以兩個下肢負重測試測量健康女性腹部肌群之穩定能力

Stabilizing Ability of Abdominal Muscles as Measured by Two Leg Loading Tests in Healthy Female

廖麗君(Lih-Jiun Liaw) ； 吳汶蘭(Wen-Lan Wu) ； 郭藍遠(Lan-Yuen Guo)

《物理治療》 37卷4期 (2012/12) Pp. 297-308

摘要

Background and Purpose: One of the major functions of the abdominal muscles is to stabilize the spine, which prevents lumbar injuries and allows coordinated limb movements in sports and activities of daily living. Leg loading tests are frequently used to assess this stabilizing ability of the abdominal muscles. The purpose of this study was to describe the pelvic tilt motor control required to maintain lumbar stability as measured by two leg loading tests, abdominal muscle test (AMT) and double-leg-lowering test (DLLT), in healthy women. In addition, the intra-rater and inter-rater reliability were also determined. Methods: Thirty-five healthy women with mean age 22.6 years (between 18 and 34 years old) volunteered to participate in the study. A repeated measures re liability study was conducted by two teams o f two examiners, two students and two physical therapists. AII DLLT and AMT measurements were tested using a pressure bio-feedback unit placed beneath the low back to detect pelvic motion. The subjects were instructed and practiced to contract the abdominal muscles to maintain the pelvis in a posterior tilted position while performing the leg lowering in the two leg loading tests. The AMT is an ordinal scale with 4 levels, and the DLLT is also an ordinal scale with 6 scores. The correlation between AMT and DLLT performance were obtained using Spearman's rank correlation coefficient (rs). Spearman's correlation coefficient (rs) and weighted kappa (kw) were used to examine the level of agreement between two measurements for the two ordinal measures. Results: The median and mean values for AMT were 3 (2-4) and 3.1±0.5. Of the 35 healthy young female, most of them (28.80%) were grade 3. The median and mean values for DLLT were 8 (5-10) and 7.5±1.5. The number of subjects was distributed over the 6 grades of DLLT, ranged from 2 (5.7%) to 11 (31.4%). There was a high correlation between AMT and DLLT performance (rs=0.72, p＜0.001). Intrarater and inter-rater agreements were high for the AMT, with Spearman r (rs) values of 0.93 and 0.87; and with weighted kappa (kw) values of 0.92 and 0.84, indicating very good agreement. Intra-rater and inter-rater agreements were also high for the DLLT, with Spearman r (rs) values of 0.98 and 0.83: and with weighted kappa (kw) values of 0.95 and 0.80, indicating very good agreement. Conclusion: Although the AMT and DLLT were shown to high levels of intra-rater and inter-rater reliability in healthy women, we recommended the DLLT may be a useful tool to assess pelvic tilt control for spine stability in the healthy young women. The results of the lumbar stability measures, by using AMT and DLLT, in the healthy female provide reference data to enable comparison with clinical group.

關鍵字

腹部肌群穩定能力 ； 下肢負重測試 ； 腹肌測試 ； 雙腳下降測試 ； 信度

並列摘要

Background and Purpose: One of the major functions of the abdominal muscles is to stabilize the spine, which prevents lumbar injuries and allows coordinated limb movements in sports and activities of daily living. Leg loading tests are frequently used to assess this stabilizing ability of the abdominal muscles. The purpose of this study was to describe the pelvic tilt motor control required to maintain lumbar stability as measured by two leg loading tests, abdominal muscle test (AMT) and double-leg-lowering test (DLLT), in healthy women. In addition, the intra-rater and inter-rater reliability were also determined. Methods: Thirty-five healthy women with mean age 22.6 years (between 18 and 34 years old) volunteered to participate in the study. A repeated measures re liability study was conducted by two teams o f two examiners, two students and two physical therapists. AII DLLT and AMT measurements were tested using a pressure bio-feedback unit placed beneath the low back to detect pelvic motion. The subjects were instructed and practiced to contract the abdominal muscles to maintain the pelvis in a posterior tilted position while performing the leg lowering in the two leg loading tests. The AMT is an ordinal scale with 4 levels, and the DLLT is also an ordinal scale with 6 scores. The correlation between AMT and DLLT performance were obtained using Spearman's rank correlation coefficient (rs). Spearman's correlation coefficient (rs) and weighted kappa (kw) were used to examine the level of agreement between two measurements for the two ordinal measures. Results: The median and mean values for AMT were 3 (2-4) and 3.1±0.5. Of the 35 healthy young female, most of them (28.80%) were grade 3. The median and mean values for DLLT were 8 (5-10) and 7.5±1.5. The number of subjects was distributed over the 6 grades of DLLT, ranged from 2 (5.7%) to 11 (31.4%). There was a high correlation between AMT and DLLT performance (rs=0.72, p＜0.001). Intrarater and inter-rater agreements were high for the AMT, with Spearman r (rs) values of 0.93 and 0.87; and with weighted kappa (kw) values of 0.92 and 0.84, indicating very good agreement. Intra-rater and inter-rater agreements were also high for the DLLT, with Spearman r (rs) values of 0.98 and 0.83: and with weighted kappa (kw) values of 0.95 and 0.80, indicating very good agreement. Conclusion: Although the AMT and DLLT were shown to high levels of intra-rater and inter-rater reliability in healthy women, we recommended the DLLT may be a useful tool to assess pelvic tilt control for spine stability in the healthy young women. The results of the lumbar stability measures, by using AMT and DLLT, in the healthy female provide reference data to enable comparison with clinical group.

並列關鍵字

Stabilizing ability of abdominal muscles ； Leg loading test ； Abdominal muscle test ； Double-Ieg-Iowering test ； Reliability