Biomechanics Research Team, Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia.
Biomechanics Research Team, Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia.
Gait Posture. 2021 Mar;85:20-24. doi: 10.1016/j.gaitpost.2021.01.015. Epub 2021 Jan 20.
Stronger toe flexor muscles improve performance outcomes in children, including balance, sprinting, jumping and side stepping. Toe flexor strength (TFS) is recommended as part of the clinical assessment of foot function in children. Fixed dynamometry, rather than handheld, is the gold standard of measurement; however, it can be prohibitively costly. No fixed dynamometer reliability studies on toe flexion have been conducted in children to date.
Does the novel fixed hand-held dynamometer (HHD) protocol provide reliable intra-rater and test-retest measurements of toe flexor strength in children aged 10 to 12?
Two trials were recorded from 14 healthy children (10-12 years), 7-14 days apart by the same rater. A Lafayette HHD (model 01163) measured peak force. The HHD was secured in a mobile custom mould below a step with a strap, which secured the foot of the participant. The receptor pads of the HHD were level with the upper surface of the step, maintaining neutral toe joints at rest. The participant was seated on an adjustable stool to ensure the hip, knee and ankle were each at 90° flexion, with the testing foot flat on the upper surface of the step. The averages of three maximal five second efforts were used for data analysis using a two-way mixed effects model with repeated measures ANOVA (intraclass correlation coefficient ICC 3,3). Standard error of measurement (SEM) was calculated to determine the absolute between trial variability.
The novel fixed HHD protocol provided excellent test-retest reliability with small measurement error for hallux (ICC 3,3 = 0.93, 95 % CI 0.78-0.98, SEM = 4.31 N) and lesser toe flexor strength testing (ICC 3,3 = 0.96, 95 % CI 0.87-0.99, SEM = 1.86 N).
The fixed HHD protocol described in this study has excellent reliability for the test-retest evaluation of children's toe flexor strength.
更强的脚趾屈肌力量可以提高儿童的运动表现，包括平衡、短跑、跳跃和侧身移动。脚趾屈肌力量（TFS）被建议作为儿童足部功能临床评估的一部分。固定测力计，而不是手持测力计，是测量的金标准；然而，它可能非常昂贵。迄今为止，尚无针对儿童脚趾弯曲的固定测力计可靠性研究。
新型固定手持测力计（HHD）方案是否能为 10 至 12 岁儿童提供可靠的、有内部分组者间和重测信度的脚趾屈肌力量测量值？
由同一位评分者在相隔 7-14 天的两次试验中记录了 14 名健康儿童（10-12 岁）的数据。拉法耶特 HHD（型号 01163）测量峰值力。HHD 被固定在一个带有表带的移动定制模具下的台阶上，该表带固定参与者的脚部。HHD 的受体垫与台阶的上表面平齐，在休息时保持中立的脚趾关节。参与者坐在可调节的凳子上，以确保髋、膝和踝均呈 90°弯曲，测试脚平放在台阶的上表面。使用双向混合效应模型进行重复测量方差分析（内部分组者间相关系数 ICC 3,3），对三次最大 5 秒努力的平均值进行数据分析。计算测量误差以确定两次试验之间的绝对变异性。
新型固定 HHD 方案为大脚趾（ICC 3,3 = 0.93，95%CI 0.78-0.98，SEM = 4.31 N）和较小的脚趾屈肌力量测试（ICC 3,3 = 0.96，95%CI 0.87-0.99，SEM = 1.86 N）提供了极好的重测信度，测量误差很小。
本研究中描述的固定 HHD 方案具有极好的可靠性，可用于评估儿童脚趾屈肌力量的重测结果。
