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Acar S, Aljumaa H, Şevik K, Karatosun V, Ünver B. The Intrarater and Interrater Reliability and Validity of Universal Goniometer, Digital Inclinometer, and Smartphone Application Measuring Range of Motion in Patients with Total Knee Arthroplasty. Indian J Orthop 2024; 58:732-739. [PMID: 38812867 PMCID: PMC11130096 DOI: 10.1007/s43465-024-01129-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/27/2024] [Indexed: 05/31/2024]
Abstract
Objectives The aim of this study was to investigate the intrarater and interrater reliability and validity of range of motion measurements obtained with a universal goniometer, digital inclinometer, and smartphone application in patients with total knee arthroplasty. Methods Range of motion of the knee joint was measured by two examiners with a universal goniometer, digital inclinometer, and a smartphone application. Data were obtained from 51 knees of 27 patients at postoperative 6 months. Two measurements made by the first examiner were compared to assess interrater reliability, and measurements from both examiners were compared to assess intrarater reliability. Statistical analysis was performed using intraclass correlation coefficient (ICC) and Spearman's rho values. Results With all three methods, active and passive knee flexion range of motion measurements showed high intrarater and interrater reliability (ICC = 0.749-0.949). Concurrent validity analysis also demonstrated statistically significant, moderate to strong correlation among the three methods (r = 0.775-0.941). Conclusion The universal goniometer, digital inclinometer, and smartphone application were all found to be reliable and valid assessment tools in clinical practice for patients with total knee arthroplasty.
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Affiliation(s)
- Serap Acar
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| | - Heba Aljumaa
- Physical Therapy and Rehabilitation, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - Kevser Şevik
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, İzmir Katip Çelebi University, Izmir, Turkey
| | - Vasfi Karatosun
- Department of Orthopedics and Traumatology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Bayram Ünver
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
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Ozlu O, Atilgan E. The effect of high-intensity laser therapy on pain and lower extremity function in patellofemoral pain syndrome: a single-blind randomized controlled trial. Lasers Med Sci 2024; 39:103. [PMID: 38630331 PMCID: PMC11024020 DOI: 10.1007/s10103-024-04017-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 02/07/2024] [Indexed: 04/19/2024]
Abstract
Patellofemoral pain syndrome (PFPS) is a set of symptoms that negatively affect the daily life activities of the individual, leading to functional disability and significant loss of labor, especially in young adults. PFPS is usually due to weakness of the vastus medialis obliquus (VMO) resulting in abnormal patellar tracking and pain. Our study aims to compare the efficacy of high-intensity laser therapy (HILT) on pain and lower extremity function in the treatment of PFPS with different electrophysical agents (EPAs). The study was designed as a single-blind randomized controlled trial. Forty-five people with PFPS (aged 25-45 years) were included in the study. The patients were randomly divided into three groups and a total of ten sessions of treatment were administered to all three groups for 2 weeks, 5 days a week. High-intensity laser (HILT) and exercise program were applied to group 1. Ultrasound (US), transcutaneous electrical nerve stimulation (TENS), and exercise program were applied to group 2. In group 3, US, interferential current (IFC), and exercise program were applied. Both groups underwent three evaluations: pre-treatment, post-treatment, and 12 weeks after treatment. Outcome measures included the visual analog scale for pain severity (VAS), knee flexion range of motion (FROM), Q angle, pain threshold, muscle strength of quadriceps and hamstring, Kujala patellofemoral scoring, lower extremity functional scale (LEFS), and Timed Up and Go Test (TUG). The ANOVA was used for comparing the data of the groups, and two-way repeated measure ANOVA was used to compare at the pre-post and post-intervention 3rd month. The LSD and Bonferroni post hoc tests were also used to identify the between-group differences. Groups 2 and 3 were statistically effective in pain and functionality (p < 0.05). Group 1 was found to be statistically more effective than other groups in reducing pain (95% confidence interval (CI), 0.000/0.000; p = 0.000), increasing knee flexion angle (95% CI, 127.524/135.809; p = 0.000), and increasing lower extremity function (95% CI, 75.970/79.362; p = 0.000). This study indicated that high-intensity laser therapy was found to be a more effective method in the treatment of patellofemoral pain syndrome after 3 months of follow-up compared to US-TENS combination and US-interferential current combination treatments. Also, HILT can be used as an effective method in combination with an appropriate exercise program including vastus medialis strengthening to reduce pain and increase functionality in the patients with PFPS.
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Affiliation(s)
- Ozge Ozlu
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Istanbul Medipol University, 34815, Istanbul, Turkey.
| | - Esra Atilgan
- Department of Orthotics and Prosthetic, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
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Helito CP, da Silva AGM, Sobrado MF, Guimarães TM, Gobbi RG, Pécora JR. Patients With More Than 6.5° of Knee Hyperextension are 14.6 Times More Likely to Have Anterior Cruciate Ligament Hamstring Graft Rupture and Worse Knee Stability and Functional Outcomes. Arthroscopy 2024; 40:898-907. [PMID: 37579954 DOI: 10.1016/j.arthro.2023.07.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/16/2023]
Abstract
PURPOSE To create a cut-off point for hyperextension that best discriminates retear and to verify whether this cut-off point can predict retear regardless of other characteristics after primary anterior cruciate ligament (ACL) reconstruction with hamstrings autograft. METHODS A cohort of patients submitted to primary isolated ACL reconstruction with hamstrings autografts was retrospectively evaluated. Patients were stratified according to the degree of passive knee hyperextension measured in the normal contralateral knee. The following data were collected: patient age and sex, time from injury to surgery, knee hyperextension, KT-1000 and pivot-shift, associated meniscus injury, intra-articular graft size, follow-up time, graft failure, and postoperative Lysholm and subjective International Knee Documentation Committee scores. RESULTS Data from 457 patients were evaluated. Median age was 31 years. Thirty-two (7.0%) presented with retear. There was a significant difference in hyperextension between patients with and without retear (P < .001), with the cut-off point established by the receiver operating characteristic curve from 6.5°. Patients with greater hyperextension had a statistically greater frequency of women, longer injury time, greater intra-articular graft diameter, greater postoperative KT-1000, and greater frequency of retear, whereas the subjective International Knee Documentation Committee and Lysholm scores were statistically lower in patients with greater hyperextension. Only hyperextension showed a statistically significant association with re-rupture (P < .001). The odds of retear in patients with hyperextension greater than 6.5 was 14.65 times the odds of patients with hyperextension less than 6.5. CONCLUSIONS Patients with more than 6.5° of hyperextension are 14.6 times more likely to have a graft rupture than patients with lower hyperextension when submitted to ACL reconstruction with hamstring tendons. Also, they present worse knee stability by the KT-1000 test and worse functional outcomes. Therefore, patients with this degree of hyperextension should not have isolated reconstruction with hamstrings as their first choice. LEVEL OF EVIDENCE Level III, retrospective comparative prognostic trial.
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Affiliation(s)
- Camilo Partezani Helito
- Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo - SP, Brazil; Hospital Sírio Libanês, São Paulo - SP, Brazil
| | - Andre Giardino Moreira da Silva
- Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo - SP, Brazil.
| | - Marcel Faraco Sobrado
- Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo - SP, Brazil; Hospital Sírio Libanês, São Paulo - SP, Brazil
| | - Tales Mollica Guimarães
- Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo - SP, Brazil
| | - Riccardo Gomes Gobbi
- Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo - SP, Brazil
| | - José Ricardo Pécora
- Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo - SP, Brazil
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Silva MDC, Woodward AP, Fearon AM, Perriman DM, Spencer TJ, Couldrick JM, Scarvell JM. Minimal clinically important change of knee flexion in people with knee osteoarthritis after non-surgical interventions using a meta-analytical approach. Syst Rev 2024; 13:50. [PMID: 38303000 PMCID: PMC10832130 DOI: 10.1186/s13643-023-02393-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/17/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Minimal clinically important change (MCIC) represents the minimum patient-perceived improvement in an outcome after treatment, in an individual or within a group over time. This study aimed to determine MCIC of knee flexion in people with knee OA after non-surgical interventions using a meta-analytical approach. METHODS Four databases (MEDLINE, Cochrane, Web of Science and CINAHL) were searched for studies of randomised clinical trials of non-surgical interventions with intervention duration of ≤ 3 months that reported change in (Δ) (mean change between baseline and immediately after the intervention) knee flexion with Δ pain or Δ function measured using tools that have established MCIC values. The risk of bias in the included studies was assessed using version 2 of the Cochrane risk-of-bias tool for randomised trials (RoB 2). Bayesian meta-analytic models were used to determine relationships between Δ flexion with Δ pain and Δ function after non-surgical interventions and MCIC of knee flexion. RESULTS Seventy-two studies (k = 72, n = 5174) were eligible. Meta-analyses included 140 intervention arms (k = 61, n = 4516) that reported Δ flexion with Δ pain using the visual analog scale (pain-VAS) and Δ function using the Western Ontario and McMaster Universities Osteoarthritis Index function subscale (function-WOMAC). Linear relationships between Δ pain at rest-VAS (0-100 mm) with Δ flexion were - 0.29 (- 0.44; - 0.15) (β: posterior median (CrI: credible interval)). Relationships between Δ pain during activity VAS and Δ flexion were - 0.29 (- 0.41, - 0.18), and Δ pain-general VAS and Δ flexion were - 0.33 (- 0.42, - 0.23). The relationship between Δ function-WOMAC (out of 100) and Δ flexion was - 0.15 (- 0.25, - 0.07). Increased Δ flexion was associated with decreased Δ pain-VAS and increased Δ function-WOMAC. The point estimates for MCIC of knee flexion ranged from 3.8 to 6.4°. CONCLUSIONS The estimated knee flexion MCIC values from this study are the first to be reported using a novel meta-analytical method. The novel meta-analytical method may be useful to estimate MCIC for other measures where anchor questions are problematic. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022323927.
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Affiliation(s)
- M Denika C Silva
- Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia.
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, Australia.
- Department of Physiotherapy, General Sir John Kotelawala Defence University, Werahera, Colombo, Sri Lanka.
| | - Andrew P Woodward
- Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia
| | - Angela M Fearon
- Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, Australia
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
| | - Diana M Perriman
- Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, Australia
- College of Medicine and Health Sciences, Australian National University, Canberra, Australia
| | - Trevor J Spencer
- Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, Australia
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
| | - Jacqui M Couldrick
- Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, Australia
| | - Jennie M Scarvell
- Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, Australia
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Iconaru EI, Tarcau E, Ciucurel C. The Influence of Weather Conditions on the Diurnal Variation in Range of Motion in Older Adults with Knee Osteoarthritis. J Clin Med 2024; 13:254. [PMID: 38202261 PMCID: PMC10780229 DOI: 10.3390/jcm13010254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/27/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
(1) Background: This study investigated the relationship between weather conditions, diurnal patterns, and total knee range of motion (ROM), as well as the severity of symptoms (pain and stiffness) in older adults with knee osteoarthritis. (2) Methods: An exploratory longitudinal study was conducted on 28 older adults with knee osteoarthritis (mean age 71.86 ± 4.49 years; 46.4% men, 53.6% women). We used as assessment tools the Visual Analog Scales (VAS) for self-reported local knee pain and stiffness, and goniometry for ROM. Measurements were taken twice, six months apart, in winter and summer, in the morning and evening of each selected day. Recorded weather factors comprised temperature, relative humidity, barometric pressure, and maximum wind speed. (3) Results: The study revealed significant effects of season and time of day on pain and stiffness, respectively (p < 0.001). Additionally, a significant interaction between season and time influenced total knee ROM (p < 0.001). Moreover, there was a statistically significant relationship between time and total knee ROM (p < 0.001). (4) Conclusions: This research underscores the complex link between seasonal fluctuations and daily variations in some symptomatic and functional aspects of knee osteoarthritis in older adults.
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Affiliation(s)
- Elena Ioana Iconaru
- Department of Medical Assistance and Physical Therapy, University Center of Pitesti, National University for Science and Technology Politehnica Bucuresti, 110040 Pitesti, Romania; (E.I.I.); (C.C.)
| | - Emilian Tarcau
- Department of Physical Education, Sport and Physical Therapy, University of Oradea, 410087 Oradea, Romania
| | - Constantin Ciucurel
- Department of Medical Assistance and Physical Therapy, University Center of Pitesti, National University for Science and Technology Politehnica Bucuresti, 110040 Pitesti, Romania; (E.I.I.); (C.C.)
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Huang H, Tang K, Song X, Zhao L, Liang Y, Xu H, Xiao L, Chen Y. Effects of contralateral versus ipsilateral electroacupuncture for analgesia and rehabilitation after unilateral total knee arthroplasty: a randomized controlled trial. Acupunct Med 2023:9645284231211601. [PMID: 38149653 DOI: 10.1177/09645284231211601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
PURPOSE Total knee arthroplasty (TKA) is a treatment for advanced knee osteoarthritis. Since postoperative pain affects rehabilitation, this study aimed to determine whether electroacupuncture (EA) contralateral to the surgical site is more effective than ipsilateral EA or sham EA in terms of relieving postoperative pain and promoting post-TKA rehabilitation. METHODS In this parallel, single-blind randomized controlled trial, 114 patients undergoing unilateral TKA were assigned to the contralateral EA (EA on the contralateral side + sham EA on the ipsilateral), ipsilateral EA (EA on the ipsilateral + sham EA on the contralateral side), or sham EA (sham EA on both sides) groups (n = 38 each). Treatment was performed once daily on postoperative days 1-3. The visual analog scale (VAS) scores, additional opioid doses via patient-controlled analgesia (PCA) pump, Hospital for Special Surgery (HSS) knee scores, active/passive range of motion (AROM/PROM), swelling around the knee joint, and Hamilton anxiety scale (HAMA) scores were used for postoperative evaluation. RESULTS At 3 days postoperatively, the VAS scores, HSS scores, AROM/PROM, swelling around the knee, and HAMA scores in the contralateral EA and ipsilateral EA groups were significantly improved compared with baseline. In addition, VAS scores, HSS scores, PROM and swelling around the knee were significantly better in the contralateral and ipsilateral EA groups than in the sham EA group, but similar in the two true EA groups. Furthermore, PCA additional dose release was significantly higher in the sham EA group than in the two true EA groups (which did not significantly differ). At 10 days postoperatively, the HSS scores, AROM/PROM, and HAMA scores were better in the contralateral and ipsilateral EA groups than in the sham EA group, but similar in the two true EA groups. CONCLUSION Contralateral EA is more effective than sham EA for treating postoperative pain following TKA, but has an analgesic effect similar to that of ipsilateral EA. TRIAL REGISTRATION NUMBER ChiCTR1800020297 (Chinese Clinical Trial Registry).
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Affiliation(s)
- Hai Huang
- Shenzhen Hospital, Shanghai University of Traditional Chinese Medicine
| | - Kangmin Tang
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiuling Song
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ling Zhao
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yongying Liang
- Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hui Xu
- Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lianbo Xiao
- Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuelai Chen
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Baltaci G, Ozunlu Pekyavas N, Atay OA. Short-time Effect of Sterile Kinesio Tape applied during Anterior Cruciate Ligament Reconstruction on Edema, Pain and Range of Motion. Res Sports Med 2023; 31:550-561. [PMID: 34856838 DOI: 10.1080/15438627.2021.2010203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
The purpose of this study was to investigate the effects of edema, pain, and range of motion of knee by sterile kinesio taping within 3 days after ACLR. We hypothesized that sterile taping which is a new material of kinesio taping reduces knee pain and swelling and improves knee range of movement after ACLR. Fifty-sixth subjects who underwent an elective ACLR with were randomized into intervention(n=28) and control groups(n=28). Subjects from both groups received standardized postoperative physiotherapy. Pain by VAS, total ROM of the knee, and circumferential girth were measured at the first, second- and third-day post-surgery. There were found statistically significant differences in all study parameters within each group. Comparison of the study parameters between both groups revealed a statistical significance at various time points except the reduction of pain in the taping group in the early postoperative phase (between the first and second day) (P<0.05). There was no statistical significance in the reduction of swelling or improvement of knee total ROM with kinesio taping. This study showed that sterile kinesio taping reduced pain, improved ROM of the knee and decreased edema in the early post-operative period after ACLR.
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Affiliation(s)
- Gul Baltaci
- Department of Physical Therapy and Rehabilitation, Private Guven Hospital, Ankara, Turkey
| | - Nihan Ozunlu Pekyavas
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Baskent University, Ankara, Turkey
| | - Ozgur Ahmet Atay
- Faculty of Medicine, Department of Orthopaedics and Traumotology, Hacettepe University, Ankara, Turkey
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Kim WD, Shin D. Effects of Pelvic-Tilt Imbalance on Disability, Muscle Performance, and Range of Motion in Office Workers with Non-Specific Low-Back Pain. Healthcare (Basel) 2023; 11:healthcare11060893. [PMID: 36981550 PMCID: PMC10048650 DOI: 10.3390/healthcare11060893] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/17/2023] [Accepted: 03/18/2023] [Indexed: 03/22/2023] Open
Abstract
Imbalance in the pelvic tilt is considered to be a major variable in low back pain. The purpose of this study was to investigate the effects of pelvic-tilt imbalance on trunk- and hip-muscle performance, range of motion, low-back pain, and the degree of disability in office workers. This was a cross-sectional study conducted in a physical therapy clinic on forty-one office workers diagnosed with non-specific low-back pain. Among the office workers with non-specific low-back pain, 25 were assigned to the pelvic-tilt-imbalance group and 16 to the normal group without pelvic-tilt imbalance. In order to determine the differences according to the imbalance in pelvic tilt, the pain intensity and disability indices were compared between the groups. In addition, the muscle performance and range of motion of the trunk and hip joints and foot pressure were measured and compared. There were differences between the groups in the disability indices and the ratio of internal and external rotation of the hip joint. However, there were no differences in the other variables. Pelvic-tilt imbalance in office workers with non-specific chronic low-back pain may exacerbate the degree of disability and be related to hip-joint rotational range of motion.
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Affiliation(s)
- Won-Deuk Kim
- Department of Physical Therapy, Graduate School of Kyungnam University, Changwon-si 51767, Republic of Korea
| | - Doochul Shin
- Department of Physical Therapy, College of Health Science, Kyungnam University, Changwon-si 51767, Republic of Korea
- Correspondence: ; Tel.: +82-55-249-2017
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Parati M, Gallotta M, De Maria B, Pirola A, Morini M, Longoni L, Ambrosini E, Ferriero G, Ferrante S. Video-based Goniometer Applications for Measuring Knee Joint Angles during Walking in Neurological Patients: A Validity, Reliability and Usability Study. SENSORS (BASEL, SWITZERLAND) 2023; 23:2232. [PMID: 36850828 PMCID: PMC9960424 DOI: 10.3390/s23042232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/07/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Easy-to-use evaluation of Range Of Motion (ROM) during walking is necessary to make decisions during neurological rehabilitation programs and during follow-up visits in clinical and remote settings. This study discussed goniometer applications (DrGoniometer and Angles - Video Goniometer) that measure knee joint ROM during walking through smartphone cameras. The primary aim of the study is to test the inter-rater and intra-rater reliability of the collected measurements as well as their concurrent validity with an electro-goniometer. The secondary aim is to evaluate the usability of the two mobile applications. A total of 22 patients with Parkinson's disease (18 males, age 72 (8) years), 22 post-stroke patients (17 males, age 61 (13) years), and as many healthy volunteers (8 males, age 45 (5) years) underwent knee joint ROM evaluations during walking. Clinicians and inexperienced examiners used the two mobile applications to calculate the ROM, and then rated their perceived usability through the System Usability Scale (SUS). Intraclass correlation coefficients (ICC) and correlation coefficients (corr) were calculated. Both applications showed good reliability (ICC > 0.69) and validity (corr > 0.61), and acceptable usability (SUS > 68). Smartphone-based video goniometers could be used to assess the knee ROM during walking in neurological patients, because of their acceptable degree of reliability, validity and usability.
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Affiliation(s)
- Monica Parati
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Milan, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, 20138 Milan, Milan, Italy
| | - Matteo Gallotta
- Istituti Clinici Scientifici Maugeri IRCCS, 20138 Milan, Milan, Italy
| | - Beatrice De Maria
- Istituti Clinici Scientifici Maugeri IRCCS, 20138 Milan, Milan, Italy
| | - Annalisa Pirola
- Istituti Clinici Scientifici Maugeri IRCCS, 20138 Milan, Milan, Italy
| | - Matteo Morini
- Istituti Clinici Scientifici Maugeri IRCCS, 20138 Milan, Milan, Italy
| | - Luca Longoni
- Istituti Clinici Scientifici Maugeri, 20851 Lissone, Monza Brianza, Italy
| | - Emilia Ambrosini
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Milan, Italy
| | - Giorgio Ferriero
- Istituti Clinici Scientifici Maugeri IRCCS Tradate, 21049 Tradate, Varese, Italy
- Department of Biotechnology and Life Sciences, University of Insubria, 21110 Varese, Varese, Italy
| | - Simona Ferrante
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Milan, Italy
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The effect of whole-body vibration in osteopenic patients after total knee arthroplasty: a randomized controlled trial. Aging Clin Exp Res 2022; 34:1381-1390. [PMID: 35028919 DOI: 10.1007/s40520-021-02043-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/21/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Total knee arthroplasty (TKA) is an important treatment for knee osteoarthritis, but the result of whole-body vibration (WBV) in knee function rehabilitation and bone loss with osteopenia was unknown. Therefore, the purpose of this study is to study whether low-frequency, low-amplitude WBV can improve the clinical outcome of knee osteoarthritis. METHODS This study was randomized and included 67 osteopenic patients (55-90 years, 85% women) for TKA surgery (control group N = 32, WBV group N = 35). All selected patients after TKA surgery tested clinical results, such as knee function and bone mass in baseline, 3 months after surgery, and 6 months after surgery. RESULTS Compared to the control group, the WBV group improved pain scores, thigh circumference, lower limb muscle strength, joint activity, and joint function in 6 months after surgery. WBV intervention also improves bone density in the spine, the microstructure of the radius and tibia, and the bone turnover marker. At 3 months after TKA surgery, the WBV group had no significant effect on knee function and bone loss. CONCLUSIONS Whole-body vibration for osteopenic patients with knee arthroplasty showed good therapeutic results in 6 months after TKA surgery, but the long-term therapeutic effect still needs to be further observed.
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García-García O, Molina-Cárdenas Á, Álvarez-Yates T, Iglesias-Caamaño M, Serrano-Gómez V. Individualized Analysis of Lateral Asymmetry Using Hip-Knee Angular Measures in Soccer Players: A New Methodological Perspective of Assessment for Lower Limb Asymmetry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084672. [PMID: 35457540 PMCID: PMC9024527 DOI: 10.3390/ijerph19084672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 12/04/2022]
Abstract
This study aimed to: (1) determine the magnitude and direction of lateral asymmetry in well-trained soccer players using hip and knee ROM tests; (2) inquire if asymmetry relies on the ROM test performed and/or gender; and (3) establish asymmetry thresholds for each ROM test to individualize lower-limbs asymmetry. One hundred amateur soccer players were assessed using hip–knee ROM tests: Straight Leg Raise, modified Thomas Test, hip internal rotation and external rotation, hip abduction (ABD) and adduction (ADD), Nachlas Test and Rigde Test. There are significant differences between tests when determining the magnitude of lateral asymmetry (F = 3.451; p = 0.001; ηp2 = 0.031) without significant differences between gender (F = 0.204; p = 0.651; ηp2 = 0.001). Asymmetry threshold results differ significantly between using a fixed or a specific threshold (F = 65.966; p = 0.001; ηp2 = 0.985). All tests indicate that the direction of asymmetry is towards the dominant limb. In conclusion, the ROM test used determines the magnitude and direction of the lateral asymmetry of the amateur soccer players. The ABD and ADD are the ROM tests that showed higher percentages of asymmetry, without differences between female and male soccer players. Using a specific asymmetry threshold formula can classify more players as asymmetrical than with a fixed threshold.
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Affiliation(s)
- Oscar García-García
- Laboratory of Sports Performance, Physical Condition and Wellness, Faculty of Education and Sports, University of Vigo, 36310 Pontevedra, Spain; (T.Á.-Y.); (M.I.-C.); (V.S.-G.)
- Correspondence: ; Tel.: +34-986801772
| | | | - Tania Álvarez-Yates
- Laboratory of Sports Performance, Physical Condition and Wellness, Faculty of Education and Sports, University of Vigo, 36310 Pontevedra, Spain; (T.Á.-Y.); (M.I.-C.); (V.S.-G.)
| | - Mario Iglesias-Caamaño
- Laboratory of Sports Performance, Physical Condition and Wellness, Faculty of Education and Sports, University of Vigo, 36310 Pontevedra, Spain; (T.Á.-Y.); (M.I.-C.); (V.S.-G.)
| | - Virginia Serrano-Gómez
- Laboratory of Sports Performance, Physical Condition and Wellness, Faculty of Education and Sports, University of Vigo, 36310 Pontevedra, Spain; (T.Á.-Y.); (M.I.-C.); (V.S.-G.)
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Molina-Cárdenas Á, Álvarez-Yates T, García-García O. Predicting Hamstring Strains in Soccer Players Based on ROM: An Analysis From a Gender Perspective. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022:1-7. [PMID: 35394405 DOI: 10.1080/02701367.2021.2011091] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 11/21/2021] [Indexed: 06/14/2023]
Abstract
Purpose: The aim of this study was to explore if specific hip and knee range-of-movement (ROM) tests can predict a risk factor for hamstring strain (HS) injury in male and female soccer players. Methods: One hundred amateur soccer players (56 men and 44 women) performed six tests to determine hip and knee ROM: straight leg raise test (SLR), modified Thomas test (TT), hip internal and external rotation (ER), hip abduction and adduction, Nachlas test and Ridge test. A logistic regression analysis was carried out to create a predictive model for HS injuries. Results: The percentage of HS injury was 20.45% and 30.35%, for female and male players. The logistic regression showed a significant model for both genders on the logit of suffering an HS injury with active-SLR and TT variables for females (R2CS = 0.491; R2N = 0.771) and active SLR and ER variables for males (R2CS = 0.623; R2N = 0.882). The predictive models correctly classify 95.5% and 94.6% of cases presenting good sensitivity (77.8% and 88.2%) and full (100%) and high (97.4%) specificity respectively. Furthermore, female players showed a greater ROM than males (p ≤ 0.01). Conclusion: Both female and male soccer players that suffered a HS injury had lower ROM in SLR, NT and RT and higher ROM in the TT that non-injured players. The tests that most likely predict HS injury are SLR and TT in females and SLR and ER in males. Thus, it is suggested to including specific exercises in amateur soccer players training programs to improve hip and knee ROM for injury prevention.
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13
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Clinimetric properties of the knee extension prone test (KEPT): A new method to assess knee hyperextension deficit. J Bodyw Mov Ther 2022; 31:146-152. [DOI: 10.1016/j.jbmt.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 02/06/2022] [Accepted: 04/02/2022] [Indexed: 11/19/2022]
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Pottorf OA, Lee DJ, Czujko PN. Reliability and Concurrent Validity of Mobile Health Technology for Patient Self-Monitoring in Physical Rehabilitation. JSES Int 2022; 6:506-511. [PMID: 35572423 PMCID: PMC9091929 DOI: 10.1016/j.jseint.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Forearm pronation and supination are important for everyday functional tasks and some recreational activities. Healthcare providers use reliable and valid tools during the physical rehabilitation process to measure joint range of motion (ROM), assess functional mobility, guide decisions for skilled interventions, and progress a plan of care. Since the onset of the COVID-19 pandemic, both healthcare providers and patients benefited from mobile health technologies that have emerged, which can be used by patients in the home to monitor ROM and assist the healthcare provider in guiding the rehabilitation process when utilizing telehealth. Purpose The goal of this study was to investigate the reliability and concurrent validity of a smartphone application for obtaining goniometric measurements of forearm pronation and supination. Methods This study consisted of 83 participants that were recruited on a voluntary basis from an academic institution. An iPhone with the application Clinometer and a standard goniometer (SG) were utilized to obtain goniometric measurements of forearm pronation and supination. The intraclass correlation coefficient (ICC) was used to analyze intrarater reliability, and the Pearson correlation coefficient was used to analyze concurrent validity. Scatterplots with regression lines were created to visually display the results. Results The smartphone demonstrated strong correlations for both pronation and supination (r = 0.71, P < .001; r = 0.73, P < .001). This study demonstrated overall good-excellent intrarater reliability and good concurrent validity for the smartphone application with a higher test-retest reliability in the measurement of forearm pronation compared to supination. Conclusions This study concludes that the reliability and concurrent validity of the smartphone was consistent with the SG for assessing forearm pronation and supination. It may be of value to further investigate interrater reliability between patient and healthcare practitioner, and report on the ease of use to assess ROM with a smartphone.
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Sarac DC, Yalcinkaya G, Unver B. Validity and reliability of a smartphone goniometer application for measuring hip range of motions. Work 2022; 71:275-280. [PMID: 34924431 DOI: 10.3233/wor-213626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Mobile applications which are designed to assess the range of motion (ROM) are widely used. OBJECTIVE The aim of this cross-sectional observational study was to determine the inter-observer and intra-observer reliability of a smartphone application "PT Goniometer" (PTG) and determine the correlation between PTG and universal goniometer (UG) regarding active ROMs of the hip in healthy participants. METHODS Thirty-four healthy young participants were included in the study. Two physiotherapists performed active hip flexion, abduction, internal rotation and external rotation ROM measurements of dominant legs of the participants by using PTG and UG. Intraclass correlation coefficients (ICC) were calculated to determine the intra-observer and inter-observer reliability. Level of correlations between PTG and UG were used to establish concurrent validity of PTG. RESULTS The PTG demonstrated excellent inter-observer and intra-observer reliability (ICC > 0.90) for all measured hip movements. The minimum detectable change (MDC95) was ranged from 3.29° to 5.1° for the intra-observer reliability, and from 2.55° to 3.21° for the inter-observer reliability. Additionally, the concurrent validity was found excellent (r = 0.91-0.93). CONCLUSION The results of the present study suggest that PTG is a valid and reliable mobile technology for measuring hip ROMs.
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Affiliation(s)
- Devrim Can Sarac
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Gamze Yalcinkaya
- Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Bayram Unver
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
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16
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Hahn S, Kröger I, Willwacher S, Augat P. Reliability and validity varies among smartphone apps for range of motion measurements of the lower extremity: a systematic review. BIOMED ENG-BIOMED TE 2021; 66:537-555. [PMID: 34768316 DOI: 10.1515/bmt-2021-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 10/01/2021] [Indexed: 11/15/2022]
Abstract
The aim of this review was to determine whether smartphone applications are reliable and valid to measure range of motion (RoM) in lower extremity joints. A literature search was performed up to October 2020 in the databases PubMed and Cochrane Library. Studies that reported reliability or validity of smartphone applications for RoM measurements were included. The study quality was assessed with the QUADAS-2 tool and baseline information, validity and reliability were extracted. Twenty-five studies were included in the review. Eighteen studies examined knee RoM, whereof two apps were analysed as having good to excellent reliability and validity for knee flexion ("DrGoniometer", "Angle") and one app showed good results for knee extension ("DrGoniometer"). Eight studies analysed ankle RoM. One of these apps showed good intra-rater reliability and excellent validity for dorsiflexion RoM ("iHandy level"), another app showed excellent reliability and moderate validity for plantarflexion RoM ("Coach's Eye"). All other apps concerning lower extremity RoM had either insufficient results, lacked study quality or were no longer available. Some apps are reliable and valid to measure RoM in the knee and ankle joint. No app can be recommended for hip RoM measurement without restrictions.
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Affiliation(s)
- Sarah Hahn
- Institute of Functional Diagnostics, Cologne, Germany
| | - Inga Kröger
- Institute of Biomechanics, BG-Unfallklinik Murnau Murnau am Staffelsee, Germany.,Institute of Biomechanics, Paracelsus Medical University Salzburg, Austria
| | - Steffen Willwacher
- Institute of Functional Diagnostics, Cologne, Germany.,Department of Mechanical and Process Engineering, Offenburg University Offenburg, Germany
| | - Peter Augat
- Institute of Biomechanics, BG-Unfallklinik Murnau Murnau am Staffelsee, Germany.,Institute of Biomechanics, Paracelsus Medical University Salzburg, Austria
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Shah NV, Gold R, Dar QA, Diebo BG, Paulino CB, Naziri Q. Smart Technology and Orthopaedic Surgery: Current Concepts Regarding the Impact of Smartphones and Wearable Technology on Our Patients and Practice. Curr Rev Musculoskelet Med 2021; 14:378-391. [PMID: 34729710 PMCID: PMC8733100 DOI: 10.1007/s12178-021-09723-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW While limited to case reports or small case series, emerging evidence advocates the inclusion of smartphone-interfacing mobile platforms and wearable technologies, consisting of internet-powered mobile and wearable devices that interface with smartphones, in the orthopaedic surgery practice. The purpose of this review is to investigate the relevance and impact of this technology in orthopaedic surgery. RECENT FINDINGS Smartphone-interfacing mobile platforms and wearable technologies are capable of improving the patients' quality of life as well as the extent of their therapeutic engagement, while promoting the orthopaedic surgeons' abilities and level of care. Offered advantages include improvements in diagnosis and examination, preoperative templating and planning, and intraoperative assistance, as well as postoperative monitoring and rehabilitation. Supplemental surgical exposure, through haptic feedback and realism of audio and video, may add another perspective to these innovations by simulating the operative environment and potentially adding a virtual tactile feature to the operator's visual experience. Although encouraging in the field of orthopaedic surgery, surgeons should be cautious when using smartphone-interfacing mobile platforms and wearable technologies, given the lack of a current academic governing board certification and clinical practice validation processes.
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Affiliation(s)
- Neil V Shah
- Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA.
| | - Richard Gold
- Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
- School of Medicine, Saint George's University, True Blue, West Indies, Grenada
| | - Qurratul-Ain Dar
- Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
| | - Bassel G Diebo
- Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
| | - Carl B Paulino
- Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
- Department of Orthopaedic Surgery, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
| | - Qais Naziri
- Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
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18
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de Carvalho Lana R, Ribeiro de Paula A, Souza Silva AF, Vieira Costa PH, Polese JC. Validity of mHealth devices for counting steps in individuals with Parkinson's disease. J Bodyw Mov Ther 2021; 28:496-501. [PMID: 34776185 DOI: 10.1016/j.jbmt.2021.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 06/02/2021] [Accepted: 06/09/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Step quantification is a good way to characterize the mobility and functional status of individuals with some functional disorder. Therefore, a validation study may lead to the feasibility of devices to stimulate an increase in the number of steps and physical activity level of individuals with Parkinson's Disease (PD). AIM To investigate the validity of mHealth devices to estimate the number of steps in individuals with PD and compare the estimate with a standard criterion measure. METHOD An observational study in a university laboratory with 34 individuals with idiopathic PD. The number of steps was measured using mHealth devices (Google Fit, Health, STEPZ, Pacer, and Fitbit INC®), and compared against a criterionstandard measure during the Two-Minute Walk Test using habitual speed. RESULTS Our sample was 82% men with a Hoehn and Yahr mean of 2.3 ± 1.3 and mean walking speed of 1.2 ± 0.2 m/s. Positive and statistically significant associations were found between Google Fit (r = 0.92; p < 0.01), STEPZ (r = 0.91; p < 0.01), Pacer (r = 0.77; p < 0.01), Health (r = 0.54; p < 0.01), and Fitbit Inc® (r = 0.82; p < 0.01) with the criterion-standard measure. CONCLUSIONS GoogleFit, STEPZ, Fitbit Inc.®, Pacer, and Health are valid instruments to measure the number of steps over a given period of time with moderate to high correlation with the criterion-standard in individuals with PD. This result shows that technology such as smartphone applications and activity monitor can be used to assess the number of steps in individuals with PD, and allows the possibility of using this technology for assessment and intervention purposes.
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Affiliation(s)
- Raquel de Carvalho Lana
- Post Graduate Program of Health Sciences, Department of Physical Therapy, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - André Ribeiro de Paula
- Post Graduate Program of Health Sciences, Department of Physical Therapy, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Flávia Souza Silva
- Post Graduate Program of Health Sciences, Department of Physical Therapy, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Pollyana Helena Vieira Costa
- Post Graduate Program of Health Sciences, Department of Physical Therapy, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Janaine Cunha Polese
- Post Graduate Program of Health Sciences, Department of Physical Therapy, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil.
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Kocak UZ, Guran O, Kalkan S, Kaya E, Kurt M, Karatosun V, Unver B. Assessing the knee flexion range of motion after total knee arthroplasty: Technology versus senses. J Bodyw Mov Ther 2021; 28:547-551. [PMID: 34776193 DOI: 10.1016/j.jbmt.2021.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 06/11/2021] [Accepted: 09/24/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Following total knee arthroplasty surgery, attention should be paid to post-operative knee range of motion to achieve daily activities. Goniometer assessment is widely used to assess the range of motion in the post-operative period. This study aimed to determine the inter-rater ability of a smartphone application and visual estimation of the knee joint after total knee arthroplasty among different professions that commonly work together and compare whether any method is superior to another. METHOD Range of motion measurements was performed by four clinicians as two physiotherapists and two orthopedic fellows. They utilized the Goniometer Reports application for smartphones, universal goniometer, and visual estimation to measure angles of knees which was operated. A two-way mixed model of intra-class correlation coefficient (ICC) with a 95% confidence level was used to assess inter-rater reliability. RESULTS Thirteen patients (11 female) and 20 knees (10 right) were assessed. The ICCs were found excellent both for between methods and between raters. CONCLUSION Our results show that technology seems a more accurate way to determine the knee range of motion after knee arthroplasty compared to senses. However, in lack of technological resources or time, or to avoid possible infection, visual estimation also could provide useful information.
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Affiliation(s)
- Umut Ziya Kocak
- Izmir Katip Celebi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir, Turkey
| | - Ortac Guran
- Sancaktepe Education and Research Hospital, Istanbul, Turkey
| | - Serpil Kalkan
- Afyon Health Sciences University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Afyon, Turkey
| | - Erol Kaya
- Merzifon Kara Mustafa Pasa City Hospital, Amasya, Turkey
| | - Merve Kurt
- Izmir Katip Celebi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir, Turkey; Dokuz Eylul University, Institute of Health Sciences, Izmir, Turkey.
| | | | - Bayram Unver
- Dokuz Eylul University, School of Physical Therapy and Rehabilitation, Izmir, Turkey
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Noutsios CD, Boisvert-Plante V, Laberge E, Perez J, Ingelmo P. The Telemedicine-Based Pediatric Examination of the Back and Lower Limbs: A Narrative Review. J Pain Res 2021; 14:2959-2979. [PMID: 34584449 PMCID: PMC8464344 DOI: 10.2147/jpr.s329173] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/03/2021] [Indexed: 12/20/2022] Open
Abstract
The COVID-19 pandemic has accelerated the transition to virtual healthcare while also prompting an abundance of new literature highlighting telemedicine's capabilities and limitations for various medical applications, notably musculoskeletal examinations. Telemedicine provides an opportunity to deliver timely patient- and family-centred care while maintaining physical distancing and improving access to remote communities. This review aims to narrate the current state of the literature on telemedicine applied in the context of a musculoskeletal examination for children aged 3 to 18 years. The PubMed and ScienceDirect databases were searched for relevant articles from January 2015 to August 2021 using a combination of keywords and nested searches. The general examination components relevant to the back and lumbosacral spine, hip, knee, ankle/foot, and gait are described. These components include inspection, palpation, range of motion, motor, and sensory examination as well as special testing. There is general feasibility, validity, and substantial reliability in performing most examination components, and primary diagnoses established virtually were found to be either the same or similar in the vast majority of cases. Despite the current literature focusing mainly on adult populations, we describe how each aspect of the exam can be reliably incorporated into a virtual appointment specific to the pediatric population. Currently available smartphone-based applications that measure joint range of motion were generally found to have high reliability and validity. Caregivers are needed for most of the consultation, especially in younger children, but select physical exam maneuvers can be self-performed by older children and adolescents alone. By providing an overview of the available smartphone tools as well as the reliability and validity of remote assessments, this review not only establishes a foundation for a structured pediatric musculoskeletal examination, but also aims to increase providers' confidence in incorporating telemedicine into their practice.
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Affiliation(s)
| | | | - Erika Laberge
- Edward’s Family Interdisciplinary Centre for Pediatric Complex Pain, Montreal Children’s Hospital (McGill University Health Centre), Montreal, QC, Canada
| | - Jordi Perez
- Alan Edwards Pain Management Unit, Montreal General Hospital (McGill University Health Centre), Montreal, QC, Canada
- Alan Edwards Centre for Pain Research, McGill University, Montreal, QC, Canada
| | - Pablo Ingelmo
- Edward’s Family Interdisciplinary Centre for Pediatric Complex Pain, Montreal Children’s Hospital (McGill University Health Centre), Montreal, QC, Canada
- Alan Edwards Centre for Pain Research, McGill University, Montreal, QC, Canada
- Research Institute, McGill University Health Centre, Montreal, QC, Canada
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21
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Kellish AS, Hakim A, Shahi A, Gutowski CJ, Kleiner MT. The Delivery of Orthopaedic Care midst COVID-19 and Social Distancing. THE ARCHIVES OF BONE AND JOINT SURGERY 2021; 9:371-378. [PMID: 34423083 PMCID: PMC8359650 DOI: 10.22038/abjs.2020.48498.2406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 11/07/2020] [Indexed: 11/06/2022]
Abstract
In this paper we present the findings of a literature review covering articles published in the last three decades describing the application of telemedicine in orthopaedics. A review of the PubMed Central and Medline provided 75 articles studying the role of telemedicine, the majority directly examining the application of telemedicine in orthopaedic patients. We report the summarized findings of these studies, the financial and HIPAA considerations of using telemedicine, and provide an example of our single urban level-1 trauma center's strategy for incorporating telemedicine into the clinical practice of orthopaedic surgeons during the COVID-19 pandemic.
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Affiliation(s)
- Alec S. Kellish
- Cooper Medical School of Rowan University, Camden New Jersey, USA
| | - Abraham Hakim
- Cooper Medical School of Rowan University, Camden New Jersey, USA
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Ishii K, Oka H, Honda Y, Oguro D, Konno Y, Kumeta K, Nishihara S, Matsuyama H, Kaneko I, Takeuchi Y, Watanabe Y, Kawano H, Ogata N. Accuracy and reliability of a smartphone application for measuring the knee joint angle. J Phys Ther Sci 2021; 33:417-422. [PMID: 34083881 PMCID: PMC8165359 DOI: 10.1589/jpts.33.417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 02/17/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Recently, a photo-based smartphone application for angle measurement—“Grid
line imaging application Professional”—was developed to evaluate joint disease treatments.
The aim of this study was to determine the accuracy and reliability of the application.
[Participants and Methods] We measured the knee joint of a mannequin using an application
and a universal goniometer. Twelve examiners measured eight knee joints of mannequins at
different arbitrary angles using the application and a universal goniometer. Correlations
between the application and universal goniometer measurements were examined using scatter
plots and correlation coefficients. Systematic errors of the application were visually
confirmed using the Bland-Altman method. Intra-class correlation coefficients were used to
evaluate the inter-examiner reliability of the application. [Results] The application and
universal goniometer measurements showed a good correlation (r=0.99) and
no systematic error. The intra-class correlation coefficient for inter-examiner
reliability was 0.999. Furthermore, to evaluate intra-examiner reliability, six examiners
measured six different knee joints twice using the application on a 2-day interval. The
intra-class correlation coefficient for intra-examiner reliability was 0.982. [Conclusion]
The accuracy of the application was equivalent to that of a universal goniometer, and both
the inter- and intra-examiner reliabilities of the application were almost perfect.
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Affiliation(s)
- Keisuke Ishii
- Trauma and Reconstruction Center, Teikyo University Hospital: 2-11-1 Kaga, Itabashi-Ku, Tokyo 173-8606, Japan
| | - Hiroyuki Oka
- 22nd Century Medical and Research Center, The University of Tokyo Hospital, Japan
| | - Yuji Honda
- Department of Rehabilitation Medicine, Teikyo University School of Medicine, Japan
| | - Daisuke Oguro
- Department of Rehabilitation Medicine, Teikyo University School of Medicine, Japan
| | | | | | | | | | - Ichiro Kaneko
- Department of Emergency Medicine, Teikyo University School of Medicine, Japan
| | - Yasuo Takeuchi
- Teikyo Simulation Education Research Center, Teikyo University School of Medicine, Japan
| | - Yoshinobu Watanabe
- Trauma and Reconstruction Center, Teikyo University Hospital: 2-11-1 Kaga, Itabashi-Ku, Tokyo 173-8606, Japan
| | - Hirotaka Kawano
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Japan
| | - Naoshi Ogata
- Department of Rehabilitation Medicine, Teikyo University School of Medicine, Japan
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A Dynamic Joint Angle Measurement Device for an Active Hand Rehabilitation System. JOURNAL OF HEALTHCARE ENGINEERING 2021. [DOI: 10.1155/2021/6688345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Traditional methods of measuring a joint angle are neither repeatable nor accurate and cannot instantly display, record, and upload the data onto a cloud drive. These mechanisms require development if they are to be used to evaluate rehabilitation programs. This pilot study aim is to create a simple dynamic joint angle measurement system and develop a hand rehabilitation application for stroke users using small and sensitive 3-axis accelerometers. Using Bluetooth communication technology, an electrogoniometer is developed to measure the free range of motion of lower limb joints and automatically send and save all data on to a cloud drive. The reliability of the proposed device is evaluated by comparison with a commercial electrogoniometer. Five healthy youth subjects and five health elderly subjects are involved in the evaluation process for this pilot study. The accuracy and repeatability of the proposed device are tested using Bland–Altman plots and linear correlation analysis. Measurements that were made by the proposed device and a commercial electrogoniometer are shown to be comparable and repeatable, as confirmed by Bland–Atman plots. There is also a very high degree of linear correlation (R2 > 0.99 for all joint angle measurements) between the lower limb joint angles that are measured using both devices. In conclusion, a portable, highly accurate and repeatable device was designed to be used for clinical assessment and for rehabilitation application that gives increased motivation to the user.
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Epskamp S, Dibley H, Ray E, Bond N, White J, Wilkinson A, Chapple CM. Range of motion as an outcome measure for knee osteoarthritis interventions in clinical trials: an integrated review. PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2020.1867393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Samantha Epskamp
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Hayley Dibley
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Elizabeth Ray
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Nicole Bond
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Joshua White
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Amanda Wilkinson
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Cathy M. Chapple
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
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25
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Keskinoğlu C, Aydın A. Wearable wireless low-cost electrogoniometer design with Kalman filter for joint range of motion measurement and 3D modeling of joint movements. Proc Inst Mech Eng H 2020; 235:222-231. [PMID: 33183138 DOI: 10.1177/0954411920971398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Joint movements are the key factor for the mobility of the people during daily activities. The evaluation of the joint movements is determined by the range of motion (ROM) parameters. The ROM might change due to age, gender, and some diseases. Therefore, it is essential to measure ROM accurately and compare it with the normal values of the healthy people. In this study, a low-cost, wireless, and wearable electrogoniometer was designed for highly precise and accurate measurements. The stability of the measurements is guaranteed with the quaternion based Kalman filter. The measurements of the developed system are compared with the traditional goniometer. The concordance correlation coefficient is calculated as a similarity metric, and the result is obtained as 1. In addition, a GUI was prepared to present 3D visualization of the movements in real-time with the ROM measurements and give visual feedback to the physiotherapists during physical examinations and to the patient during the home therapy sessions. The measurements also can be recorded using the GUI for retrospective analysis.
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Affiliation(s)
- Cemil Keskinoğlu
- Department of Biomedical Engineering, Cukurova University, Adana, Turkey
| | - Ahmet Aydın
- Department of Biomedical Engineering, Cukurova University, Adana, Turkey
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26
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Romero-Franco N, Jiménez-Reyes P, González-Hernández JM, Fernández-Domínguez JC. Assessing the concurrent validity and reliability of an iPhone application for the measurement of range of motion and joint position sense in knee and ankle joints of young adults. Phys Ther Sport 2020; 44:136-142. [PMID: 32506036 DOI: 10.1016/j.ptsp.2020.05.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/08/2020] [Accepted: 05/09/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To analyze the concurrent validity and reliability of an iPhone application for assessing range of motion (ROM) and joint position sense (JPS) in ankle and knee joints. DESIGN Cross-sectional study. SETTING Sport laboratory. PARTICIPANTS Twenty healthy and physically active volunteers. INTERVENTIONS All participants performed a ROM and a JPS test in ankle and knee joints, which were simultaneously evaluated with photo-analysis and the iPhone application. MAIN OUTCOMES MEASURES A total of 80 angles were obtained with the iPhone app and the photo-analysis and compared for concurrent validity. Reliability was evaluated through re-scoring of images with the iPhone app by two different testers. RESULTS Very high correlation was observed between both methods for ankle and knee ROM and knee JPS (r > 0.90), and high correlation for ankle JPS (r = 0.71-0.90), while Bland-Altman plots showed absolute agreement for all the variables. Inter- and intra-tester reliability was perfect for all the variables (ICC > 0.81), except for the inter-tester reliability of ankle JPS, which was substantial (ICC = 0.61-0.81). CONCLUSIONS This new iPhone application is valid and reliable for measuring ankle and knee ROM and JPS, although special attention is needed during ankle evaluation to avoid errors.
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Affiliation(s)
- Natalia Romero-Franco
- Nursing and Physiotherapy Department, University of the Balearic Islands, E-07122, Palma de Mallorca, Spain.
| | - Pedro Jiménez-Reyes
- Centre for Sport Studies, Rey Juan Carlos University, E-28943, Madrid, Spain.
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27
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Huang H, Song X, Zhao L, Zheng L, Xiao L, Chen Y. Opposing needling for analgesia and rehabilitation after unilateral total knee arthroplasty: a randomized, sham-controlled trial protocol. Trials 2020; 21:385. [PMID: 32381110 PMCID: PMC7203890 DOI: 10.1186/s13063-020-04251-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 03/13/2020] [Indexed: 01/11/2023] Open
Abstract
Background This randomized controlled clinical trial aims to evaluate the efficacy and safety of opposing needling in patients undergoing unilateral total knee arthroplasty (TKA). Opposing needling is one of the special needling methods used in acupuncture and moxibustion therapy. It involves needling acupoints on the contralateral side for pain management. Although, opposing needling is used for pain management in clinics, evidence to support its effectiveness as an analgesic after total knee arthroplasty is scant. We designed a randomized controlled clinical trial to evaluate efficacy and safety of opposing electroacupuncture (EA) in alleviating pain associated with unilateral total knee arthroplasty. Methods/design This is a protocol for a randomized controlled patient- and assessor-blinded trial with three parallel arms (A, opposing EA; B, operated side EA; C, sham EA). Yinlingquan (SP9), Yanglingquan (GB34), Futu (ST32), and Zusanli (ST36) acupoints are selected for all three groups. In group A, the healthy side will be treated with EA, while the operated side will be administered sham EA. In group B, the operated side will be treated with EA while on the healthy side sham EA will be used. For group C, sham EA will be used on both sides. All patients in the three groups will receive treatment once a day for 3 days. The post-operative pain measured using a visual analogue scale score (including pain while resting and being active) and the additional dose of the patient-controlled analgesic pump after operation will be recorded as the primary outcomes. Secondary outcomes such as knee function and swelling, range of motion (including active and passive range of motion), post-operative anxiety, and acupuncture tolerance will also be assessed. Discussion Opposing needling is a potential non-pharmacological treatment for relieving pain and improving functional rehabilitation after TKA, during which patients receive acupuncture on the healthy side rather than on the operated side. This sham controlled clinical trial, designed to evaluate efficacy and safety of opposing needling for patients after TKA, will provide evidence for pain management and functional rehabilitation after unilateral TKA. Trial registration ChiCTR, ChiCTR1800020297 (http://www.chictr.org.cn/edit.aspx?pid=34231&htm=4). Registered 22 December 2018.
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Affiliation(s)
- Hai Huang
- Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, 540 Xinhua Rd., Shanghai, 200052, China
| | - Xiuling Song
- Shanghai University of Traditional Chinese Medicine, 1200 Cailun Rd., Shanghai, 201203, China
| | - Ling Zhao
- Shanghai University of Traditional Chinese Medicine, 1200 Cailun Rd., Shanghai, 201203, China
| | - Lin Zheng
- Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, 540 Xinhua Rd., Shanghai, 200052, China
| | - Lianbo Xiao
- Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, 540 Xinhua Rd., Shanghai, 200052, China.
| | - Yuelai Chen
- Shanghai University of Traditional Chinese Medicine, 1200 Cailun Rd., Shanghai, 201203, China.
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28
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Evaluation of Whole-Body Vibration Exercise on Neuromuscular Activation Through Electromyographic Pattern of Vastus Lateralis Muscle and on Range of Motion of Knees in Metabolic Syndrome: A Quasi-Randomized Cross-Over Controlled Trial. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9234997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Metabolic syndrome (MetS) is related to overweight and obesity, and contributes to clinical limitations. Exercise is used for the management of MetS individuals, who are often not motivated to perform this practice. Whole body vibration exercise (WBVE) produces several biological effects, besides being safe, effective, and feasible for MetS individuals. This pseudo-randomized and cross-over controlled trial study aimed to analyze the effects of WBVE on MetS individuals’ neuromuscular activation using the surface electromyography (sEMG) pattern (root mean square (RMS)) of the vastus lateralis (VL) muscle and on the range of motion (ROM) of the knees. Participants (n = 39) were allocated to two groups: the treatment group (TG), which was exposed to WBVE, and the control group (CG). WBVE interventions were performed twice a week, for a period of 5 weeks. ROM and sEMG were analyzed at baseline, after the first session, and before and after the last session. sEMG (%RMS) significantly increased in the acute effect of the last session of WBVE (108.00 ± 5.07, p < 0.008, right leg; 106.20 ± 3.53, p < 0.02, left leg) compared to the CG. ROM did not significantly change in TG or CG. In conclusion, 5 weeks of WBVE exerted neuromuscular effects capable of increasing VL muscle RMS in individuals with MetS, this effect being potentially useful in the physical rehabilitation of these individuals.
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29
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Hsiao YH, Chien SH, Tu HP, Fu JCM, Tsai ST, Chen YS, Chen YJ, Chen CH. Early Post-Operative Intervention of Whole-Body Vibration in Patients After Total Knee Arthroplasty: A Pilot Study. J Clin Med 2019; 8:jcm8111902. [PMID: 31703305 PMCID: PMC6912668 DOI: 10.3390/jcm8111902] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 11/03/2019] [Accepted: 11/05/2019] [Indexed: 12/12/2022] Open
Abstract
(1) Background: Knee osteoarthritis causes pain, weakness, muscle atrophy, and disability. The application of whole-body vibration in patients with knee osteoarthritis can improve strength, balance, and functional activities. The purpose of the study is to evaluate the effects of early whole-body vibration intervention in patients after total knee arthroplasty. (2) Method: A single-blinded randomized control trial. Fifty-two patients with knee osteoarthritis post total knee replacement from a medical center in southern Taiwan were randomly assigned to either a whole-body vibration group or control group. Main outcome measures included pain severity, leg circumference, knee range of motion, knee extensor strength, a five-times sit to stand test, and a timed up and go test. (3) Results: Immediately post treatment, the patients in the vibration group showed a significant increase in knee extensor strength and improvement in calf swelling compared to the control group. A trend toward decrease in pain severity and improvement in functional performance were observed in both groups without a significant difference between the groups. There was no significant difference in knee range of motion (ROM) and functional performance between the groups. (4) Conclusions: The whole-body vibration intervention in patients early post total knee arthroplasty showed significant immediate effect in increasing knee extensor strength and decreasing calf swelling.
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Affiliation(s)
- Yu-Hsuan Hsiao
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; (Y.-H.H.); (J.C.-M.F.); (S.-T.T.); (Y.-S.C.)
| | - Song-Hsiung Chien
- Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan;
| | - Hung-Pin Tu
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Jimmy Chun-Ming Fu
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; (Y.-H.H.); (J.C.-M.F.); (S.-T.T.); (Y.-S.C.)
| | - Shih-Ting Tsai
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; (Y.-H.H.); (J.C.-M.F.); (S.-T.T.); (Y.-S.C.)
| | - Ying-Shan Chen
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; (Y.-H.H.); (J.C.-M.F.); (S.-T.T.); (Y.-S.C.)
| | - Yi-Jen Chen
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; (Y.-H.H.); (J.C.-M.F.); (S.-T.T.); (Y.-S.C.)
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: (Y.-J.C.); (C.-H.C.); Tel.: +886-7-312-1101 (ext. 5962) (Y.-J.C.); +886-7-312-1101 (ext. 5962) (C.-H.C.)
| | - Chia-Hsin Chen
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; (Y.-H.H.); (J.C.-M.F.); (S.-T.T.); (Y.-S.C.)
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Physical Medicine and Rehabilitation, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 801, Taiwan
- Orthopaedic Research Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: (Y.-J.C.); (C.-H.C.); Tel.: +886-7-312-1101 (ext. 5962) (Y.-J.C.); +886-7-312-1101 (ext. 5962) (C.-H.C.)
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30
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Argent R, Drummond S, Remus A, O'Reilly M, Caulfield B. Evaluating the use of machine learning in the assessment of joint angle using a single inertial sensor. J Rehabil Assist Technol Eng 2019; 6:2055668319868544. [PMID: 31452927 PMCID: PMC6700879 DOI: 10.1177/2055668319868544] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 06/04/2019] [Indexed: 01/05/2023] Open
Abstract
Introduction Joint angle measurement is an important objective marker in rehabilitation. Inertial measurement units may provide an accurate and reliable method of joint angle assessment. The objective of this study was to assess whether a single sensor with the application of machine learning algorithms could accurately measure hip and knee joint angle, and investigate the effect of inertial measurement unit orientation algorithms and person-specific variables on accuracy. Methods Fourteen healthy participants completed eight rehabilitation exercises with kinematic data captured by a 3D motion capture system, used as the reference standard, and a wearable inertial measurement unit. Joint angle was calculated from the single inertial measurement unit using four machine learning models, and was compared to the reference standard to evaluate accuracy. Results Average root-mean-squared error for the best performing algorithms across all exercises was 4.81° (SD = 1.89). The use of an inertial measurement unit orientation algorithm as a pre-processing step improved accuracy; however, the addition of person-specific variables increased error with average RMSE 4.99° (SD = 1.83°). Conclusions Hip and knee joint angle can be measured with a good degree of accuracy from a single inertial measurement unit using machine learning. This offers the ability to monitor and record dynamic joint angle with a single sensor outside of the clinic.
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Affiliation(s)
- Rob Argent
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland.,Beacon Hospital, Dublin, Ireland.,School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
| | - Sean Drummond
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Alexandria Remus
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland.,School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
| | - Martin O'Reilly
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland.,School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
| | - Brian Caulfield
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland.,School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
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31
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Keogh JWL, Cox A, Anderson S, Liew B, Olsen A, Schram B, Furness J. Reliability and validity of clinically accessible smartphone applications to measure joint range of motion: A systematic review. PLoS One 2019; 14:e0215806. [PMID: 31067247 PMCID: PMC6505893 DOI: 10.1371/journal.pone.0215806] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 04/09/2019] [Indexed: 12/01/2022] Open
Abstract
Measuring joint range of motion is an important skill for many allied health professionals. While the Universal Goniometer is the most commonly utilised clinical tool for measuring joint range of motion, the evolution of smartphone technology and applications (apps) provides the clinician with more measurement options. However, the reliability and validity of these smartphones and apps is still somewhat uncertain. The aim of this study was to systematically review the literature regarding the intra- and inter-rater reliability and validity of smartphones and apps to measure joint range of motion. Eligible studies were published in English peer-reviewed journals with full text available, involving the assessment of reliability and/or validity of a non-videographic smartphone app to measure joint range of motion in participants >18 years old. An electronic search using PubMed, Medline via Ovid, EMBASE, CINAHL, and SPORTSDiscus was performed. The risk of bias was assessed using a standardised appraisal tool. Twenty-three of the eligible 25 studies exceeded the minimum 60% score to be classified as a low risk of bias, although 3 of the 13 criteria were not achieved in >50% of the studies. Most of the studies demonstrated adequate intra-rater or inter-rater reliability and/or validity for >50% of the range of motion tests across all joints assessed. However, this level of evidence appeared weaker for absolute (e.g. mean difference ± limit of agreement, minimal detectable change) than relative (e.g. intraclass correlation, correlation) measures; and for spinal rotation than spinal extension, flexion and lateral flexion. Our results provide clinicians with sufficient evidence to support the use of smartphones and apps in place of goniometers to measure joint motion. Future research should address some methodological limitations of the literature, especially including the inclusion of absolute and not just relative reliability and validity statistics.
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Affiliation(s)
- Justin W. L. Keogh
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- Sports Performance Research Institute New Zealand (SPRINZ), AUT University, Auckland, New Zealand
- Cluster for Health improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
- * E-mail:
| | - Alistair Cox
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Sarah Anderson
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Bernard Liew
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Alicia Olsen
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Ben Schram
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
- Water Based Research Unit, Bond Institute of Health and Sport, Bond University, Gold Coast, QLD, Australia
| | - James Furness
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
- Water Based Research Unit, Bond Institute of Health and Sport, Bond University, Gold Coast, QLD, Australia
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