Roessingh Research and Development,PO Box 310, 7500 AH Enschede, The Netherlands. .
J Rehabil Med. 2022 Jan 3;54:jrm00247. doi: 10.2340/jrm.v53.637.
To determine the diagnostic value of the Duncan-Ely test in predicting abnormal rectus femoris activity during gait in stroke survivors walking with a stiff knee gait.
Cross-sectional diagnostic study.
A total of 95 patients with chronic stroke.
During physical examination, the Duncan-Ely test was performed and scored. Surface electromyography of the rectus femoris was then recorded during dynamic gait. To determine the diagnostic value, the results of the Duncan-Ely test and surface electromyography recordings (gold standard) were compared.
The Duncan-Ely test had a sensitivity of 73%, a specificity of 29%, a positive predictive value of 60%, and a negative predictive value of 42%. The area under the curve was 0.488 ([AQ1] CI 0.355-0.621, p = 0.862), showing that the Duncan-Ely test is not better than random guessing.
The Duncan-Ely test has no predictive value for determining abnormal activity of the rectus femoris during gait. Using this test can lead to incorrect identification of abnormal rectus femoris activity, which might hamper the selection of optimal treatment options. We recommend stopping use of the Duncan-Ely test to predict rectus femoris overactivity during swing, and instead use surface electromyography.
确定 Duncan-Ely 试验在预测脑卒中患者僵硬膝步态行走时股直肌异常活动中的诊断价值。
横断面诊断研究。
共 95 例慢性脑卒中患者。
在体格检查过程中，进行 Duncan-Ely 试验并评分。然后在动态步态过程中记录股直肌的表面肌电图。为了确定诊断价值，将 Duncan-Ely 试验结果与表面肌电图记录（金标准）进行比较。
Duncan-Ely 试验的灵敏度为 73%，特异性为 29%，阳性预测值为 60%，阴性预测值为 42%。曲线下面积为 0.488（[AQ1]CI 0.355-0.621，p=0.862），表明 Duncan-Ely 试验并不优于随机猜测。
Duncan-Ely 试验对预测步态中股直肌异常活动没有预测价值。使用该试验可能导致对股直肌异常活动的错误识别，从而阻碍最佳治疗方案的选择。我们建议停止使用 Duncan-Ely 试验来预测摆动期股直肌过度活动，转而使用表面肌电图。
