前十字韧带损伤患者使用 ForceFrame 测力计的有效性、一致性和可靠性。

IF 1.6 Q3 SPORT SCIENCES
International Journal of Sports Physical Therapy Pub Date : 2024-09-01 eCollection Date: 2024-01-01 DOI:10.26603/001c.122486
Kamilla Arp, Thomas Frydendal, Troels Kjeldsen, Ulrik Dalgas, Signe Timm, Bjarke Viberg, Kim Ingwersen, Claus Varnum
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引用次数: 0

摘要

背景:前交叉韧带(ACL)损伤和前交叉韧带重建后,恢复膝关节伸肌(KE)和屈肌(KF)的最大肌力对于降低前交叉韧带重建后的再次损伤率和减少膝关节骨性关节炎的风险非常重要。目的:评估ForceFrame(FF)测力计在膝关节伸肌和屈肌等长测试中的可靠性(重复测试可靠性、测试者间可靠性和重复测试一致性)和有效性(并发有效性、收敛有效性和ForceFrame(FF)与等动测力计(ID)的一致性):研究设计:横断面研究:本研究招募了 27 名前交叉韧带损伤或重建的参与者。在两天内分别对膝关节伸肌和屈肌的最大自主等长收缩(MVIC)进行测试。第一天包括使用 FF、黄金标准 ID 和手持式测力计(HHD)进行有效性评估。第二天包括由两名评估员使用 FF 进行可靠性评估。主要结果指标是 FF 的日间重复测试可靠性、一致性和测试者之间的可靠性,以及并发有效性(FF 与 ID 和 HHD 的对比)。信度采用类间相关系数(ICC)测试重测信度和测试者之间的信度,而一致性则采用布兰德和阿尔特曼图(Bland & Altman plots)测试,图中包含一致性限值(LOA)、测量标准误差(SEM)和可检测到的最小变化(SDC)。FF、ID和HHD之间的并发效度采用皮尔逊相关性进行评估,平均差采用布兰德和阿尔特曼图进行评估:本研究共纳入 27 名参与者(10 名女性,17 名男性),中位年龄为 25 岁(19-60 岁不等)。KE的MVIC(ICC=0.77,CI95:0.48-0.90)和KF(ICC=0.83,CI95:0.61-0.92)的日常测试-重复测试可靠性良好,KE的MVIC(ICC=0.97,CI95:0.94-0.98)和KF(ICC=0.93,95CI:0.85-0.97)的测试者间可靠性极佳。KE和KF的测量标准误差(SEM)分别为8%和9%,而可检测到的最小变化(SDC)分别为22%和27%。与 ID 相比,FF 对 KE 的并发有效性较好(r=0.56),对膝关节屈肌(KF)的并发有效性较差(r=0.24),与 HHD 相比,KE 的相关性中等(r=0.74),KF 的相关性较差(r=0.12)。FF和ID之间的Bland & Altman图显示,KE的平均差异为-0.51牛米/公斤,KF的平均差异为-0.32牛米/公斤:FF可用于获得可靠有效的结果,以评估KE的MVIC,但不能用于KF。应该注意的是,FF 得出的绝对结果可能被认为低估了实际 MVIC。在 FF 中评估 KF 的测试位置似乎不是最佳的,可以考虑不同的测试位置:证据等级:3 级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Validity, Agreement and Reliability of the ForceFrame Dynamometer in Patients with Anterior Cruciate Ligament Injury.

Background: Restoring maximal muscle strength of the knee extensors (KE) and knee flexors (KF) following anterior cruciate ligament (ACL) injury and ACL reconstruction is of great importance to reduce the re-injury rate after ACL reconstruction and to reduce the risk of knee osteoarthritis. Therefore, it is essential that clinicians and healthcare providers use valid and reliable measures to assess knee muscle strength to ensure a safe return to sport.

Purpose: To evaluate the reliability (test-retest reliability, inter-tester reliability and test-retest agreement) and validity (concurrent validity, convergent validity and ForceFrame (FF) vs. isokinetic dynamometer (ID) agreement) of the ForceFrame (FF) dynamometer during isometric testing of the knee extensors and flexors.

Study design: Cross-sectional study.

Material and methods: Twenty-seven participants with ACL injury or reconstruction were recruited for participation in this study. maximal voluntary isometric contration (MVIC) of the knee extensors and flexors was tested on two separate days. Day one included validity assessments with FF, a gold-standard ID and a handheld dynamometer (HHD). Day two included reliability assessments with FF performed by two assessors. Main outcome measures were day-to-day test-retest reliability and agreement and inter-tester reliability of FF, and concurrent validity (FF vs. an ID and a HHD). Reliability was tested as test-retest and inter-tester reliability using interclass correlation coefficient (ICC), while agreement was tested using Bland & Altman plots with limits of agreement (LOA), standard error of measurement (SEM) and smallest detectable change (SDC). Concurrent validity between FF, ID, and HHD was assessed using Pearson's correlations and mean difference was evaluated by Bland & Altman plots.

Results: Twenty-seven participants (10 females, 17 males) with a median age of 25 years (range 19-60) were included in this study. There was a good day-to-day test-retest reliability for MVIC of KE (ICC=0.77, CI95:0.48-0.90) and KF (ICC=0.83, CI95:0.61-0.92) and excellent inter-tester reliability for MVIC of KE (ICC=0.97, CI95:0.94-0.98) and KF (ICC=0.93, 95CI:0.85-0.97). Standard error of measurement (SEM) was 8% and 9%, while the smallest detectable change (SDC) was 22% and 27% for KE and KF, respectively. FF showed fair concurrent validity compared to ID for KE (r=0.56), poor concurrent validity for knee flexors (KF (r=0.24) and compared to HHD a moderate correlation for KE (r=0.74) and poor correlation for KF (r=0.12). Bland & Altman plots between FF and the ID showed a mean difference of -0.51 Nm/kg for KE and -0.32Nm/kg for KF.

Conclusions: FF can be used to obtain reliable and valid results to assess MVIC of the KE, but not the KF. It should be noted that absolute results produced by the FF may be considered an underestimation of actual MVIC. The test position to assess KF in FF does not appear to be optimal, and different test-positions may be considered.

Level of evidence: Level 3.

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来源期刊
CiteScore
2.50
自引率
5.90%
发文量
124
审稿时长
16 weeks
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