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功能表现测试识别慢性踝关节不稳患者的能力:系统评价与荟萃分析。

Ability of Functional Performance Tests to Identify Individuals With Chronic Ankle Instability: A Systematic Review With Meta-Analysis.

机构信息

School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska.

Department of Health & Exercise Science, Appalachian State University, Boone, North Carolina.

出版信息

Clin J Sport Med. 2019 Nov;29(6):509-522. doi: 10.1097/JSM.0000000000000535.


DOI:10.1097/JSM.0000000000000535
PMID:31688183
Abstract

OBJECTIVE: The purpose of this systematic review with meta-analysis was to determine the effectiveness of functional performance tests (FPTs) in differentiating between individuals with chronic ankle instability (CAI) and healthy controls. DATA SOURCES: The National Library of Medicine Catalog (PubMed), the Cumulative Index for Nursing and Allied Health Literature (CINAHL), and the SPORTDiscus, from inception to June 2017 were searched. Search terms consisted of: "Functional Performance Test*" OR "Dynamic Balance Test*" OR "Postural Stability Test*" OR "Star Excursion Balance Test*" OR "Hop Test*" AND "Ankle Instability" OR "Ankle Sprain." Included articles assessed differences in FPTs in patients with CAI compared with a control group. MAIN RESULTS: Included studies were assessed for methodological quality and level of evidence. Individual and mean effect sizes were also calculated for FPTs from the included articles. Twenty-nine studies met the criteria and were analyzed. The most common FPTs were timed-hop tests, side-hop, multiple-hop test, single-hop for distance, foot-lift test, and the Star Excursion Balance Tests (SEBTs). The side-hop (g = -1.056, P = 0.009, n = 7), timed-hop tests (g = -0.958, P = 0.002, n = 9), multiple-hop test (g = 1.399, P < 0.001, n = 3), and foot-lift tests (g = -0.761, P = 0.020, n = 3) demonstrated the best utility with large mean effect sizes, whereas the SEBT anteromedial (g = 0.326, P = 0.022, n = 7), medial (g = 0.369, P = 0.006, n = 7), and posteromedial (g = 0.374, P < 0.001, n = 13) directions had moderate effects. CONCLUSIONS: The side-hop, timed-hopping, multiple-hop, and foot-lift seem the best FPTs to evaluate individuals with CAI. There was a large degree of heterogeneity and inconsistent reporting, potentially limiting the clinical implementation of these FPTs. These tests are cheap, effective, alternatives compared with instrumented measures.

摘要

目的:本系统评价和荟萃分析的目的是确定功能表现测试(FPTs)在区分慢性踝关节不稳定(CAI)患者和健康对照组方面的有效性。

资料来源:从 1998 年 1 月到 2017 年 6 月,检索了美国国立医学图书馆目录(PubMed)、护理与联合健康文献累积索引(CINAHL)和 SPORTDiscus。检索词包括:“功能性运动测试*”或“动态平衡测试*”或“姿势稳定性测试*”或“星形偏移平衡测试*”或“跳跃测试*”和“踝关节不稳定”或“踝关节扭伤”。纳入的文章评估了 CAI 患者与对照组之间 FPT 的差异。

主要结果:对纳入研究进行了方法学质量和证据水平评估。还计算了纳入文章中 FPT 的个体和平均效应量。29 项研究符合标准并进行了分析。最常见的 FPT 是计时跳跃测试、侧跳、多跳测试、单足跳跃距离、抬脚测试和星形偏移平衡测试(SEBTs)。侧跳(g = -1.056,P = 0.009,n = 7)、计时跳跃测试(g = -0.958,P = 0.002,n = 9)、多跳测试(g = 1.399,P < 0.001,n = 3)和抬脚测试(g = -0.761,P = 0.020,n = 3)显示出最大的效用,具有较大的平均效应量,而 SEBT 前内侧(g = 0.326,P = 0.022,n = 7)、内侧(g = 0.369,P = 0.006,n = 7)和后内侧(g = 0.374,P < 0.001,n = 13)方向具有中等效应。

结论:侧跳、计时跳跃、多跳和抬脚似乎是评估 CAI 患者的最佳 FPTs。存在较大程度的异质性和报告不一致,可能限制了这些 FPTs 的临床应用。与仪器测量相比,这些测试便宜、有效、替代方法。

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