PDF(Pubmed)
Abstract：
BACKGROUND: Pain provocation tests are recommended for assessing pain severity and as an outcome measure for individuals with patellar tendinopathy.
OBJECTIVE: To evaluate floor and ceiling effects, sensitivity to change, and responsiveness cut-offs of two provocative load tests among athletes with patellar tendinopathy.
METHODS: Athletes (N = 41) performed six repetitions for the single leg decline squat (SLDS) and resisted knee extension (KE) at baseline and 12 weeks. Participants rated their pain during each test on a visual analog scale (VAS). Sensitivity to change was assessed by calculating effect size (ES) and the standardized response mean (SRM). The responsiveness cut-offs were assessed using a combination of anchor and distribution- based methods to determine the minimal clinically important difference (MCID) for each test.
RESULTS: A floor or ceiling effect was observed in only a small number of participants for both tests except for KE, for which approximately one third of participants had a floor effect at week 12. There was higher sensitivity to change for SLDS (ES: 1.93/SRM: 1.43) compared with KE (ES:0.96/SRM: 1.09). The MCID corresponded to a decrease of 1.6 points for SLDS and 1.0 for KE, while the distribution-based method estimated 1.2 points for SLDS and 1.1 for KE.
CONCLUSIONS: This study found moderate to high sensitivity to change and established MCID values for the SLDS and KE test in athletes with patellar tendinopathy before and after rehabilitation. Both tests may be useful as pain on loading outcomes as athletes progress with their rehabilitation, but the KE test results in higher floor effects and has lower sensitivity to change.
OBJECTIVE: To evaluate floor and ceiling effects, sensitivity to change, and responsiveness cut-offs of two provocative load tests among athletes with patellar tendinopathy.
METHODS: Athletes (N = 41) performed six repetitions for the single leg decline squat (SLDS) and resisted knee extension (KE) at baseline and 12 weeks. Participants rated their pain during each test on a visual analog scale (VAS). Sensitivity to change was assessed by calculating effect size (ES) and the standardized response mean (SRM). The responsiveness cut-offs were assessed using a combination of anchor and distribution- based methods to determine the minimal clinically important difference (MCID) for each test.
RESULTS: A floor or ceiling effect was observed in only a small number of participants for both tests except for KE, for which approximately one third of participants had a floor effect at week 12. There was higher sensitivity to change for SLDS (ES: 1.93/SRM: 1.43) compared with KE (ES:0.96/SRM: 1.09). The MCID corresponded to a decrease of 1.6 points for SLDS and 1.0 for KE, while the distribution-based method estimated 1.2 points for SLDS and 1.1 for KE.
CONCLUSIONS: This study found moderate to high sensitivity to change and established MCID values for the SLDS and KE test in athletes with patellar tendinopathy before and after rehabilitation. Both tests may be useful as pain on loading outcomes as athletes progress with their rehabilitation, but the KE test results in higher floor effects and has lower sensitivity to change.
摘要：
背景：疼痛激发试验被推荐用于评估疼痛严重程度，并作为髌腱病患者的预后指标。
目的：为了评估地板和天花板的影响，对变化的敏感性,以及髌骨肌腱病运动员两次挑衅性负荷试验的反应性截止。
方法：运动员（N=41）在基线和12周时进行了六次重复单腿下蹲（SLDS）和抵抗膝盖伸展（KE）。参与者在视觉模拟量表（VAS）上对每次测试中的疼痛进行评分。通过计算效应大小（ES）和标准化反应平均值（SRM）来评估对变化的敏感性。使用锚定和基于分布的方法的组合来评估响应性截止值,以确定每个测试的最小临床重要差异(MCID)。
结果：除KE外，两项测试仅在少数参与者中观察到地板或天花板效应，大约三分之一的参与者在第12周出现最低效应。与KE（ES：0.96/SRM：1.09）相比，SLDS（ES：1.93/SRM：1.43）对变化的敏感性更高。MCID对应于SLDS下降1.6点，KE下降1.0点，而基于分布的方法为SLDS估计了1.2点，为KE估计了1.1点。
结论：这项研究发现，在患有髌腱病的运动员康复前后，对SLDS和KE测试的变化和建立的MCID值具有中等至高度的敏感性。这两种测试都可能是有用的，因为随着运动员康复的进展，对负荷结果的疼痛，但KE测试结果在较高的地板效应和变化的敏感性较低。
目的：为了评估地板和天花板的影响，对变化的敏感性,以及髌骨肌腱病运动员两次挑衅性负荷试验的反应性截止。
方法：运动员（N=41）在基线和12周时进行了六次重复单腿下蹲（SLDS）和抵抗膝盖伸展（KE）。参与者在视觉模拟量表（VAS）上对每次测试中的疼痛进行评分。通过计算效应大小（ES）和标准化反应平均值（SRM）来评估对变化的敏感性。使用锚定和基于分布的方法的组合来评估响应性截止值,以确定每个测试的最小临床重要差异(MCID)。
结果：除KE外，两项测试仅在少数参与者中观察到地板或天花板效应，大约三分之一的参与者在第12周出现最低效应。与KE（ES：0.96/SRM：1.09）相比，SLDS（ES：1.93/SRM：1.43）对变化的敏感性更高。MCID对应于SLDS下降1.6点，KE下降1.0点，而基于分布的方法为SLDS估计了1.2点，为KE估计了1.1点。
结论：这项研究发现，在患有髌腱病的运动员康复前后，对SLDS和KE测试的变化和建立的MCID值具有中等至高度的敏感性。这两种测试都可能是有用的，因为随着运动员康复的进展，对负荷结果的疼痛，但KE测试结果在较高的地板效应和变化的敏感性较低。
