Physical outcome measures: The role of strength and range of motion in orthopaedic research

Marcano-Fernández, Francesc; Prada, Carlos; Johal, Herman

doi:10.1016/j.injury.2019.11.017

Cited by 6 publications

(4 citation statements)

References 28 publications

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“…Clinical outcome measures included pain assessed with a visual analog scale (VAS; 0 points for no pain and 10 points for maximum pain) and sagittal ankle ROM measured according to a previously published protocol using a goniometer applied along the lateral border of the leg and foot. 4,12,14,15 To avoid bias, these parameters were assessed by research associates who were otherwise not involved in any clinical duties. Research associates were regularly trained by board-certified foot and ankle surgeons to ensure adequate angular measurements.…”

Section: Methodsmentioning

confidence: 99%

Ankle Range of Motion Following 3-Component Total Ankle Arthroplasty

et al. 2020

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Background: Although surgeons have argued that preserving motion at the level of the ankle joint may be crucial for the long-term success in the treatment of end-stage ankle osteoarthritis, there is little evidence regarding the potential of total ankle arthroplasty (TAA) to increase ankle range of motion (ROM). In addition, the effect of a percutaneous heel cord lengthening (HCL) during TAA on ankle motion is poorly understood. Methods: A total of 357 primary TAAs treated with a 3-component device (336 patients, mean age 62.6 [24-85] years) performed between May 2003 and November 2017 were retrospectively analyzed. Sagittal ankle ROM was assessed according to a previously published protocol preoperatively (PreOP), 1 year postoperatively (PostOP), and at the last available follow-up (LastFU). Pain assessed on a visual analog scale (VAS) was assessed at the same time points. The effect of a percutaneous HCL on ankle ROM and VAS for pain was also evaluated. Results: Preoperative ankle ROM increased from mean 31.3 (0-69) to 33.9 (5-65) degrees 1 year postoperatively ( P = .0002) and decreased to 31.9 (5-70) degrees at the LastFU ( P = .007). Percutaneous HCL showed no effect on ankle ROM development after TAA ( P = .141). Ankle ROM improvement after TAA (PreOP to LastFU) was higher in ankles with lower preoperative ankle motion ( P < .0001). A lower ankle ROM at the last follow-up tended to be associated with a higher pain level ( P = .056). Conclusion: Although ankles with a lower preoperative sagittal ROM gained motion, the current data suggest that TAA has little potential to increase the preoperative available ankle motion. In some patients with a high preoperative ankle ROM, a slight decrease of ankle motion was observed postoperatively. Patients with limited ankle motion at long-term follow-up tended toward experiencing higher pain levels. The short- and long-term effect of a percutaneous HCL on ankle ROM following TAA was minimal. Level of Evidence: Level III, retrospective comparative series.

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Section: Methodsmentioning

confidence: 99%

Ankle Range of Motion Following 3-Component Total Ankle Arthroplasty

et al. 2020

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“…Although some authors report similarity between clinical measurements in the literature, 13 in our study, measurement with the traditional goniometer was inaccurate to determine the true amplitude of the leg-foot movement. Marcano-Fernandez et al 14 commented that the traditional goniometer, although widely used in orthopedics, leads to many measurement errors, and has low reliability. Russell et al, 12 evaluating ankle mobility in dancers, found different results comparing the traditional goniometer and the inclinometer.…”

Section: Discussionmentioning

confidence: 99%

“…Apesar de alguns autores relatarem semelhança entre as mensurações clínicas na literatura, 13 no nosso estudo a mensuração com o goniômetro tradicional se mostrou imprecisa para medir a verdadeira amplitude do movimento perna-pé. Marcano-Fernandez et al 14 comentaram que o goniômetro tradicional, apesar de amplamente utilizado na ortopedia, leva a muitos erros de medida e tem baixa confiabilidade. Russel et al, 12 avaliando a mobilidade do tornozelo em bailarinas, encontraram resultados diferentes comparando o goniômetro tradicional e o inclinômetro.…”

Section: Discussionunclassified

Avaliação da amplitude do movimento perna-pé. Qual método de aferição é mais fidedigno?

Costa

Tejerina

Silva

et al. 2022

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivo Avaliar os métodos de mensuração do movimento perna-pé em tornozelos e pés normais comparando os resultados das medidas clínicas com a mensuração radiográfica e determinar qual é a amplitude do movimento perna-pé considerada normal. Métodos O movimento perna-pé foi mensurado em 44 pacientes (60 pés) empregando um goniômetro tradicional, goniômetro digital, inclinômetro, aplicativo para smartphone, além da mensuração radiográfica (considerada padrão ouro). A dorsiflexão máxima foi alcançada pedindo ao paciente dar um passo à frente com o pé contralateral e realizar o máximo de dorsiflexão possível no tornozelo estudado sem retirar o calcanhar do solo. Já para a flexão plantar máxima, foi solicitado ao paciente para dar um passo para trás com pé contralateral e fazer o máximo de flexão plantar possível sem retirar o antepé estudado do solo. Resultados Os valores obtidos na mensuração radiográfica foram maiores do que os obtidos com a mensuração clínica. Quando comparamos apenas os resultados da mensuração clínica, o goniômetro tradicional se mostrou impreciso. Segundo o método radiográfico, a média de amplitude do movimento perna-pé foi de 65,6 graus. Já a média da flexão plantar máxima foi de 34,9 graus, e a média da dorsiflexão máxima foi de 30,7 graus. Conclusões O método mais adequado para a avaliação da amplitude do movimento perna-pé é o radiográfico. O goniômetro tradicional se mostrou o método clínico mais impreciso. A média de amplitude do movimento perna-pé em adultos jovens e saudáveis foi de 65 graus.

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“…10 In addition, the ankle range of motion (ROM) was measured according to a standardized protocol using a goniometer applied along the lateral border of the leg and foot under load application. 7,25,26 To avoid bias, these parameters were assessed by research associates who were otherwise not involved in any clinical duties. Research associates were regularly trained by board-certified foot and ankle surgeons to ensure adequate angular measurements.…”

Section: Methodsmentioning

confidence: 99%

3D Assessment in Posttraumatic Ankle Osteoarthritis

et al. 2020

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Introduction: Auto-generated 3-dimensional (3D) measurements based on weightbearing cone-beam computed tomography (CT) scan technology may allow for a more accurate hind- and midfoot assessment. The current study evaluated the reliability and clinical relevance of such measurements in patients with posttraumatic end-stage ankle osteoarthritis. Methods: Seventy-two patients treated at our institution for posttraumatic end-stage ankle osteoarthritis, with available weightbearing conventional radiographs and a cone-beam CT scan, were analyzed. Twenty healthy individuals aged between 40 and 70 years served as controls. Seven variables were measured on weightbearing conventional radiographs (2D) and compared to 3D measurements that were based on reconstructions from weightbearing cone-beam CT scans. The reliability of each measurement was calculated and subgroups formed according to commonly observed deformities. Results: Inter- and intraobserver reliability was superior for 3D compared to 2D measurements. The accuracy of 3D measurements performed on osteoarthritic ankles was similar to 3D measurements performed on healthy individuals. Thirty-three of the 72 included patients (46%) evidenced an inframalleolar compensation of a supramalleolar/intra-articular ankle deformity (78% = varus compensation; 22% = valgus compensation), whereas 24 of those 72 patients (33%) showed no compensation or a further increase of a supramalleolar/intra-articular ankle deformity (67% = varus deformity; 33% = valgus deformity). Conclusion: Auto-generated 3D measurements of the hind- and midfoot were found to be reliable in both healthy individuals and patients with posttraumatic end-stage ankle osteoarthritis. Such measurements may be crucial for a detailed understanding of the location and extent of hindfoot deformities, possibly impacting decision making in the treatment of end-stage ankle osteoarthritis. Level of Evidence: Level III, comparative study.

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Physical outcome measures: The role of strength and range of motion in orthopaedic research

Cited by 6 publications

References 28 publications

Ankle Range of Motion Following 3-Component Total Ankle Arthroplasty

Ankle Range of Motion Following 3-Component Total Ankle Arthroplasty

Avaliação da amplitude do movimento perna-pé. Qual método de aferição é mais fidedigno?

3D Assessment in Posttraumatic Ankle Osteoarthritis

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