J Orthop Sports Phys Ther. 2018 Apr;48(4):260-269. doi: 10.2519/jospt.2018.7840. Epub 2018 Mar 16.
Study Design Cross-sectional study. Objectives To evaluate intrarater and interrater agreement among physical therapists with different clinical experience in performing a visual rating of movement-pattern quality of patients with femoroacetabular impingement (FAI) syndrome using a semi-quantitative scale. Background Visual rating of movement patterns in patients with FAI syndrome is of interest, because poor control of dynamic hip motion is frequently noted. Methods A video camera was used to record the performance of 34 patients with FAI syndrome performing single-limb standing, squat, frontal lunge, hop lunge, bridge, and plank. Visual rating of movement, as recorded on video, was performed by a highly experienced, a moderately experienced, and a novice physical therapist on 2 occasions using a semi-quantitative scale. Hip abductor strength was assessed using dynamometry, and hip pain and function were assessed with a patient-reported questionnaire. Intrarater and interrater agreement among physical therapists was evaluated using Gwet's agreement coefficient 1. Construct validity was evaluated as the association between physical therapists' rating and patients' hip abductor strength, pain, and function. Results Good intrarater and interrater agreement was observed in the highly experienced and moderately experienced physical therapists when rating single-limb standing, bridge, and plank. Poor to moderate intrarater and interrater agreement was found when they rated squat, frontal lunge, and hop lunge. Poor performers, as rated by the highly experienced physical therapist only, demonstrated lower hip abductor strength (P<.05), and similar hip pain and hip function compared to those of good performers. Conclusion Movement-pattern quality of patients with FAI syndrome should be rated by a highly experienced physical therapist. J Orthop Sports Phys Ther 2018;48(4):260-269. doi:10.2519/jospt.2018.7840.
横断面研究。
评估不同临床经验的物理治疗师在使用半定量量表对患有股骨髋臼撞击综合征（FAI）的患者进行运动模式质量的视觉评估时的组内和组间一致性。
对 FAI 综合征患者运动模式的视觉评估很有意义，因为经常注意到动态髋关节运动控制不佳。
使用摄像机记录 34 例 FAI 综合征患者进行单腿站立、下蹲、前弓步、跳跃弓步、桥接和木板运动的表现。使用半定量量表，由一位经验丰富、一位经验中等和一位新手物理治疗师两次对录像中的运动进行视觉评估。使用测力法评估髋外展肌力量，使用患者报告的问卷评估髋部疼痛和功能。使用 Gwet 一致性系数 1 评估治疗师之间的组内和组间一致性。通过物理治疗师的评估与患者髋外展肌力量、疼痛和功能之间的相关性来评估结构效度。
在高度经验丰富和中度经验丰富的物理治疗师中，观察到单腿站立、桥接和木板的良好组内和组间一致性。在评估下蹲、前弓步和跳跃弓步时，发现较差到中等的组内和组间一致性。只有高度经验丰富的物理治疗师评为较差的患者，其髋外展肌力量较低（P<.05），与表现较好的患者相比，髋部疼痛和功能相似。
FAI 综合征患者的运动模式质量应由经验丰富的物理治疗师进行评估。
对于治疗师来说，对运动模式的视觉评估可能是一种有用的工具，可用于识别患有 FAI 综合征的患者的运动控制问题。然而，需要进一步的研究来确定最佳的评估方法和协议，以及与临床结果的相关性。
