Gianola Silvia, Castellini Greta, Stucovitz Elena, Nardo Alice, Banfi Giuseppe
Unit of Clinical Epidemiology, IRCCS Galeazzi Orthopedic Institute, Milan, Italy.
Center of Biostatistics for Clinical Epidemiology, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
BMC Musculoskelet Disord. 2017 Jul 14;18(1):299. doi: 10.1186/s12891-017-1660-8.
Single-leg squat (SLS) is a functional test visually rated by clinicians for assessing lower limb function as a preventive injury strategy. SLS clinical rating is a qualitative evaluation and it does not count objective outcomes as kinematics data and surface electromyography (sEMG) assessment. Based on the SLS rating, the aims of this study were (i) to determine the clinical rating agreement among six raters and (ii) to assess kinematic and sEMG predictors of good SLS performance in physically and non-physically active individuals.
Seventy-two healthy adults, divided in physically active and non-physically active groups, performed three SLSs on their dominant leg. Clinical ratings, kinematic data and sEMG were acquired. By using a validated clinical scale, six expert clinicians rated each SLS watching a video at three different time points. Intra and inter-rater agreement of clinical ratings were undertaken and a binary logistic regression analysis was used to determine kinematic and sEMG as predictors of SLS performance.
The weighted kappa coefficient for intra-rater reliability within each rater ranged between moderate and almost perfect agreement (0.55-0.85) whereas the weighted kappa coefficient for inter-rater reliability among raters was fair (0.34, time point 0; 0.31, time point 1; 0.30, time point 2). SLS analyses of physically active compared to non-physically active group showed a statistically significant difference in knee flexion and hip flexion (p = 0.041 and p = 0.023 respectively) and no difference in clinical ratings (p = 0.081). Greater knee flexion can predict the good SLS performance taking into account the belonging group (p = 0.019).
Physically active individuals seemed to be at less risk to perform a non-good SLS and they had greater knee and hip flexions kinematics than non-physically active individuals. Knee flexion can predict the SLS performance quality therefore a greater knee flexion might also be considered a protective element from injuries.
ClinicalTrials.gov identifier (trial has been registred retrospectively: NCT03203083. Date registration: June 21, 2017.
单腿深蹲(SLS)是一种功能性测试,由临床医生通过视觉评估来评估下肢功能,作为一种预防损伤的策略。SLS临床评分是一种定性评估,不包括运动学数据和表面肌电图(sEMG)评估等客观结果。基于SLS评分,本研究的目的是:(i)确定六位评估者之间的临床评分一致性;(ii)评估身体活跃和非身体活跃个体中SLS表现良好的运动学和sEMG预测因素。
72名健康成年人分为身体活跃组和非身体活跃组,用优势腿进行三次单腿深蹲。采集临床评分、运动学数据和sEMG。六位专家临床医生使用经过验证的临床量表,在三个不同时间点观看视频对每次单腿深蹲进行评分。进行临床评分的评估者内和评估者间一致性分析,并使用二元逻辑回归分析确定运动学和sEMG作为SLS表现的预测因素。
每位评估者的评估者内可靠性加权kappa系数在中等至几乎完美一致之间(0.55 - 0.85),而评估者间可靠性加权kappa系数为一般(时间点0为0.34;时间点1为0.31;时间点2为0.30)。身体活跃组与非身体活跃组的SLS分析显示,膝关节屈曲和髋关节屈曲存在统计学显著差异(分别为p = 0.041和p = 0.023),临床评分无差异(p = 0.081)。考虑所属组别时,更大的膝关节屈曲可预测SLS表现良好(p = 0.019)。
身体活跃的个体进行单腿深蹲表现不佳的风险似乎较低,且他们的膝关节和髋关节屈曲运动学比非身体活跃个体更大。膝关节屈曲可预测单腿深蹲的表现质量,因此更大的膝关节屈曲也可能被视为预防损伤的一个保护因素。
ClinicalTrials.gov标识符(试验已追溯注册:NCT03203083。注册日期:2017年6月21日)