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单腿深蹲测试：一种“自上而下”还是“自下而上”的功能表现测试？

The Single Leg Squat Test: A "Top-Down" or "Bottom-Up" Functional Performance Test?

作者信息

Carroll Lindsay A, Kivlan Benjamin R, Martin RobRoy L, Phelps Amy L, Carcia Christopher R

机构信息

Duquesne University.

Department of Physical Therapy, Duquesne University; UPMC Center for Sports Medicine.

出版信息

Int J Sports Phys Ther. 2021 Apr 1;16(2):360-370. doi: 10.26603/001c.21317.

DOI:10.26603/001c.21317
PMID:33842032
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8016417/
Abstract

BACKGROUND: Medial knee deviation (MKD) during the single leg squat test (SLST) is a common clinical finding that is often attributed to impairments of proximal muscular structures. Investigations into the relationship between MKD and the foot and ankle complex have provided conflicting results, which may impact clinicians' interpretation of the SLST. PURPOSE: The purpose of this study was to compare ankle dorsiflexion range of motion (ROM) and foot posture in subjects that perform the SLST with MKD (fail) versus without MKD (pass). HYPOTHESIS: There will be a difference in ankle dorsiflexion ROM and/or foot posture between healthy individuals that pass and fail the SLST for MKD. STUDY DESIGN: Cross-sectional study. METHODS: Sixty-five healthy, active volunteers (sex = 50 female, 15 male; age = 25.2 +/- 5.6 years; height = 1.7 +/- .1 m; weight = 68.5 +/- 13.5 kg) who demonstrated static balance and hip abductor strength sufficient for performance of the SLST participated in the study. Subjects were divided into pass and fail groups based on visual observation of MKD during the SLST. Foot Posture Index (FPI-6) scores and measures of non-weight bearing and weight bearing active ankle dorsiflexion (ROM) were compared. RESULTS: There were 33 individuals in the pass group and 32 in the fail group. The groups were similar on age (p = .899), sex (p = .341), BMI (p = .818), and Tegner Activity Scale score (p = .456). There were no statistically significant differences between the groups on the FPI-6 (pass group mean = 2.5 +/- 3.9; fail group mean = 2.3 +/- 3.5; p = .599), or any of the measures of dorsiflexion range of motion (non-weight bearing dorsiflexion with knee extended: pass group = 6.9 +/- 3.7, fail group = 7.8 +/- 3.0; non-weight bearing dorsiflexion with knee flexed: pass group = 13.5 +/- 5.6, fail group = 13.9 +/- 5.3; weight bearing dorsiflexion: pass group = 42.7 +/- 6.0, 42.7 +/- 8.3, p = .611). CONCLUSIONS: Failure on the SLST is not related to differences in clinical measures of active dorsiflexion ROM or foot posture in young, healthy individuals. These findings suggest that clinicians may continue using the SLST to assess neuromuscular performance of the trunk, hip, and knee without ankle dorsiflexion ROM or foot posture contributing to results. LEVEL OF EVIDENCE: Level 3.

摘要

背景：单腿深蹲测试（SLST）期间的膝内翻（MKD）是一种常见的临床发现，通常归因于近端肌肉结构的损伤。对MKD与足踝复合体之间关系的研究结果相互矛盾，这可能会影响临床医生对SLST的解读。 目的：本研究的目的是比较在SLST中出现MKD（失败）与未出现MKD（通过）的受试者的踝关节背屈活动度（ROM）和足部姿势。 假设：在SLST中通过和未通过MKD测试的健康个体之间，踝关节背屈ROM和/或足部姿势会存在差异。 研究设计：横断面研究。 方法：65名健康、活跃的志愿者（50名女性，15名男性；年龄=25.2±5.6岁；身高=1.7±0.1米；体重=68.5±13.5千克）参与了本研究，他们表现出足以进行SLST的静态平衡和髋外展肌力量。根据SLST期间对MKD的视觉观察，将受试者分为通过组和未通过组。比较足部姿势指数（FPI-6）评分以及非负重和负重时的主动踝关节背屈（ROM）测量值。 结果：通过组有33人，未通过组有32人。两组在年龄（p = 0.899）、性别（p = 0.341）、BMI（p = 0.818）和Tegner活动量表评分（p = 0.456）方面相似。两组在FPI-6（通过组平均值=2.5±3.9；未通过组平均值=2.3±3.5；p = 0.599）或任何背屈活动度测量值上均无统计学显著差异（膝关节伸展时非负重背屈：通过组=6.9±3.7，未通过组=7.8±3.0；膝关节屈曲时非负重背屈：通过组=13.5±5.6，未通过组=13.9±5.3；负重背屈：通过组=42.7±6.0，未通过组=42.7±8.3，p = 0.611）。 结论：在年轻、健康个体中，SLST未通过与主动背屈ROM或足部姿势的临床测量差异无关。这些发现表明，临床医生可以继续使用SLST来评估躯干、髋部和膝部的神经肌肉性能，而踝关节背屈ROM或足部姿势不会影响结果。 证据水平：3级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a98e/8016417/f6ce54a0a93a/ijspt_2021_16_2_21317_54311.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a98e/8016417/69dd8d3a92d1/ijspt_2021_16_2_21317_54307.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a98e/8016417/50ba2eb14564/ijspt_2021_16_2_21317_54308.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a98e/8016417/07148303f3e3/ijspt_2021_16_2_21317_54309.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a98e/8016417/5f053d8ed794/ijspt_2021_16_2_21317_54310.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a98e/8016417/f6ce54a0a93a/ijspt_2021_16_2_21317_54311.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a98e/8016417/278618d95cc2/ijspt_2021_16_2_21317_54306.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a98e/8016417/69dd8d3a92d1/ijspt_2021_16_2_21317_54307.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a98e/8016417/50ba2eb14564/ijspt_2021_16_2_21317_54308.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a98e/8016417/07148303f3e3/ijspt_2021_16_2_21317_54309.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a98e/8016417/5f053d8ed794/ijspt_2021_16_2_21317_54310.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a98e/8016417/f6ce54a0a93a/ijspt_2021_16_2_21317_54311.jpg

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本文引用的文献

[1]
Conservative management acutely improves functional movement and clinical outcomes in patients with pre-arthritic hip pain.

J Hip Preserv Surg. 2020-1-22

[2]
How Much Does the Talocrural Joint Contribute to Ankle Dorsiflexion Range of Motion During the Weight-Bearing Lunge Test? A Cross-sectional Radiographic Validity Study.

J Orthop Sports Phys Ther. 2019-7-23

[3]
DEFINING LOWER EXTREMITY DOMINANCE: THE RELATIONSHIP BETWEEN PREFERRED LOWER EXTREMITY AND TWO FUNCTIONAL TASKS.

Int J Sports Phys Ther. 2019-4

[4]
Evidence for Reliability and Validity of Functional Performance Testing in the Evaluation of Nonarthritic Hip Pain.

J Athl Train. 2019-3-4

[5]
Association between double-leg squat and single-leg squat performance and injury incidence among incoming NCAA Division I athletes: A prospective cohort study.

Phys Ther Sport. 2018-11

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Int J Sports Phys Ther. 2018-6

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Int J Sports Phys Ther. 2017-12

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