Cibulka Michael T, Wunderlich Payton, Klockenga Hayden, Reed Andrew, Sandman John
Physical Therapy Maryville University.
Int J Sports Phys Ther. 2023 Apr 1;18(2):368-374. doi: 10.26603/001c.73190. eCollection 2023.
A shortened rectus femoris muscle has been associated with many different musculoskeletal problems. Assessing rectus femoris muscle length is commonly performed using the Modified Thomas Test. However, this test position is often difficult to assume and there are difficulties with reliably measuring rectus femoris length. A method that that uses an easier position to assume and could be more reliable would be beneficial to therapists. The purpose of this study was to determine observer agreement using a new test for assessment of rectus femoris length. A second purpose was to determine if those with anterior knee pain have different rectus femoris muscle length than those without anterior knee pain.
Fifty-three participants with and without anterior knee pain were enrolled. Rectus femoris muscle length was measured lying prone with the leg measured on the table while the non-measured leg was off the table in a position of 90° hip flexion. Rectus femoris muscle was lengthened by passively bending the knee until a firm end-feel. The angle of knee flexion was then measured. The process was then repeated after a brief rest period.
Observer agreement assessing rectus femoris length using this method showed "almost perfect" reliability for both intra- and inter-rater testing: intra-rater: ICC = .99, [CI: .98-.99], inter-rater: ICC = .96, [CI: .92- .98]. Agreement for the sub-sample of those with anterior knee pain (N=16) showed "almost perfect" reliability for intra-rater (ICC 1,1 = .98); [CI: 0.94-.99] and inter-rater reliability (ICC 2,1 = 0.88); [CI: 0.70 -.95]. No differences were noted in rectus femoris length between those without and those with anterior knee pain (t= 0.82, p> 0.01); [CI: -7.8 -3.33]; (SEM = 1.3°; MDC=3.6°).
This new method of assessing rectus femoris length is reliable between and within raters. No differences were noted in rectus femoris length between those with anterior knee pain and those without.
股直肌缩短与许多不同的肌肉骨骼问题相关。评估股直肌长度通常采用改良托马斯试验。然而，该试验姿势往往难以摆出，且股直肌长度的可靠测量存在困难。一种采用更易摆出的姿势且可能更可靠的方法对治疗师会很有帮助。本研究的目的是通过一种评估股直肌长度的新试验来确定观察者间的一致性。第二个目的是确定有膝前痛的人与无膝前痛的人股直肌长度是否不同。
招募了53名有或无膝前痛的参与者。测量股直肌长度时，参与者俯卧，被测量的腿放在桌上，未测量的腿在髋关节屈曲90°的位置离开桌子。通过被动屈膝直至有坚实的终末感觉来延长股直肌。然后测量膝关节屈曲角度。在短暂休息后重复该过程。
使用该方法评估股直肌长度时，观察者间的一致性在组内和组间测试中均显示出“几乎完美”的可靠性：组内：ICC = 0.99，[CI：0.98 - 0.99]，组间：ICC = 0.96，[CI：0.92 - 0.98]。有膝前痛的子样本（N = 16）的一致性在组内（ICC 1,1 = 0.98）；[CI：0.94 - 0.99]和组间可靠性（ICC 2,1 = 0.88）；[CI：0.70 - 0.95]方面显示出“几乎完美”的可靠性。无膝前痛者与有膝前痛者的股直肌长度无差异（t = 0.82，p > 0.01）；[CI：-7.8 - 3.33]；（SEM = 1.3°；MDC = 3.6°）。
这种评估股直肌长度的新方法在评估者之间和评估者内部都是可靠的。有膝前痛者与无膝前痛者的股直肌长度无差异。
