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Marmura H, Bryant DM. Evaluation of Outcomes After Anterior Cruciate Ligament Reconstruction: What We Know, What We Have, and What to Consider. Clin Sports Med 2024; 43:479-499. [PMID: 38811123 DOI: 10.1016/j.csm.2023.08.011] [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: 05/31/2024]
Abstract
Measurement of success following anterior cruciate ligament reconstruction (ACLR) hinges on the appropriate use of high quality and meaningful outcome measures. We identified and categorized over 100 outcome measures for ACLR using the International Classification of Functioning, Disability and Health (ICF) model. The ICF model is a useful framework to facilitate decisions about outcome selection and describe recovery following ACL injury. We outline key considerations when selecting outcome measures during study design (purpose, measurement properties, sample size, global assessment) or evaluating reported outcomes (measurement properties, sample size, magnitude/precision, clinical relevance, applicability), and discuss challenges in outcome measurement following ACLR.
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Affiliation(s)
- Hana Marmura
- Faculty of Health Sciences, Western University, 1151 Richmond Street, London, ON N6A 5B9, Canada; Fowler Kennedy Sport Medicine Clinic, 3M Centre, 1151 Richmond Street, London, ON N6A 3K7, Canada; Bone and Joint Institute, Western University, The Dr. Sandy Kirkley Centre for Musculoskeletal Research, University Hospital B6-200, London, ON N6G 2V4, Canada; Lawson Research, London Health Sciences Centre, 800 Commissioners Road East, London, ON N6A 5W9, Canada
| | - Dianne M Bryant
- Faculty of Health Sciences, Western University, 1151 Richmond Street, London, ON N6A 5B9, Canada; Fowler Kennedy Sport Medicine Clinic, 3M Centre, 1151 Richmond Street, London, ON N6A 3K7, Canada; Bone and Joint Institute, Western University, The Dr. Sandy Kirkley Centre for Musculoskeletal Research, University Hospital B6-200, London, ON N6G 2V4, Canada; Lawson Research, London Health Sciences Centre, 800 Commissioners Road East, London, ON N6A 5W9, Canada; Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, ON N6A 5C1, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Health Sciences Centre, 2C1280 Main Street West Hamilton, ON L8S 4L8, Canada.
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Silva MDC, Perriman DM, Fearon AM, Couldrick JM, Scarvell JM. Minimal important change and difference for knee osteoarthritis outcome measurement tools after non-surgical interventions: a systematic review. BMJ Open 2023; 13:e063026. [PMID: 37202126 DOI: 10.1136/bmjopen-2022-063026] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVES To systematically review and provide estimates of the minimal important change (MIC) and difference (MID) for outcome tools in people with knee osteoarthritis (OA) after non-surgical interventions. Design A systematic review. DATA SOURCES MEDLINE, CINAHL, Web of Science, Scopus and Cochrane databases were searched up to 21 September 2021. ELIGIBILITY CRITERIA We included studies that calculated MIC and MID using any calculation method including anchor, consensus and distribution methods, for any knee OA outcome tool after non-surgical interventions. DATA EXTRACTION AND SYNTHESIS We extracted reported MIC, MID and minimum detectable change (MDC) estimates. We used quality assessment tools appropriate to the studies' methods to screen out low-quality studies. Values were combined to produce a median and range, for each method. RESULTS Forty-eight studies were eligible (anchor-k=12, consensus-k=1 and distribution-k=35). MIC values for 13 outcome tools including Knee injury and Osteoarthritis Outcome Score (KOOS)-pain, activities of daily living (ADL), quality of life (QOL) and Western Ontario and McMaster Universities Arthritis Index (WOMAC)-function were estimated using 5 high-quality anchor studies. MID values for 23 tools including KOOS-pain, ADL, QOL and WOMAC-function, stiffness and total were estimated using 6 high-quality anchor studies. One moderate quality consensus study reported MIC for pain, function and global assessment. MDC values from distribution method estimates for 126 tools including KOOS-QOL and WOMAC-total were estimated using 38 good-to-fair-quality studies. CONCLUSION Median MIC, MID and MDC estimates were reported for outcome tools in people with knee OA after non-surgical interventions. The results of this review clarify the current understanding of MIC, MID and MDC in the knee OA population. However, some estimates suggest considerable heterogeneity and require careful interpretation. PROSPERO REGISTRATION NUMBER CRD42020215952.
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Affiliation(s)
- M Denika C Silva
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- Department of Physiotherapy, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Werahera, Sri Lanka
| | - Diana M Perriman
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Angela M Fearon
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Jacqui M Couldrick
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Jennie M Scarvell
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, Australian Capital Territory, Australia
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Weber F, Müller C, Bahns C, Kopkow C, Färber F, Gellert P, Otte I, Vollmar HC, Brannath W, Diederich F, Kloep S, Rothgang H, Dieter V, Krauß I, Kloek C, Veenhof C, Collisi S, Repschläger U, Böbinger H, Grüneberg C, Thiel C, Peschke D. Smartphone-assisted training with education for patients with hip and/or knee osteoarthritis (SmArt-E): study protocol for a multicentre pragmatic randomized controlled trial. BMC Musculoskelet Disord 2023; 24:221. [PMID: 36959595 PMCID: PMC10034894 DOI: 10.1186/s12891-023-06255-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 02/20/2023] [Indexed: 03/25/2023] Open
Abstract
Introduction Hip and knee osteoarthritis are associated with functional limitations, pain and restrictions in quality of life and the ability to work. Furthermore, with growing prevalence, osteoarthritis is increasingly causing (in)direct costs. Guidelines recommend exercise therapy and education as primary treatment strategies. Available options for treatment based on physical activity promotion and lifestyle change are often insufficiently provided and used. In addition, the quality of current exercise programmes often does not meet the changing care needs of older people with comorbidities and exercise adherence is a challenge beyond personal physiotherapy. The main objective of this study is to investigate the short- and long-term (cost-)effectiveness of the SmArt-E programme in people with hip and/or knee osteoarthritis in terms of pain and physical functioning compared to usual care. Methods This study is designed as a multicentre randomized controlled trial with a target sample size of 330 patients. The intervention is based on the e-Exercise intervention from the Netherlands, consists of a training and education programme and is conducted as a blended care intervention over 12 months. We use an app to support independent training and the development of self-management skills. The primary and secondary hypotheses are that participants in the SmArt-E intervention will have less pain (numerical rating scale) and better physical functioning (Hip Disability and Osteoarthritis Outcome Score, Knee Injury and Osteoarthritis Outcome Score) compared to participants in the usual care group after 12 and 3 months. Other secondary outcomes are based on domains of the Osteoarthritis Research Society International (OARSI). The study will be accompanied by a process evaluation. Discussion After a positive evaluation, SmArt-E can be offered in usual care, flexibly addressing different care situations. The desired sustainability and the support of the participants’ behavioural change are initiated via the app through audio-visual contact with their physiotherapists. Furthermore, the app supports the repetition and consolidation of learned training and educational content. For people with osteoarthritis, the new form of care with proven effectiveness can lead to a reduction in underuse and misuse of care as well as contribute to a reduction in (in)direct costs. Trial registration German Clinical Trials Register, DRKS00028477. Registered on August 10, 2022. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-023-06255-7.
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Affiliation(s)
- Franziska Weber
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Health Sciences), Gesundheitscampus 6-8, 44801 Bochum, Germany
- grid.5477.10000000120346234Department of Rehabilitation, Physiotherapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Carsten Müller
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Health Sciences), Gesundheitscampus 6-8, 44801 Bochum, Germany
| | - Carolin Bahns
- grid.8842.60000 0001 2188 0404Department of Therapy Science I, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Christian Kopkow
- grid.8842.60000 0001 2188 0404Department of Therapy Science I, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Francesca Färber
- grid.6363.00000 0001 2218 4662Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Paul Gellert
- grid.6363.00000 0001 2218 4662Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ina Otte
- grid.5570.70000 0004 0490 981XInstitute of General Practice and Family Medicine, Ruhr University Bochum, Bochum, Germany
| | - Horst Christian Vollmar
- grid.5570.70000 0004 0490 981XInstitute of General Practice and Family Medicine, Ruhr University Bochum, Bochum, Germany
| | - Werner Brannath
- grid.7704.40000 0001 2297 4381Competence Center for Clinical Trials Bremen, University of Bremen, Bremen, Germany
| | - Freya Diederich
- grid.7704.40000 0001 2297 4381Department for Health, Long-Term Care and Pensions, SOCIUM Research Center on Inequality and Social Policy, University of Bremen, Bremen, Germany
| | - Stephan Kloep
- grid.7704.40000 0001 2297 4381Competence Center for Clinical Trials Bremen, University of Bremen, Bremen, Germany
| | - Heinz Rothgang
- grid.7704.40000 0001 2297 4381Department for Health, Long-Term Care and Pensions, SOCIUM Research Center on Inequality and Social Policy, University of Bremen, Bremen, Germany
| | - Valerie Dieter
- grid.411544.10000 0001 0196 8249Department of Sports Medicine, University Hospital, Medical Clinic, Interfaculty Research Institute for Sports and Physical Activity, Tuebingen, Germany
| | - Inga Krauß
- grid.411544.10000 0001 0196 8249Department of Sports Medicine, University Hospital, Medical Clinic, Interfaculty Research Institute for Sports and Physical Activity, Tuebingen, Germany
| | - Corelien Kloek
- grid.5477.10000000120346234Research Group Innovation of Human Movement Care, HU University of Applied Sciences, Utrecht, The Netherlands
| | - Cindy Veenhof
- grid.5477.10000000120346234Department of Rehabilitation, Physiotherapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- grid.5477.10000000120346234Research Group Innovation of Human Movement Care, HU University of Applied Sciences, Utrecht, The Netherlands
| | - Sandra Collisi
- grid.491717.dReferat Projektmanagement und Digitalisierung, Bundesverband selbstständiger Physiotherapeuten – IFK e. V., Bochum, Germany
| | - Ute Repschläger
- grid.491717.dReferat Projektmanagement und Digitalisierung, Bundesverband selbstständiger Physiotherapeuten – IFK e. V., Bochum, Germany
| | - Hannes Böbinger
- grid.492243.a0000 0004 0483 0044Innovationsfonds & Produktportfolio, Techniker Krankenkasse, Hamburg, Germany
| | - Christian Grüneberg
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Health Sciences), Gesundheitscampus 6-8, 44801 Bochum, Germany
| | - Christian Thiel
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Health Sciences), Gesundheitscampus 6-8, 44801 Bochum, Germany
| | - Dirk Peschke
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Health Sciences), Gesundheitscampus 6-8, 44801 Bochum, Germany
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Driban JB, Vincent HK, Trojian TH, Ambrose KR, Baez S, Beresic N, Berkoff DJ, Callahan LF, Cohen B, Franek M, Golightly YM, Harkey M, Kuenze CM, Minnig MC, Mobasheri A, Naylor A, Newman CB, Padua DA, Pietrosimone B, Pinto D, Root H, Salzler M, Schmitt L, Snyder-Mackler L, Taylor JB, Thoma LM, Vincent KR, Wellsandt E, Williams M. Evidence Review for Preventing Osteoarthritis After an Anterior Cruciate Ligament Injury: An Osteoarthritis Action Alliance Consensus Statement. J Athl Train 2023; 58:198-219. [PMID: 37130279 PMCID: PMC10176847 DOI: 10.4085/1062-6050-0504.22] [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: 05/04/2023]
Abstract
CONTEXT The Osteoarthritis Action Alliance formed a secondary prevention task group to develop a consensus on secondary prevention recommendations to reduce the risk of osteoarthritis after a knee injury. OBJECTIVE Our goal was to provide clinicians with secondary prevention recommendations that are intended to reduce the risk of osteoarthritis after a person has sustained an anterior cruciate ligament injury. Specifically, this manuscript describes our methods, literature reviews, and dissenting opinions to elaborate on the rationale for our recommendations and to identify critical gaps. DESIGN Consensus process. SETTING Virtual video conference calls and online voting. PATIENTS OR OTHER PARTICIPANTS The Secondary Prevention Task Group consisted of 29 members from various clinical backgrounds. MAIN OUTCOME MEASURE(S) The group initially convened online in August 2020 to discuss the target population, goals, and key topics. After a second call, the task group divided into 9 subgroups to draft the recommendations and supportive text for crucial content areas. Twenty-one members completed 2 rounds of voting and revising the recommendations and supportive text between February and April 2021. A virtual meeting was held to review the wording of the recommendations and obtain final votes. We defined consensus as >80% of voting members supporting a proposed recommendation. RESULTS The group achieved consensus on 15 of 16 recommendations. The recommendations address patient education, exercise and rehabilitation, psychological skills training, graded-exposure therapy, cognitive-behavioral counseling (lacked consensus), outcomes to monitor, secondary injury prevention, system-level social support, leveraging technology, and coordinated care models. CONCLUSIONS This consensus statement reflects information synthesized from an interdisciplinary group of experts based on the best available evidence from the literature or personal experience. We hope this document raises awareness among clinicians and researchers to take steps to mitigate the risk of osteoarthritis after an anterior cruciate ligament injury.
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Affiliation(s)
| | - Jeffrey B. Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Heather K. Vincent
- UF Health Sports Performance Center, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville
| | - Thomas H. Trojian
- UF Health Sports Performance Center, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville
| | | | - Shelby Baez
- Osteoarthritis Action Alliance, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill
| | | | - David J. Berkoff
- Department of Kinesiology, Michigan State University, East Lansing
| | - Leigh F. Callahan
- Osteoarthritis Action Alliance, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill
| | | | - Madison Franek
- University of North Carolina Therapy Services, UNC Wellness Center at Meadowmont, Chapel Hill
| | - Yvonne M. Golightly
- Department of Epidemiology, Thurston Arthritis Research Center, Injury Prevention Research Center, Osteoarthritis Action Alliance, University of North Carolina at Chapel Hill
| | - Matthew Harkey
- Department of Kinesiology, Michigan State University, East Lansing
| | | | - Mary Catherine Minnig
- Department of Epidemiology, Thurston Arthritis Research Center, Injury Prevention Research Center, Osteoarthritis Action Alliance, University of North Carolina at Chapel Hill
| | - Ali Mobasheri
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Finland; Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania; Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium
| | | | - Connie B. Newman
- Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, NYU Grossman School of Medicine, New York, NY
| | - Darin A. Padua
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Brian Pietrosimone
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, NC
| | - Daniel Pinto
- Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Hayley Root
- Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Matthew Salzler
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff
| | - Laura Schmitt
- Division of Physical Therapy, School of Health and Rehabilitation Sciences, Ohio State University, Columbus
| | | | - Jeffrey B. Taylor
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, NC
| | - Louise M. Thoma
- Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill
| | - Kevin R. Vincent
- UF Health Sports Performance Center, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville
| | - Elizabeth Wellsandt
- Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha
| | - Monette Williams
- Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha
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Gille J, Körner V, Oheim R, Paech A, Mittelstädt H, Schulz AP, Schagemann J. Dynamic Postural Stability after Cartilage Repair in the Knee. Open Orthop J 2022. [DOI: 10.2174/18743250-v16-e2206300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Background:
Articular cartilage has an exceptionally poor capacity for healing, but Autologous Matrix Induced Chondrogenesis is a procedure with a substantial body of literature that demonstrates its performance in chondral and osteochondral repair. However, data concerning dynamic postural stability after cartilage repair procedures is lacking.
Objective:
Therefore, the present study was designed to assess postural stability following cartilage repair in the knee.
Methods:
20 adults had undergone Autologous Matrix Induced Chondrogenesis for the treatment of full-thickness cartilage defects, with minimum 36 months of follow-up. Clinical outcomes were evaluated by patient reported outcome measures while dynamic postural stability was assessed using the star excursion balance test. The untreated, contralateral limbs served as controls.
Results:
At a mean follow-up of 43 months, patients reported a Visual Analog Score for pain of 1.6±2.2, a mean Lysholm score of 78.5±17.9 and a mean Knee Osteoarthritis Outcome Score of 143.3±16.1. The star excursion balance test showed no significant difference between limbs.
Conclusion:
With no difference in dynamic postural stability, our results indicate that this treatment provides a positive clinical outcome, with no deficits in postural stability when compared to the contralateral, untreated leg.
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Halvorson RT, Castillo FT, Ahamed F, Khattab K, Scheffler A, Matthew RP, Lotz J, Vail TP, Feeley BT, Bailey JF. Point-of-care motion capture and biomechanical assessment improve clinical utility of dynamic balance testing for lower extremity osteoarthritis. PLOS DIGITAL HEALTH 2022; 1:e0000068. [PMID: 36812556 PMCID: PMC9931224 DOI: 10.1371/journal.pdig.0000068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 05/20/2022] [Indexed: 11/19/2022]
Abstract
Musculoskeletal conditions impede patient biomechanical function. However, clinicians rely on subjective functional assessments with poor test characteristics for biomechanical outcomes because more advanced assessments are impractical in the ambulatory care setting. Using markerless motion capture (MMC) in clinic to record time-series joint position data, we implemented a spatiotemporal assessment of patient kinematics during lower extremity functional testing to evaluate whether kinematic models could identify disease states beyond conventional clinical scoring. 213 trials of the star excursion balance test (SEBT) were recorded by 36 subjects during routine ambulatory clinic visits using both MMC technology and conventional clinician scoring. Conventional clinical scoring failed to distinguish patients with symptomatic lower extremity osteoarthritis (OA) from healthy controls in each component of the assessment. However, principal component analysis of shape models generated from MMC recordings revealed significant differences in subject posture between the OA and control cohorts for six of the eight components. Additionally, time-series models of subject posture change over time revealed distinct movement patterns and reduced overall postural change in the OA cohort compared to the controls. Finally, a novel metric quantifying postural control was derived from subject specific kinematic models and was shown to distinguish OA (1.69), asymptomatic postoperative (1.27), and control (1.23) cohorts (p = 0.0025) and to correlate with patient-reported OA symptom severity (R = -0.72, p = 0.018). Time series motion data have superior discriminative validity and clinical utility than conventional functional assessments in the case of the SEBT. Novel spatiotemporal assessment approaches can enable routine in-clinic collection of objective patient-specific biomechanical data for clinical decision-making and monitoring recovery.
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Affiliation(s)
- Ryan T. Halvorson
- Department of Orthopaedic Surgery, University of California San Francisco, United States of America
| | - Francine T. Castillo
- School of Medicine, University of California San Francisco, United States of America
| | - Fayyaz Ahamed
- School of Medicine, University of California San Francisco, United States of America
| | - Karim Khattab
- Department of Orthopaedic Surgery, University of California San Francisco, United States of America
| | - Aaron Scheffler
- Department of Epidemiology and Biostatistics, University of California San Francisco, United States of America
| | - Robert P. Matthew
- Department of Physical Therapy and Rehabilitation, University of California San Francisco, United States of America
| | - Jeffrey Lotz
- Department of Orthopaedic Surgery, University of California San Francisco, United States of America
| | - Thomas P. Vail
- Department of Orthopaedic Surgery, University of California San Francisco, United States of America
| | - Brian T. Feeley
- Department of Orthopaedic Surgery, University of California San Francisco, United States of America
| | - Jeannie F. Bailey
- Department of Orthopaedic Surgery, University of California San Francisco, United States of America
- * E-mail:
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Chen H, Wang C, Wu J, Wang M, Wang S, Wang X, Wang J, Yu H, Hu Y, Shang S. Measurement properties of performance-based measures to assess physical function in knee osteoarthritis: A systematic review. Clin Rehabil 2022; 36:1489-1511. [PMID: 35702008 DOI: 10.1177/02692155221107731] [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: 11/16/2022]
Abstract
OBJECTIVE To systematically review the measurement properties of performance-based measures to assess physical function in people with knee osteoarthritis. DATA SOURCES PubMed, Web of Science, Embase, Scopus, CINAHL, and PsycINFO were searched in May 2022. METHODS This study was conducted in accordance with the guidelines recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Clinical trials on the psychometric properties of performance-based tools for measuring physical function in people with knee osteoarthritis were included. Two reviewers independently rated measurement properties using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). "Best evidence synthesis" was made using COnsensus-based Standards for the selection of health Measurement INstruments outcomes and the quality of findings. RESULTS Thirty-six out of 3425 publications were eligible for inclusion. Thirty-two performance-based measures were evaluated including 26 single-activity measures and 6 multi-activity measures. Measurement properties evaluated included internal consistency (2 measures), reliability (23 measures), measurement error (20 measures), hypotheses testing for construct validity (22 measures), and responsiveness (23 measures). On balance of the limited evidence, the walk 40 m fast-paced test and 6-minute walking test were the best rated walking tests. The 30-second chair stand test and timed up and go test were the best rated sit-to-stand tests. The Performance Tests Measures and Physical Activity Restrictions may be the suitable multi-activity measures for knee osteoarthritis. CONCLUSIONS Further good quality research investigating the measurement properties, and in particular, the measurement error of performance-based measures in patients with knee osteoarthritis is needed.
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Affiliation(s)
- Hongbo Chen
- Department of Epidemiology and Biostatistics, School of Public Health, 12465Peking University, Beijing, China.,School of Nursing, 12465Peking University, China, Beijing, China
| | - Cui Wang
- School of Nursing, 12465Peking University, China, Beijing, China
| | - Junhui Wu
- Department of Epidemiology and Biostatistics, School of Public Health, 12465Peking University, Beijing, China.,School of Nursing, 12465Peking University, China, Beijing, China
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, 12465Peking University, Beijing, China
| | - Siyue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, 12465Peking University, Beijing, China
| | - Xiaowen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, 12465Peking University, Beijing, China
| | - Jiating Wang
- Department of Epidemiology and Biostatistics, School of Public Health, 12465Peking University, Beijing, China
| | - Huan Yu
- Department of Epidemiology and Biostatistics, School of Public Health, 12465Peking University, Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, 12465Peking University, Beijing, China.,Medical Informatics Center, 12465Peking University, Beijing, China
| | - Shaomei Shang
- School of Nursing, 12465Peking University, China, Beijing, China
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8
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Effects of Patellofemoral Pain Syndrome on Changes in Dynamic Postural Stability during Landing in Adult Women. Appl Bionics Biomech 2022; 2022:7452229. [PMID: 35592870 PMCID: PMC9113904 DOI: 10.1155/2022/7452229] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/07/2022] [Accepted: 04/15/2022] [Indexed: 11/25/2022] Open
Abstract
Background This study investigated the effects of lower limb movements on dynamic postural stability (DPS) during drop landing in adult women with patellofemoral pain syndrome (PFPS). Methods Thirty-eight adult women were recruited and divided into two groups, the PFPS group and the control group. The study participants performed a single-leg drop landing from a 30 cm box, and their lower limb movements and DPS were measured. Differences between groups were examined using independent sample t-tests. In addition, stepwise multiple linear regression was used to examine the kinematic parameters that contribute to the DPS. Results The PFPS group had significantly lower hip flexion, internal rotation, knee flexion, ankle external rotation, pelvic oblique, tilt, rotation, and higher hip abduction, knee valgus, and ankle plantarflexion. In terms of DPS, the PFPS group had a significantly higher anteroposterior and a lower mediolateral than that of the control group. In the control group, regression analysis revealed a controlled anteroposterior using knee flexion, while the PFPS group controlled mediolateral through ankle plantarflexion. Conclusions Patients with PFPS experienced more shock on their knee joint during landing than patients in the control group with greater anteroposterior instability and lower mediolateral instability.
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9
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Reliability of the Modified Star Excursion Balance Test in individuals with Down Syndrome. J Bodyw Mov Ther 2022; 32:171-175. [DOI: 10.1016/j.jbmt.2022.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/08/2022] [Accepted: 05/15/2022] [Indexed: 11/23/2022]
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10
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Primeau CA, Birmingham TB, Moyer RF, O'Neil KA, Werstine MS, Alcock GK, Giffin JR. Trajectories of perceived exertion and pain over a 12-week neuromuscular exercise program in patients with knee osteoarthritis. Osteoarthritis Cartilage 2020; 28:1427-1431. [PMID: 32828912 DOI: 10.1016/j.joca.2020.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 07/10/2020] [Accepted: 07/31/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Exercise programs rely on the overload principle, yet patients with knee osteoarthritis (OA) may not adequately progress exercises due to fear of exacerbating symptoms. OBJECTIVE To describe trajectories for perceived exertion and exercise-induced knee pain during a neuromuscular exercise program for patients with knee OA. DESIGN Participants with knee OA completed a 12-week neuromuscular exercise program consisting of weekly supervised sessions plus home exercises. During each supervised session, the Borg's rating of perceived exertion (RPE; 6 = no exertion, 20 = maximal exertion) and knee pain (pre, post, max) using Numeric Rating Scales (NRS; 0 = no pain, 10 = worst imaginable pain) were completed. Mean changes in RPE and pain from weeks 1-12 were calculated. Mixed effects regression was used to investigate trajectories over time (weeks) for RPE, and maximum pain (pre-to-max) and pain-change (pre-to-post) during exercise. RESULTS 56 patients (95%) completed the program. From week 1-12, RPE increased by 2.6 (95%CI, 1.7 to 3.5), from 'somewhat hard' to 'very hard', while max pain decreased by 1.0 NRS (95%CI, 0.5 to 1.3) and pain-change decreased by 0.9 NRS (95%CI, 0.4 to 1.3). Linear mixed effects regression showed a quadratic increase for RPE over time until between weeks 9 and 10, then RPE plateaued. Maximum pain decreased linearly over time. Pain-change showed a quadratic decrease over time until approximately week 9, then pain-change plateaued. CONCLUSIONS In patients with knee OA participating in a 12-week neuromuscular exercise program, perceived exertion during exercise progressed from 'somewhat hard' to 'very hard' at 9 weeks, while exercise-induced knee pain decreased. Patients were able to work harder while experiencing decreases rather than increases in pain.
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Affiliation(s)
- C A Primeau
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada; Bone and Joint Institute, Western University, London, ON, Canada; Wolf Orthopaedic Biomechanics Laboratory, Western University, London, ON, Canada; Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, Canada.
| | - T B Birmingham
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada; Bone and Joint Institute, Western University, London, ON, Canada; Wolf Orthopaedic Biomechanics Laboratory, Western University, London, ON, Canada; Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, Canada.
| | - R F Moyer
- School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - K A O'Neil
- Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, Canada.
| | - M S Werstine
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada; Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, Canada.
| | - G K Alcock
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada; Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, Canada.
| | - J R Giffin
- Bone and Joint Institute, Western University, London, ON, Canada; Wolf Orthopaedic Biomechanics Laboratory, Western University, London, ON, Canada; Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, Canada; Department of Surgery, Schulich School of Medicine and Dentistry, Western University Ontario, London, ON, Canada.
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Psychometric properties and domains of postural control tests for individuals with knee osteoarthritis: a systematic review. Int J Rehabil Res 2020; 43:102-115. [PMID: 32282571 DOI: 10.1097/mrr.0000000000000403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Individuals with knee osteoarthritis (OA) commonly demonstrate impaired postural control. We aimed to systematically review psychometric properties of tests that assess postural control in people with knee OA and secondly, to determine domains of postural control measured by these tests. PubMed, CINAHL, Embase and Web of Science databases were searched to January 2019. Two independent review authors screened references according to eligibility criteria. The Consensus-based Standards for the selection of health Measurement Instruments were used to evaluate study methodological quality. Postural control tests identified from included studies were assessed to determine postural control constructs using the Systems Framework for Postural Control identifying nine domains. Following the screening of 2643 references, five cross-sectional studies and one longitudinal study (n = 408) were included. Four studies evaluated reliability, validity or responsiveness of three clinical measures: Community Balance and Mobility Scale, Star Excursion Balance Test and Tinetti Performance Oriented Mobility Assessment. Two assessed reliability or validity of a force platform. Results showed that evidence for reliability, validity and responsiveness of all these postural measures is limited. The most common domain of postural control assessed was 'static stability'. No study used measures that evaluated all nine postural control domains. Our results highlight limited investigation of psychometric properties specific to postural control in knee OA. The few existing ones have limitations regarding psychometric robustness and completeness regarding different domains of postural control. Future research should focus on verifying the quality of existing tools to evaluate postural control in knee OA for research and clinical purposes.
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Abstract
The classification and monitoring of individuals with early knee osteoarthritis (OA) are important considerations for the design and evaluation of therapeutic interventions and require the identification of appropriate outcome measures. Potential outcome domains to assess for early OA include patient-reported outcomes (such as pain, function and quality of life), features of clinical examination (such as joint line tenderness and crepitus), objective measures of physical function, levels of physical activity, features of imaging modalities (such as of magnetic resonance imaging) and biochemical markers in body fluid. Patient characteristics such as adiposity and biomechanics of the knee could also have relevance to the assessment of early OA. Importantly, research is needed to enable the selection of outcome measures that are feasible, reliable and validated in individuals at risk of knee OA or with early knee OA. In this Perspectives article, potential outcome measures for early symptomatic knee OA are discussed, including those measures that could be of use in clinical practice and/or the research setting.
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