Accuracy and reliability of knee goniometry methods

Hancock, Graeme E.; Hepworth, Tracey; Wembridge, Kevin

doi:10.1186/s40634-018-0161-5

Cited by 138 publications

(126 citation statements)

References 10 publications

(24 reference statements)

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“…If we were to consider all the studies that assessed relative intra-rater reliability with an iPhone 4, all six studies demonstrated that smartphone apps had adequate relative intra-rater reliability [1, 34, 37, 42, 48, 64]. Thirteen of 17 studies reported good absolute intra-rater reliability as defined by a SEM or MDC < 5 o or LOA < ± 9.8 o for more than 50% of the joint movements they examined, with only four studies not satisfying this threshold [40, 44, 51, 59]. It should however be noted that the study by Quek et al [44] satisfied the criteria for more than 50% of the movements when quantified by the SEM (the three of the four movements) but failing this when reliability was assessed by the MDC for all four movements.…”

Section: Resultsmentioning

confidence: 99%

Reliability and validity of clinically accessible smartphone applications to measure joint range of motion: A systematic review

et al. 2019

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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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Section: Resultsmentioning

confidence: 99%

Reliability and validity of clinically accessible smartphone applications to measure joint range of motion: A systematic review

et al. 2019

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“…A universal goniometer was placed next to the femoral lateral epicondyle. The static handle of the goniometer was aligned with the thigh, using the femoral major trochanter as a reference, while the mobile handle aligned with the leg referencing the fibula lateral malleolus [ 31 ]. For the knee extension assessment, patients lay in a supine position and the limb being evaluated was raised by the heel, with knee stabilisation in contact with the stretcher.…”

Section: Methodsmentioning

confidence: 99%

Effects of exercise combined with whole body vibration in patients with patellofemoral pain syndrome: a randomised-controlled clinical trial

Yañez-Álvarez

Bermúdez-Pulgarín

Hernández-Sánchez

et al. 2020

BMC Musculoskelet Disord

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Background Patellofemoral pain is a prevalent condition in the general population, especially in women, and produces functional impairment in patients. Therapeutic exercise is considered an essential part of the conservative management. The use of vibration platforms may help improve strength and function and reduce pain in patients with knee disorders. The aim of this investigation was to determine the effects of adding whole body vibration (vertical, vibration frequency of 40 Hz, with an amplitude from 2 to 4 mm) to an exercise protocol for pain and disability in adults with patellofemoral pain. Methods A randomised clinical trial was designed, where 50 subjects were randomly distributed into either an exercise group plus whole body vibration or a control group. Pain, knee function (self-reported questionnaire) and range of motion and lower limb functionality were assessed at baseline and at 4 weeks. The experimental group performed 12 supervised sessions of hip, knee and core strengthening exercises on a vibration platform 3 times per week during 4 weeks. The control group followed the same protocol but without vibration stimuli. Differences in outcome measures were explored using an analysis of the variance of 2 repeated measures. Effect sizes were estimated using Square Eta (η2). Significant level was set al P < 0.05. Results Statistically significant differences were found after intervention in favour of the experimental group in the between-groups comparison and in the interaction of the experimental group before and after treatment in terms of pain perception (P = 0.000; η2 = 0.63) and function outcomes scores (P = 0.000; η2 0.39 and 0.51 for lower limb functional scale and Kujala scores respectively). Conclusion A 4-week whole body vibration exercise programme reduces pain level intensity and improves lower limb functionality in patellofemoral pain patients and is more effective than exercise alone in improving pain and function in the short-term. Trial registration ClinicalTrials.gov (NCT04031248). This study was prospectively registered on the 24th July, 2019.

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“…In both regular care and clinical trials, the decrease that was seen shortly after KJD, recovered within months and normalized after a year, with the observed changes being minimal and less than the minimally detectable difference reported in literature. [27] As such, the differences are considered not to be clinically relevant and within variation of measurement.…”

Section: δWomac Mean (95%ci)mentioning

confidence: 99%

Knee joint distraction in regular care for treatment of knee osteoarthritis: A comparison with clinical trial data

et al. 2020

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Objectives Knee joint distraction (KJD) has been evaluated as a joint-preserving treatment to postpone total knee arthroplasty in knee osteoarthritis patients in three clinical trials. Since 2014 the treatment is used in regular care in some hospitals, which might lead to a deviation from the original indication and decreased treatment outcome. In this study, baseline characteristics, complications and clinical benefit are compared between patients treated in regular care and in clinical trials. Methods In our hospital, 84 patients were treated in regular care for 6 weeks with KJD. Surgical details, complications, and range of motion were assessed from patient hospital charts. Patient-reported outcome measures were evaluated in regular care before and one year after treatment. Trial patients (n = 62) were treated and followed as described in literature. Results Patient characteristics were not significantly different between groups, except for distraction duration (regular care 45.3±4.3; clinical trials 48.1±8.1 days; p = 0.019). Pin tract infections were the most occurring complication (70% regular care; 66% clinical trials), but there was no significant difference in treatment complications between groups (p>0.1). The range of motion was recovered within a year after treatment for both groups. WOMAC questionnaires showed statistically and clinically significant improvement for both groups (both p<0.001 and >15 points in all subscales) and no significant differences between groups (all differences p>0.05). After one year, 70% of patients were responders (regular care 61%, trial 75%; p = 0.120). Neither regular care compared to clinical trial, nor any other characteristic could predict clinical response.

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Accuracy and reliability of knee goniometry methods

Cited by 138 publications

References 10 publications

Reliability and validity of clinically accessible smartphone applications to measure joint range of motion: A systematic review

Reliability and validity of clinically accessible smartphone applications to measure joint range of motion: A systematic review

Effects of exercise combined with whole body vibration in patients with patellofemoral pain syndrome: a randomised-controlled clinical trial

Knee joint distraction in regular care for treatment of knee osteoarthritis: A comparison with clinical trial data

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