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Published in: BMC Musculoskeletal Disorders 1/2017

Open Access 01-12-2017 | Research article

Single leg squat performance in physically and non-physically active individuals: a cross-sectional study

Authors: Silvia Gianola, Greta Castellini, Elena Stucovitz, Alice Nardo, Giuseppe Banfi

Published in: BMC Musculoskeletal Disorders | Issue 1/2017

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Abstract

Background

Single-leg squat (SLS) is a functional test visually rated by clinicians for assessing lower limb function as a preventive injury strategy. SLS clinical rating is a qualitative evaluation and it does not count objective outcomes as kinematics data and surface electromyography (sEMG) assessment. Based on the SLS rating, the aims of this study were (i) to determine the clinical rating agreement among six raters and (ii) to assess kinematic and sEMG predictors of good SLS performance in physically and non-physically active individuals.

Methods

Seventy-two healthy adults, divided in physically active and non-physically active groups, performed three SLSs on their dominant leg. Clinical ratings, kinematic data and sEMG were acquired. By using a validated clinical scale, six expert clinicians rated each SLS watching a video at three different time points. Intra and inter-rater agreement of clinical ratings were undertaken and a binary logistic regression analysis was used to determine kinematic and sEMG as predictors of SLS performance.

Results

The weighted kappa coefficient for intra-rater reliability within each rater ranged between moderate and almost perfect agreement (0.55–0.85) whereas the weighted kappa coefficient for inter-rater reliability among raters was fair (0.34, time point 0; 0.31, time point 1; 0.30, time point 2). SLS analyses of physically active compared to non-physically active group showed a statistically significant difference in knee flexion and hip flexion (p = 0.041 and p = 0.023 respectively) and no difference in clinical ratings (p = 0.081). Greater knee flexion can predict the good SLS performance taking into account the belonging group (p = 0.019).

Conclusions

Physically active individuals seemed to be at less risk to perform a non-good SLS and they had greater knee and hip flexions kinematics than non-physically active individuals. Knee flexion can predict the SLS performance quality therefore a greater knee flexion might also be considered a protective element from injuries.

Trial registration

ClinicalTrials.​gov identifier (trial has been registred retrospectively: NCT03203083. Date registration: June 21, 2017.
Appendix
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Literature
1.
go back to reference Leetun DT, Ireland ML, Willson JD, Ballantyne BT, Davis IM. Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exerc. 2004;36:926–34.CrossRefPubMed Leetun DT, Ireland ML, Willson JD, Ballantyne BT, Davis IM. Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exerc. 2004;36:926–34.CrossRefPubMed
2.
go back to reference Weeks BK, Carty CP, Horan SA. Kinematic predictors of single-leg squat performance: a comparison of experienced physiotherapists and student physiotherapists. BMC Musculoskelet Disord. 2012;13:207.CrossRefPubMedPubMedCentral Weeks BK, Carty CP, Horan SA. Kinematic predictors of single-leg squat performance: a comparison of experienced physiotherapists and student physiotherapists. BMC Musculoskelet Disord. 2012;13:207.CrossRefPubMedPubMedCentral
3.
go back to reference Hewett TE, Myer GD. The mechanistic connection between the trunk, hip, knee, and anterior cruciate ligament injury. Exerc Sport Sci Rev. 2011;39:161–6.PubMedPubMedCentral Hewett TE, Myer GD. The mechanistic connection between the trunk, hip, knee, and anterior cruciate ligament injury. Exerc Sport Sci Rev. 2011;39:161–6.PubMedPubMedCentral
4.
go back to reference Fredericson M, Cookingham CL, Chaudhari AM, Dowdell BC, Oestreicher N, Sahrmann SA. Hip abductor weakness in distance runners with iliotibial band syndrome. Clin J Sport Med. 2000;10:169–75.CrossRefPubMed Fredericson M, Cookingham CL, Chaudhari AM, Dowdell BC, Oestreicher N, Sahrmann SA. Hip abductor weakness in distance runners with iliotibial band syndrome. Clin J Sport Med. 2000;10:169–75.CrossRefPubMed
5.
go back to reference Ireland ML, Willson JD, Ballantyne BT, Davis IM. Hip strength in females with and without patellofemoral pain. J Orthop Sports Phys Ther. 2003;33:671–6.CrossRefPubMed Ireland ML, Willson JD, Ballantyne BT, Davis IM. Hip strength in females with and without patellofemoral pain. J Orthop Sports Phys Ther. 2003;33:671–6.CrossRefPubMed
6.
go back to reference Shirey M, Hurlbutt M, Johansen N, King GW, Wilkinson SG, Hoover DL. The influence of core musculature engagement on hip and knee kinematics in women during a single leg squat. Int J Sports Phys Ther. 2012;7:1–12.PubMedPubMedCentral Shirey M, Hurlbutt M, Johansen N, King GW, Wilkinson SG, Hoover DL. The influence of core musculature engagement on hip and knee kinematics in women during a single leg squat. Int J Sports Phys Ther. 2012;7:1–12.PubMedPubMedCentral
7.
go back to reference Bailey R, Selfe J, Richards J. The single leg squat test in the assessment of musculoskeletal function: a review. Physiotherapy Ireland. 2010;31 Bailey R, Selfe J, Richards J. The single leg squat test in the assessment of musculoskeletal function: a review. Physiotherapy Ireland. 2010;31
8.
go back to reference DiMattia MA, Livengood AL, Uhl TL, Mattacola CG, Malone TR. What are the validity of the single leg squat and its relationship to hip abduction strength. J Sport Rehabil. 2005;14:108–23.CrossRef DiMattia MA, Livengood AL, Uhl TL, Mattacola CG, Malone TR. What are the validity of the single leg squat and its relationship to hip abduction strength. J Sport Rehabil. 2005;14:108–23.CrossRef
9.
go back to reference Crossley KM, Zhang WJ, Schache AG, Bryant A, Cowan SM. Performance on the single-leg squat task indicates hip abductor muscle function. Am J Sports Med. 2011;39:866–73.CrossRefPubMed Crossley KM, Zhang WJ, Schache AG, Bryant A, Cowan SM. Performance on the single-leg squat task indicates hip abductor muscle function. Am J Sports Med. 2011;39:866–73.CrossRefPubMed
10.
go back to reference Chmielewski TL, Hodges MJ, Horodyski M, Bishop MD, Conrad BP, Tillman SM. Investigation of clinician agreement in evaluating movement quality during unilateral lower extremity functional tasks: a comparison of 2 rating methods. J Orthop Sports Phys Ther. 2007;37:122–9.CrossRefPubMed Chmielewski TL, Hodges MJ, Horodyski M, Bishop MD, Conrad BP, Tillman SM. Investigation of clinician agreement in evaluating movement quality during unilateral lower extremity functional tasks: a comparison of 2 rating methods. J Orthop Sports Phys Ther. 2007;37:122–9.CrossRefPubMed
11.
go back to reference Poulsen DR, James CR. Concurrent validity and reliability of clinical evaluation of the single leg squat. Physiother Theory Pract. 2011;27:586–94.CrossRefPubMed Poulsen DR, James CR. Concurrent validity and reliability of clinical evaluation of the single leg squat. Physiother Theory Pract. 2011;27:586–94.CrossRefPubMed
12.
go back to reference Ugalde V, Brockman C, Bailowitz Z, Pollard CD. Single leg squat test and its relationship to dynamic knee valgus and injury risk screening. PM R. 2015;7:229–35. quiz 235CrossRefPubMed Ugalde V, Brockman C, Bailowitz Z, Pollard CD. Single leg squat test and its relationship to dynamic knee valgus and injury risk screening. PM R. 2015;7:229–35. quiz 235CrossRefPubMed
13.
go back to reference Stensrud S, Myklebust G, Kristianslund E, Bahr R, Krosshaug T. Correlation between two-dimensional video analysis and subjective assessment in evaluating knee control among elite female team handball players. Br J Sports Med. 2011;45:589–95.CrossRefPubMed Stensrud S, Myklebust G, Kristianslund E, Bahr R, Krosshaug T. Correlation between two-dimensional video analysis and subjective assessment in evaluating knee control among elite female team handball players. Br J Sports Med. 2011;45:589–95.CrossRefPubMed
14.
go back to reference Alenezi F, Herrington L, Jones P, Jones R. The reliability of biomechanical variables collected during single leg squat and landing tasks. J Electromyogr Kinesiol. 2014;24:718–21.CrossRefPubMed Alenezi F, Herrington L, Jones P, Jones R. The reliability of biomechanical variables collected during single leg squat and landing tasks. J Electromyogr Kinesiol. 2014;24:718–21.CrossRefPubMed
15.
go back to reference Horan SA, Watson SL, Carty CP, Sartori M, Weeks BK. Lower-limb kinematics of single-leg squat performance in young adults. Physiother Can. 2014;66:228–33.CrossRefPubMedPubMedCentral Horan SA, Watson SL, Carty CP, Sartori M, Weeks BK. Lower-limb kinematics of single-leg squat performance in young adults. Physiother Can. 2014;66:228–33.CrossRefPubMedPubMedCentral
16.
go back to reference Nakagawa TH, Maciel CD, Serrao FV. Trunk biomechanics and its association with hip and knee kinematics in patients with and without patellofemoral pain. Man Ther. 2015;20:189–93.CrossRefPubMed Nakagawa TH, Maciel CD, Serrao FV. Trunk biomechanics and its association with hip and knee kinematics in patients with and without patellofemoral pain. Man Ther. 2015;20:189–93.CrossRefPubMed
17.
go back to reference Hopper LS, Sato N, Weidemann AL. Single-leg squats can predict leg alignment in dancers performing ballet movements in “turnout”. Open Access J Sports Med. 2016;7:161–6.CrossRefPubMedPubMedCentral Hopper LS, Sato N, Weidemann AL. Single-leg squats can predict leg alignment in dancers performing ballet movements in “turnout”. Open Access J Sports Med. 2016;7:161–6.CrossRefPubMedPubMedCentral
18.
go back to reference Claiborne TL, Armstrong CW, Gandhi V, Pincivero DM. Relationship between hip and knee strength and knee valgus during a single leg squat. J Appl Biomech. 2006;22:41–50.CrossRefPubMed Claiborne TL, Armstrong CW, Gandhi V, Pincivero DM. Relationship between hip and knee strength and knee valgus during a single leg squat. J Appl Biomech. 2006;22:41–50.CrossRefPubMed
19.
go back to reference Nguyen AD, Shultz SJ, Schmitz RJ, Luecht RM, Perrin DH. A preliminary multifactorial approach describing the relationships among lower extremity alignment, hip muscle activation, and lower extremity joint excursion. J Athl Train. 2011;46:246–56.CrossRefPubMedPubMedCentral Nguyen AD, Shultz SJ, Schmitz RJ, Luecht RM, Perrin DH. A preliminary multifactorial approach describing the relationships among lower extremity alignment, hip muscle activation, and lower extremity joint excursion. J Athl Train. 2011;46:246–56.CrossRefPubMedPubMedCentral
21.
go back to reference Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports Med. 2006;36:189–98.CrossRefPubMed Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports Med. 2006;36:189–98.CrossRefPubMed
22.
go back to reference von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007;4:e296.CrossRef von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007;4:e296.CrossRef
23.
go back to reference NCSS. PASS, power analysis and sample size. UT: Kaysville; 2008. NCSS. PASS, power analysis and sample size. UT: Kaysville; 2008.
24.
go back to reference D'Ercole S, Tieri M, Martinelli D, Tripodi D. The effect of swimming on oral health status: competitive versus non-competitive athletes. J Appl Oral Sci. 2016;24:107–13.CrossRefPubMedPubMedCentral D'Ercole S, Tieri M, Martinelli D, Tripodi D. The effect of swimming on oral health status: competitive versus non-competitive athletes. J Appl Oral Sci. 2016;24:107–13.CrossRefPubMedPubMedCentral
25.
go back to reference Zeller BL, McCrory JL, Kibler WB, Uhl TL. Differences in kinematics and electromyographic activity between men and women during the single-legged squat. Am J Sports Med. 2003;31:449–56.PubMed Zeller BL, McCrory JL, Kibler WB, Uhl TL. Differences in kinematics and electromyographic activity between men and women during the single-legged squat. Am J Sports Med. 2003;31:449–56.PubMed
26.
go back to reference Davis RB, Ounpuu S, Tyburski D, Gage JR. A gait analysis data collection and reduction technique. Hum Mov Sci. 1991;10:575–87.CrossRef Davis RB, Ounpuu S, Tyburski D, Gage JR. A gait analysis data collection and reduction technique. Hum Mov Sci. 1991;10:575–87.CrossRef
27.
go back to reference NORMAN. G. R, L. SD: Biostatistics: the bare essentials. St. Louis, Mosby.; 1994. NORMAN. G. R, L. SD: Biostatistics: the bare essentials. St. Louis, Mosby.; 1994.
29.
go back to reference Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74.CrossRefPubMed Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74.CrossRefPubMed
30.
go back to reference Watkins Pa: Foundations of clinical research: Applications to practice. 3rd edn edn: Upper Saddle River, NJ, Pearson/Prentice Ha; 2009. Watkins Pa: Foundations of clinical research: Applications to practice. 3rd edn edn: Upper Saddle River, NJ, Pearson/Prentice Ha; 2009.
31.
go back to reference Watkins Pa: Foundations of Clinical Research: Applications to Practice 3rd edition edn: prentice hall; 2009. Watkins Pa: Foundations of Clinical Research: Applications to Practice 3rd edition edn: prentice hall; 2009.
32.
go back to reference Sim J, Wright CC. The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther. 2005;85:257–68.PubMed Sim J, Wright CC. The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther. 2005;85:257–68.PubMed
33.
go back to reference Ageberg E, Bennell KL, Hunt MA, Simic M, Roos EM, Creaby MW. Validity and inter-rater reliability of medio-lateral knee motion observed during a single-limb mini squat. BMC Musculoskelet Disord. 2010;11:265.CrossRefPubMedPubMedCentral Ageberg E, Bennell KL, Hunt MA, Simic M, Roos EM, Creaby MW. Validity and inter-rater reliability of medio-lateral knee motion observed during a single-limb mini squat. BMC Musculoskelet Disord. 2010;11:265.CrossRefPubMedPubMedCentral
34.
35.
go back to reference Donohue MR, Ellis SM, Heinbaugh EM, Stephenson ML, Zhu Q, Dai B. Differences and correlations in knee and hip mechanics during single-leg landing, single-leg squat, double-leg landing, and double-leg squat tasks. Res Sports Med. 2015;23:394–411.CrossRefPubMed Donohue MR, Ellis SM, Heinbaugh EM, Stephenson ML, Zhu Q, Dai B. Differences and correlations in knee and hip mechanics during single-leg landing, single-leg squat, double-leg landing, and double-leg squat tasks. Res Sports Med. 2015;23:394–411.CrossRefPubMed
Metadata
Title
Single leg squat performance in physically and non-physically active individuals: a cross-sectional study
Authors
Silvia Gianola
Greta Castellini
Elena Stucovitz
Alice Nardo
Giuseppe Banfi
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2017
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-017-1660-8

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