Strength Testing with the Single Leg Wall Hold Test

assessment Feb 15, 2018

Why Is Quadriceps Strength Important?

The Quadriceps has been shown to be one of the most important muscle groups in upright human function with a lack of strength in this muscle been shown to increase the risk of ACL injury, reduced running performance, and association with falls in the elderly. 

Being able to objectively assess muscle strength in the Quadriceps is therefore important for many health and fitness professionals to help prevent injury and enhance performance. 

How To Assess Quadriceps Strength?

A Single-Leg Wall Hold test is a functional performance test that looks at the capacity of the knee to bear load as well as the endurance strength of the surrounding musculature, primarily recruiting the Quadriceps muscle (Kim et al 2019).

  1. The client is positioned up against a wall and adopts a position of either 90° (more challenging) or 45° (less challenging) of knee and hip flexion. This can be measured and standardized by placing an inclinometer on the front of the thigh.
  2. Hands are placed on hips to standardize arm position and the opposite foot is lifted off the floor.
  3. Cue the client to remain in this position for as long as possible. Failure is when the client cannot continue any longer or puts their opposite foot down. 
  4. Measure the time each side and compare from side to side.

Why Use A Single-Leg Wall Hold Test As An Exercise?

While it can be used as a test, the Single Leg Wall Hold/squat is a very useful clinical exercise and along with other weight-bearing exercises that are similar because it has been shown in patients suffering from Patellofemoral pain syndrome (PFPS) that is has helped “patients to recover faster and return to function earlier” (Escamilla et al 2009).

Some of the highlights from the study include:

  • “PCL tensile force was lower and ACL tensile force was higher in the one leg squat and wall squat short compared to the wall squat long” (Escamilla. R, 2009).
  • “Low ACL tensile force was generated during the one leg squat between 0-40° knee flexion” making it useful for early stage ACL rehab programs (Escamilla. R, 2009).
  • “The use of weight-bearing exercises have been shown to be effective, both in short- and long-term outcomes, in decreasing PFPS and in enhancing functional performance” (Escamilla. R, 2009).

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