Sommer H M, Vallentyne S W
Department of Internal Medicine, University of Manitoba, Winnipeg, Canada.
Med Sci Sports Exerc. 1995 Jun;27(6):800-4.
This study reviewed the assessment of medial tibial stress syndrome (MTSS), a common lower limb overuse injury among athletes and dancers. The purpose of the study was twofold: 1) to determine whether abnormal foot alignment is positively correlated with a previous diagnosis of MTSS and 2) to assess the interrater reliability of the proposed methods. We therefore studied foot alignment retrospectively both qualitatively and quantitatively in both a closed and open kinetic chain manner. The specific measures evaluated were: 1) standing foot angle (SFA), 2) nonweight-bearing hindfoot angle, and 3) nonweight-bearing forefoot angle. Qualitative parameters were used for the non weight-bearing measures along the continuum: varus-neutral-valgus. The authors made their measurements independently and were blinded to the previous authors results. Case limbs (as defined as the symptomatic limb in a subject with the diagnosis of MTSS) were found to have a SFA < controls (P = 0.0001). Case limbs also tended towards having a higher incidence of hindfoot (P = 0.017) as well as forefoot (P = 0.08) varus alignment. We found that a SFA of < 140 degrees and a varus alignment of the hindfoot and/or forefoot, were predictive of a previous history of MTSS. These methods were found to be reliable and can be performed in an office setting without any special equipment.
本研究回顾了胫骨内侧应力综合征（MTSS）的评估，这是运动员和舞者中常见的下肢过度使用损伤。该研究的目的有两个：1）确定足部异常排列是否与先前诊断的MTSS呈正相关；2）评估所提出方法的评分者间信度。因此，我们以闭合和开放动力链方式对足部排列进行了回顾性的定性和定量研究。评估的具体测量指标为：1）站立足角（SFA）；2）非负重时后足角；3）非负重时前足角。对于非负重测量，沿着内翻-中立-外翻连续统一体使用定性参数。作者独立进行测量，且对先前作者的结果不知情。发现病例肢体（定义为诊断为MTSS的受试者中的症状肢体）的SFA < 对照组（P = 0.0001）。病例肢体后足（P = 0.017）以及前足（P = 0.08）内翻排列的发生率也往往更高。我们发现，SFA < 140度以及后足和/或前足内翻排列可预测MTSS的既往病史。这些方法被发现是可靠的，并且可以在办公室环境中进行，无需任何特殊设备。
