Harrison E L, Duenkel N, Dunlop R, Russell G
School of Physical Therapy, University of Saskatchewan, Saskatoon, Canada.
Phys Ther. 1994 Mar;74(3):245-52. doi: 10.1093/ptj/74.3.245.
Although surgical reconstruction of the anterior cruciate ligament (ACL) is commonly performed to increase stability of the knee, persistent changes in neuromuscular function have frequently been cited as contributing to disability. This study investigated single-leg standing balance in a sample of patients 10 to 18 months following reconstructive ACL surgery. In addition, the effect of leg dominance on standing balance was analyzed in a sample of subjects without knee injury. The validity and interrater reliability of a clinical method of measuring balance using observation were also determined.
Seventy-eight subjects without knee injury and 17 patients following ACL surgery participated in the study after they had been screened for balance disorders.
Postural sway measurements were recorded during single-leg standing with the subjects' eyes open and closed. Simultaneously, two physical therapists graded each subject's performance using a simple ordinal scale.
No differences were found between the dominant and nondominant legs of the subjects without knee injury or between the involved and noninvolved legs of the patients who had undergone ACL surgery. The interrater reliability was high, but limited concurrent validity was found.
The findings suggest that single-leg standing balance can be reliably evaluated by physical therapists. The single-leg standing balance test, however, may not provide information that assists clinicians in determining clinical change or functional level for patients following rehabilitation for ACL surgery.
尽管前交叉韧带（ACL）重建手术常用于增强膝关节稳定性，但神经肌肉功能的持续改变常被认为是导致功能障碍的原因。本研究调查了ACL重建手术后10至18个月患者样本的单腿站立平衡情况。此外，还分析了在无膝关节损伤的受试者样本中，腿的优势对站立平衡的影响。同时还确定了一种通过观察测量平衡的临床方法的有效性和评分者间信度。
78名无膝关节损伤的受试者和17名ACL手术后患者在经过平衡障碍筛查后参与了本研究。
在受试者单腿站立且眼睛睁开和闭合时记录姿势摆动测量值。同时，两名物理治疗师使用简单的序数量表对每个受试者的表现进行评分。
在无膝关节损伤的受试者中，优势腿和非优势腿之间以及ACL手术患者的患侧腿和未患侧腿之间均未发现差异。评分者间信度较高，但发现同时效度有限。
研究结果表明，物理治疗师可以可靠地评估单腿站立平衡。然而，单腿站立平衡测试可能无法为临床医生提供有助于确定ACL手术后康复患者的临床变化或功能水平的信息。
