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Performance on the Single-Leg Squat Task Indicates Hip Abductor Muscle Function
Abstract
Background: Contemporary clinical expertise and emerging research in anterior knee pain indicate that treatment of hip muscle function will result in greater effects, if such treatments can be provided to those with hip muscle dysfunction. Thus, it is imperative to develop and evaluate a clinical assessment tool that is capable of identifying people with poor hip muscle function. Hypothesis: The clinical assessment of single-leg squat performance will have acceptable inter- and intrarater reliability. Furthermore, people with good performance on the single-leg squat will have better hip muscle function (earlier onset of gluteus medius activity and greater lateral trunk, hip abduction, and external rotation strength) than people with poor performance. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A consensus panel of 5 experienced clinicians developed criteria to rate the performance of a single-leg squat task as “good,” “fair,” or “poor.” The panel rated the performance of 34 asymptomatic participants (mean ± SD: age, 24 ± 5 y; height, 1.69 ± 0.10 m; weight, 65.0 ± 10.7 kg), and these ratings served as the standard. The ratings of 3 different clinicians were compared with those of the consensus panel ratings (interrater reliability) and to their own rating on 2 occasions (intrarater reliability). For the participants rated as good performers (n = 9) and poor performers (n = 12), hip muscle strength (hip abduction, external rotation, and trunk side bridge) and onset timing of anterior (AGM) and posterior gluteus medius (PGM) electromyographic activity were compared. Results: Concurrency with the consensus panel was excellent to substantial for the 3 raters (agreement 87%-73%; κ = 0.800-0.600). Similarly, intrarater agreement was excellent to substantial (agreement 87%-73%; κ = 0.800-0.613). Participants rated as good performers had significantly earlier onset timing of AGM (mean difference, –152; 95% confidence interval [CI], –258 to –48 ms) and PGM (mean difference, –115; 95% CI, –227 to –3 ms) electromyographic activity than those who were rated as poor performers. The good performers also exhibited greater hip abduction torque (mean difference, 0.47; 95% CI, 0.10-0.83 N·m·Bw −1 ) and trunk side flexion force (mean difference, 1.08; 95% CI, 0.25-1.91 N·Bw −1 ). There was no difference in hip external rotation torque ( P > .05) between the 2 groups. Conclusion: Targeted treatments, although considered ideal, rely on the capacity to identify subgroups of people with chronic anterior knee pain who might respond optimally to a given treatment component. Clinical assessment of performance on the single-leg squat task is a reliable tool that may be used to identify people with hip muscle dysfunction.
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“An equivalent approach was adopted by Crossley and colleagues, 11 who reported excellent interrater agreement (80-87% k ¼ 0.700-0.800) for similarly qualified physiotherapists.”
From Lower-Limb Kinematics of Single-Leg Squat Performance in Young Adults (2014) · cites this paper as [11]
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“Commensurate with previous investigations, 1,11-13 and to most closely resemble clinical practice, squat depth was not standardized.”
From Lower-Limb Kinematics of Single-Leg Squat Performance in Young Adults (2014) · cites this paper as [11]
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Metadata
- Authors
- Crossley, K. M., Zhang, W.-J., Schache, A. G., Bryant, A., & Cowan, S. M.
- Affiliations
- The University of Melbourne (AU)
- Venue
- The American Journal of Sports Medicine
- Publisher
- SAGE Publications
- Published
- 2011-02-18
- Volume
- 39
- Issue
- 4
- Pages
- 866-873
- ISSN
- 0363-5465 (ISSN-L)
- 1552-3365
- OpenAlex
- W1993627110
- Cited by
- 360
- References
- 36
- Citations by year
- 2026: 14 · 2025: 19 · 2024: 30 · 2023: 18 · 2022: 22 · 2021: 22 · 2020: 19 · 2019: 32 · 2018: 33 · 2017: 23 · 2016: 27 · 2015: 29 · 2014: 30 · 2013: 18 · 2012: 19
- FWCI
- 13.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Health Sciences › Medicine › Surgery › Hip disorders and treatments
- Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
- Keywords
- single-leg squat, gluteus medius, hip abductor strength, hip external rotation strength, anterior knee pain, inter-rater reliability, intra-rater reliability, clinical assessment tools, electromyography, hip muscle strength, trunk lateral flexion
- MeSH terms
- Adult, Exercise Test, Female, Hip Joint, Humans, Male, Muscular Diseases, Task Performance and Analysis, Reproducibility of Results, Cohort Studies, Muscle, Skeletal, Muscle Strength, Young Adult
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