Levinsky-Wingate Academic College (Wingate Campus), Netanya, Israel.
Department of Physical Therapy, Zefat Academic College, Zefat, Israel.
BMC Musculoskelet Disord. 2023 Oct 12;24(1):807. doi: 10.1186/s12891-023-06943-4.
Clinical methods for assessing quality of movement and functional tests are important to clinicians. Typical deviations from normal kinematics during the clinical test of Forward Step Down Test (FSDT) are pelvic tilt and hip adduction which are associated with the risk of knee pain.
(1) to examine the correlation between clinical assessment of the FSDT and joint angle measurements of pelvis, hip, knee and ankle joints in males and females; (2) to examine the differences in joint angles between individuals rated as good, fair or poor in a FSDT performance test.
Ninety-two healthy individuals performing FSDT were video-taped with two-dimensional digital video cameras. The clinical assessment of the FSDT was rated by two experienced physical therapists as good, fair, or poor based on a Crossley et al. (2011) validated scale. Measurements of pelvic drop, hip adduction and knee valgus were taken using Image J software.
Out of 177 lower limbs, 74 (37 in each limb) were clinically rated as "good/fair" (41.80%) while 103 (52 in the dominant leg and 51 in the non-dominant leg) were rated as "poor" (58.19%). No significant differences were observed between dominant and non-dominant legs or between males and females in clinical rating of the FSDT. Pelvic drop angle was significantly higher and hip adduction angle was significantly lower for "poor" clinical rating compared to "good/fair" in both dominant and non-dominant legs (p < 0.001) in males and females. Females demonstrated higher pelvic drop, lower hip adduction and higher knee valgus angles compared with males (p < 0.05).
This study showed that the clinical rating of FSDT is correlated with joint angle measurements suggesting that this assessment can be utilized in clinical practice. Individuals with poor quality performance of FSDT showed higher pelvic drop and hip adduction movement. Further studies examining different populations with diverse disorders or pathologies are essential.
评估运动质量和功能测试的临床方法对临床医生很重要。在进行前向踏步下降测试（FSDT）的临床测试时，通常会出现骨盆倾斜和髋关节内收的典型异常，这些异常与膝关节疼痛的风险有关。
（1）研究男性和女性 FSDT 的临床评估与骨盆、髋关节、膝关节和踝关节关节角度测量之间的相关性；（2）研究在 FSDT 表现测试中表现为良好、中等或差的个体之间关节角度的差异。
92 名健康个体进行 FSDT 测试时，使用二维数字摄像机进行录像。FSDT 的临床评估由两名经验丰富的物理治疗师根据 Crossley 等人（2011 年）验证的量表进行评分，分为良好、中等或差。使用 Image J 软件测量骨盆下降、髋关节内收和膝关节外翻角度。
在 177 条下肢中，74 条（每条下肢 37 条）临床评分“良好/中等”（41.80%），103 条（优势腿 52 条，非优势腿 51 条）评分“差”（58.19%）。在 FSDT 的临床评分中，优势腿和非优势腿之间以及男性和女性之间没有观察到显著差异。在男性和女性中，与“良好/中等”评分相比，“差”临床评分的骨盆下降角度显著更高，髋关节内收角度显著更低（p<0.001）。与男性相比，女性的骨盆下降角度更高，髋关节内收角度更低，膝关节外翻角度更高（p<0.05）。
本研究表明，FSDT 的临床评分与关节角度测量相关，表明这种评估可以在临床实践中使用。FSDT 表现质量差的个体表现出更高的骨盆下降和髋关节内收运动。进一步研究不同人群的不同疾病或病理状态至关重要。
