Feasibility, reliability and validity of self-measurement of knee range-of-motion using an accelerometer-based smartphone application by patients with total knee arthroplasty.

Autor: Chew ES; Department of Physiotherapy, Singapore General Hospital, Singapore, Singapore., Woon EL; Department of Physiotherapy, Singapore General Hospital, Singapore, Singapore., Miao-Shi Low JK; Department of Physiotherapy, Singapore General Hospital, Singapore, Singapore., Haseler LJ; School of Allied Health Care, Curtin University, Perth, Australia., Ismail I; School of Computing, National University of Singapore, Singapore, Singapore., Alif MB; School of Computing, National University of Singapore, Singapore, Singapore., Kwan YH; Programme in Health Services and System Research, Duke-NUS Medical School, Singapore, Singapore., Tan JW; Department of Physiotherapy, Singapore General Hospital, Singapore, Singapore., Koh SS; Department of Physiotherapy, Singapore General Hospital, Singapore, Singapore., Pang HN; Department of Orthopedic Surgery, Singapore General Hospital, Singapore, Singapore., Chen JDY; Department of Orthopedic Surgery, Singapore General Hospital, Singapore, Singapore., Yeo SJ; Department of Orthopedic Surgery, Singapore General Hospital, Singapore, Singapore., Lim SY; School of Computing, National University of Singapore, Singapore, Singapore., Tan CI; Department of Physiotherapy, Singapore General Hospital, Singapore, Singapore.; School of Allied Health Care, Curtin University, Perth, Australia., Pua YH; Department of Physiotherapy, Singapore General Hospital, Singapore, Singapore.; Medicine Academic Programme, Duke-NUS Graduate Medical School, Singapore, Singapore.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Oct 03; Vol. 19 (10), pp. e0307219. Date of Electronic Publication: 2024 Oct 03 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0307219
Abstrakt: Aims: Limited knee range-of-motion (ROM) is common following total knee arthroplasty (TKA). It is associated with functional limitations and patient dissatisfaction. Regular knee ROM assessment is important but accurate testing traditionally requires timely access to trained healthcare professionals. Although accelerometer-based smartphone goniometry has shown to provide reliable and valid joint angles, current evidence of its use still positions healthcare providers as end users instead of patients themselves. Therefore, to maximize the impact of smartphone goniometry on post-TKA care, our study aimed to examine the feasibility, reliability, and validity of patients' self-measurement of knee ROM using an accelerometer-based smartphone goniometry application.
Methods: Patients were given standard instructions with a practice trial before the actual measurements. Passive knee flexion and extension ROM was measured on 2 sessions in 30 patients with TKA using 4 block-randomized methods: (i) smartphone self-assessment, (ii) long-arm goniometry by physiotherapist, (iii) smartphone assessment by physiotherapist, and (iv) extendable-arm goniometry by physiotherapist with placement adjudication. Feasibility was assessed by the number of participants who could independently perform the self-measurement. To assess intra- and inter-session reliability, we computed intraclass correlation coefficients (ICCs) from random-effects models. To assess intra- and inter-session agreement, we computed mean absolute differences (MADs) and minimum detectable change (MDC). To assess concurrent validity, we designated extendable-arm goniometry as the "gold standard" and compared other methods against it using ICCs and MADs.
Results: All patients were able to comprehend and execute the assessment. 87% (n = 26) found the application easy to administer. Smartphone goniometry by patients showed excellent intra- and inter-session reliability (ICCs>0.97) and minimum variability (MAD = 0.9°-3.9°; MDC95 = 3.1°-9.0°). Smartphone or long-arm goniometry by physiotherapists did not outperform patients' self-assessment (ICC = 0.96-0.99, MAD = 0.7°-3.1°; MDC95 = 2.2°-8.0°). Compared against extendable-arm goniometry, smartphone goniometry by patients measured knee flexion and extension ROM with a MAD of 4.5° (ICC, 0.97) and 2.2° (ICC = 0.98), respectively.
Conclusion: Our study demonstrates that smartphone goniometry is feasible, reliable and accurate, and can be used with confidence in the self-assessment of knee ROM post-TKA. Future studies should further explore its utility in telemonitored rehabilitation, and its possible integration into mobile health applications to enhance accessibility to care following TKA.
Competing Interests: This manuscript has not been published and is not under consideration for publication elsewhere. All authors reviewed the results and approved the final version of the manuscript. The authors have declared that no competing interests exist.
(Copyright: © 2024 Chew et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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