Ganderton C, O'Brien Mjm, Han J, Wallis A K, Munro D, O'Shea T, Grabinski R, King M G
RMIT University, PO Box 71, Bundoora 3083, Australia.
Med Probl Perform Art. 2024 Jun;39(2):56-63. doi: 10.21091/mppa.2024.2008.
Developmental dysplasia of the hip (DDH) is common in performing artists and other young active individuals and involves abnormalities in bony morphology of the acetabulum and proximal femur that can negatively impact walking biomechanics, muscular strength, quality of life, and sleep. Rehabilitation for hip-related conditions should target known modifiable impairments such as hip muscle strength, though a reliable method of assessment in this population remains unclear.
To determine the inter- and intra-rater reliability of hip muscle strength assessments using handheld dynamometry (HHD) in young active circus artists with DDH.
Reliability of hip strength in all planes was assessed using HHD in 21 adult performing circus arts students (mean age 21.3 yrs [3.2]; 13 M, 5 F, 3 NB) with symptomatic radiologically and clinically diagnosed hip dysplasia. The reliability of average peak force and absolute peak force were expressed for each position tested. Reliability was assessed using intraclass correlation coefficients (ICC) with standard error of measurement (SEM) and minimal detectable change (MDC) values calculated to improve clinical interpretability.
Good to excellent inter-rater reliability resulted for all hip muscle strength testing positions, ICC=0.88 (95%CI 0.70 to 0.95) to ICC=0.97 (0.92 to 0.99), except average peak hip flexion strength, ICC=0.71 (0.28 to 0.88). Absolute peak hip abduction, ICC=0.77 (0.16 to 0.94), and adduction strength, ICC=0.72 (-0.55 to 0.92), demonstrated the lowest intra-rater reliability. Transverse plane strength measures (rotation) produced the lowest SEM and MDC values followed by the frontal plane (abduction/adduction) and sagittal plane (flexion/extension).
HHD is an appropriate and reliable method to assess hip muscle strength in circus artists with DDH.
髋关节发育不良（DDH）在表演艺术家和其他年轻活跃个体中很常见，涉及髋臼和股骨近端的骨形态异常，这会对行走生物力学、肌肉力量、生活质量和睡眠产生负面影响。髋关节相关疾病的康复应针对已知的可改变损伤，如髋部肌肉力量，尽管在这一人群中可靠的评估方法仍不明确。
确定在患有DDH的年轻活跃马戏团艺术家中使用手持测力计（HHD）评估髋部肌肉力量时评分者间和评分者内的可靠性。
对21名有症状的经放射学和临床诊断为髋关节发育不良的成年马戏团艺术专业学生（平均年龄21.3岁[3.2]；13名男性，5名女性，3名非二元性别）使用HHD评估所有平面的髋部力量可靠性。对每个测试位置的平均峰值力和绝对峰值力的可靠性进行了评估。使用组内相关系数（ICC）评估可靠性，并计算测量标准误差（SEM）和最小可检测变化（MDC）值以提高临床可解释性。
除平均峰值髋部屈曲力量（ICC = 0.71[0.28至0.88]）外，所有髋部肌肉力量测试位置的评分者间可靠性良好至优秀，ICC = 0.88（95%CI 0.70至0.95）至ICC = 0.97（0.92至0.99）。绝对峰值髋部外展（ICC = 0.77[0.16至0.94]）和内收力量（ICC = 0.72[-0.55至0.92]）的评分者内可靠性最低。横断面力量测量（旋转）产生最低的SEM和MDC值，其次是额状面（外展/内收）和矢状面（屈曲/伸展）。
HHD是评估患有DDH的马戏团艺术家中髋部肌肉力量的一种合适且可靠的方法。
