Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
Department of Orthopaedic Surgery, Sports Orthopaedic Research Center-Copenhagen (SORC-C), Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark.
Knee Surg Sports Traumatol Arthrosc. 2021 May;29(5):1604-1611. doi: 10.1007/s00167-020-06369-8. Epub 2020 Nov 24.
The purpose of this study was to evaluate concurrent validity of the heel-rise work test performed with use of the heel as a surrogate for the center of body mass.
The study was a validity study performed on a prospective cohort of consecutive patients. Forty-five patients were included in the study. The heel-rise work test estimates the total work performed by repeated heel-rises until fatigue. In this study, the heel-rise work was assessed by the linear encoder and a motion capture system simultaneously for validation. The linear encoder was attached to the patient's heel and reflective marker was attached to the pelvis and heel. Student's paired t-test, linear regression analysis and Bland Altman plots were used to estimate the measurement error of the linear encoder.
The heel-rise work test overestimated the total work with 21.0% on the injured leg and 24.7% on the non-injured leg. Student's paired t-test showed no difference in measurement error between the limbs (n.s.). The linear regression analysis showed no difference in limb symmetry index between the two methods of heel-rise work estimation (a (slope) = 1.00, R = 0.94, p < 0.0001).
The heel-rise work test performed using the heel as a surrogate for center of body mass overestimates the total work with 21.0-24.7% compared to a gold standard but was able to precisely detect the relative difference between the limbs. The heel marker can be considered a valid measurement device for assessing relative differences between the limbs.
Clinical testing of injuries to the lower body using the heel-rise work test is valid when using the relative difference between the limbs.
I.
本研究旨在评估以足跟替代身体重心进行跟腱上抬工作测试的同步效度。
本研究为前瞻性连续队列研究。共纳入 45 例患者。跟腱上抬工作测试通过反复足跟上抬直至疲劳来评估总工作量。在本研究中，线性编码器和运动捕捉系统同时对跟腱上抬工作进行评估以进行验证。线性编码器附着于患者足跟，反射标记附着于骨盆和足跟。采用学生配对 t 检验、线性回归分析和 Bland-Altman 图评估线性编码器的测量误差。
跟腱上抬工作测试在伤侧和健侧分别高估了总工作量 21.0%和 24.7%。学生配对 t 检验显示，两种方法测量的肢体间测量误差无差异（P>0.05）。线性回归分析显示，两种跟腱上抬工作估计方法的肢体对称性指数无差异（斜率（a）=1.00，R=0.94，P<0.0001）。
与金标准相比，以足跟替代身体重心进行的跟腱上抬工作测试高估了 21.0%-24.7%的总工作量，但能够精确地检测到肢体间的相对差异。足跟标记可被视为评估肢体间相对差异的有效测量装置。
当使用肢体间的相对差异时，使用跟腱上抬工作测试对下肢损伤进行临床测试是有效的。
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