA：67-80%；AC1：0.37-0.61）。除了跳降测试外，所有测试的敏感性（≥80%）和特异性（≥50%）都是可以接受的。经验（DOR 1.6-2.8 倍更好）和运动速度较慢（4.9 倍更好）提高了评分准确性。专家评估为良好对线与不良对线的组之间，峰值 3D 和 2D 运动学存在差异。
物理治疗师的目测评估是一种有效的工具，可以识别出在额状面动态骨盆和膝关节对线不良的年轻运动员。
