Moisan Gabriel, McBride Sean, Isabelle Pier-Luc, Chicoine Dominic, Walha Roua
Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada.
Groupe de recherche sur les affections neuro-musculo-squelettiques (GRAN), Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada.
Musculoskeletal Care. 2023 Mar;21(1):102-107. doi: 10.1002/msc.1675. Epub 2022 Jul 14.
The first metatarsophalangeal joint plays a fundamental role during the gait cycle. The Hubscher manoeuvre, which consists of passively dorsiflexing the first metatarsophalangeal joint of an individual in relaxed stance and observing the raising of the medial longitudinal arch, is a clinical test thought to examine the function of the first metatarsophalangeal joint. However, the hallux dorsiflexion achieved during this test is not related to hallux dorsiflexion during gait. On the other hand, unlike kinematic tests, results from kinetic tests have been shown to be strongly correlated with dynamic joint biomechanics. Thus, given the need for valid and reliable tests to evaluate the function of the first metatarsophalangeal joint, this study aimed to assess the reliability of a new kinetic test, namely, the first metatarsophalangeal joint dorsiflexion resistance test.
Thirty young adults completed two data collection sessions 1 week apart, during which the first metatarsophalangeal joint dorsiflexion resistance test was performed. Intrarater and interrater reliability were assessed using intraclass correlation coefficients (ICC), minimal detectable difference (MDD), standard error of the mean (SEM) and limits of agreements (LoA).
For the intrarater reliability, the ICC was 0.77 (p < 0.001), the SEM was 6.5 N, the MDD was 18.1 N and the LoA were -7.9 to 26.9 N. For the interrater reliability, the ICC was 0.86 (p < 0.001), the SEM was 6.9 N, the MDD was 19.0 N and the LoA were -6.4 to 21.8 N.
The results of this study demonstrate good intra and interrater reliability of the first metatarsophalangeal joint dorsiflexion resistance test, which provides evidence to support its use in clinical and research contexts. Further work is required to establish the test results' relationship with joint kinetics during gait and to provide normative values in individuals with and without musculoskeletal disorders as well as among different age groups and genders to optimise its utilization in clinical and research settings.
第一跖趾关节在步态周期中起重要作用。胡布舍尔手法是一种临床测试,具体操作是在个体放松站立时被动背屈其第一跖趾关节,并观察内侧纵弓的抬高情况,该手法旨在检查第一跖趾关节的功能。然而,此测试中实现的拇趾背屈与步态期间的拇趾背屈无关。另一方面,与运动学测试不同,动力学测试结果已被证明与动态关节生物力学密切相关。因此,鉴于需要有效且可靠的测试来评估第一跖趾关节的功能,本研究旨在评估一种新的动力学测试——第一跖趾关节背屈阻力测试的可靠性。
30名年轻成年人在相隔1周的时间内完成了两次数据收集,期间进行了第一跖趾关节背屈阻力测试。使用组内相关系数(ICC)、最小可检测差异(MDD)、平均标准误差(SEM)和一致性界限(LoA)评估了评估者内和评估者间的可靠性。
对于评估者内可靠性,ICC为0.77(p < 0.001),SEM为6.5 N,MDD为18.1 N,LoA为 -7.9至26.9 N。对于评估者间可靠性,ICC为0.86(p < 0.001),SEM为6.9 N,MDD为19.0 N,LoA为 -6.4至21.8 N。
本研究结果表明第一跖趾关节背屈阻力测试具有良好的评估者内和评估者间可靠性,这为支持其在临床和研究环境中的应用提供了证据。需要进一步开展工作,以确定测试结果与步态期间关节动力学的关系,并为患有和未患有肌肉骨骼疾病的个体以及不同年龄组和性别提供规范值,以优化其在临床和研究环境中的应用。