J Orthop Sports Phys Ther. 2019 Dec;49(12):934-941. doi: 10.2519/jospt.2019.8697. Epub 2019 Jul 23.
Ankle dorsiflexion range of motion is commonly measured during the weight-bearing lunge test (WBLT) as the horizontal knee distance traveled or tibial inclination. These measures are assumed to represent talocrural dorsiflexion, yet have not been validated against radiographic images.
To determine the (1) contribution of the talocrural joint to tibial inclination during the WBLT, (2) validity of inclinometer and photographic measures of tibial inclination compared to radiographic images, and (3) the association between tibial inclination and horizontal distance measures.
Tibial inclination using an inclinometer, horizontal distance via a ruler, and radiographic and photographic images were recorded in 20 participants in standing and during the end-range WBLT. Two assessors used computer software to measure talar rotation and tibial inclination from digital radiographs and photographs. The limits of agreement between photographic and inclinometer measures compared to radiographic measures, as well as correlations between measures, were calculated.
In the end-range WBLT, 91.8% of motion occurred at the talocrural joint, with 8.2% occurring distally. There were very strong correlations (all, 0.88, <.001) between end-range radiographic and photographic measures, radiographic and inclinometer measures, and radiographic, inclinometer, and photographic measures of tibial inclination and horizontal lunge distance. Calculation of the limits of agreement indicated unacceptable agreement between inclinometer and radiographic measures (-7.84°, 5.92°) and acceptable agreement between photographic and radiographic measures (-2.17°, 2.49°).
Tibial inclination during the WBLT primarily occurs at the talocrural joint. While inclinometer and photographic measures of tibial inclination can reliably be used clinically to measure dorsiflexion range of motion during the WBLT, inclinometer results differ slightly from those obtained via radiographs. .
在负重弓步测试（WBLT）中，通常会测量踝关节背屈活动范围，即水平膝关节移动距离或胫骨倾斜度。这些测量值被认为代表距下关节背屈，但尚未通过 X 射线图像进行验证。
确定（1）在 WBLT 中距下关节对胫骨倾斜的贡献，（2）与 X 射线图像相比，测斜仪和摄影测量胫骨倾斜的有效性，以及（3）胫骨倾斜与水平距离测量之间的关联。
在 20 名参与者站立和末端 WBLT 期间，使用测斜仪记录胫骨倾斜度，使用标尺记录水平距离，并记录 X 射线和摄影图像。两名评估者使用计算机软件从数字 X 射线和照片测量距骨旋转和胫骨倾斜度。计算摄影测量与测斜仪测量值与 X 射线测量值之间的协议界限，并计算测量值之间的相关性。
在末端 WBLT 中，91.8%的运动发生在距下关节，8.2%发生在远端。末端 WBLT 的 X 射线和摄影测量值、X 射线和测斜仪测量值以及 X 射线、测斜仪和摄影测量值的胫骨倾斜度和水平弓步距离之间存在非常强的相关性（均为，0.88，<.001）。测斜仪和 X 射线测量值之间的协议界限表明存在不可接受的一致性（-7.84°，5.92°），而摄影和 X 射线测量值之间的协议界限表明存在可接受的一致性（-2.17°，2.49°）。
在 WBLT 期间，胫骨倾斜主要发生在距下关节。虽然测斜仪和摄影测量胫骨倾斜度可以在临床上可靠地用于测量 WBLT 期间的背屈活动范围，但测斜仪的结果与 X 射线图像略有不同。
