Reliability of Knee Joint Range of Motion and Circumference Measurements after Total Knee Arthroplasty: Does Tester Experience Matter?

被引：118
作者：
Jakobsen, Thomas [1 ]
Christensen, Malene [2 ]
Christensen, Stine [2 ]
Olsen, Marie [2 ]
Bandholm, Thomas [3 ,4 ]
机构：
[1] Copenhagen Univ Hosp Hvidovre, Dept Physiotherapy, Copenhagen, Denmark
[2] Metropolitan Univ Coll, Fac Physiotherapy, Copenhagen, Denmark
[3] Copenhagen Univ Hosp Hvidovre, Clin Res Ctr, Dept Orthopaed Surg, Copenhagen, Denmark
[4] Copenhagen Univ Hosp Hvidovre, Clin Res Ctr, Dept Physiotherapy, Copenhagen, Denmark
来源：
PHYSIOTHERAPY RESEARCH INTERNATIONAL | 2010年 / 15卷 / 03期
关键词：
range of motion; reliability; synovial fluid; total knee arthroplasty;
D O I：
10.1002/pri.450
中图分类号：
R49 [康复医学];
学科分类号：
100215 ;
摘要：
Background and Purpose. Two of the most utilized outcome measures to assess knee joint range of motion ( ROM) and intra-articular effusion are goniometry and circumference, respectively. Neither goniometry nor circumference of the knee joint have been examined for both intra-tester and inter-tester in patients with total knee arthroplasty (TKA). The purpose of this study was to determine the intra-tester and inter-tester reliability of active and passive knee joint ROM and circumference in patients with TKA when administered by physiotherapists (testers) with different clinical experience. Method. The design was an intra-tester, inter-tester and intra-day reliability study. Nineteen outpatients (10 females) having received a TKA were examined by an inexperienced and an experienced physiotherapist. Following a standardized protocol, active and passive knee joint ROM and circumference measurements were obtained using a universal goniometer and a tape measure, respectively. To establish reliability, intra-class correlation coefficients (ICC2,1) and smallest real difference (SRD) were calculated. Results. The knee joint ROM and circumference measurements were generally reliable (ICC > 0.8) within and between physiotherapists (except passive knee extension). Changes in knee joint ROM of more than 6.6 degrees and 10 degrees (except active knee flexion) and knee joint circumference of more than 1.0 cm and 1.63 cm represent a real clinical improvement (SRD) or deterioration for a single individual within and between physiotherapists, respectively. Generally, the experienced tester recorded larger knee joint ROM and lower circumference values than that of the inexperienced tester. Conclusions. In clinical practice, we suggest that repeated knee goniometric and circumferential measurements should be recorded by the same physiotherapist in individual patients with TKA. Tester experience appears not to influence the degree of reliability. Copyright (C) 2009 John Wiley & Sons, Ltd.
引用
收藏
页码：126 / 134
页数：9
相关论文
共 28 条
  • [1] Alonso A., Hekeik P., Adams R., Predicting a recovery time from the initial assessment of a quadriceps contusion injury, Australian Journal of Physiotherapy, 46, 3, pp. 167-177, (2000)
  • [2] Batterham A.M., George K.P., Reliability in evidence-based clinical practice: a primer for allied health professionals, Physical Therapy in Sport, 1, 2, pp. 54-62, (2000)
  • [3] Baumgartner T.A., Jackson A.S., Measurement for Evaluation in Physical Education and Exercise Science, (1995)
  • [4] Beaupre L.A., Davies D.M., Jones C.A., Cinats J.G., Exercise combined with continuous passive motion or slider board therapy compared with exercise only: a randomized controlled trial of patients following total knee arthroplasty, Physical Therapy, 81, 4, pp. 1029-1037, (2001)
  • [5] Beckerman H., Roebroeck M.E., Lankhorst G.J., Becher J.G., Bezemer P.D., Verbeek A.L., Smallest real difference, a link between reproducibility and responsiveness, Quality of Life Research, 10, 7, pp. 571-578, (2001)
  • [6] Brosseau L., Balmer S., Tousignant M., O'Sullivan J.P., Goudreault C., Goudreault M., Gringras S., Intra- and intertester reliability and criterion validity of the parallelogram and universal goniometers for measuring maximum active knee flexion and extension of patients with knee restrictions, Archives of Physical Medicine and Rehabilitation, 82, 3, pp. 396-402, (2001)
  • [7] Denegar C.R., Ball D.W., Assessing reliability and precision of measurement: an introduction to intraclass correlation and standard error of measurement, Journal of Sport Rehabilitation, 2, pp. 35-42, (1993)
  • [8] Edwards J.Z., Greene K.A., Davis R.S., Kovacik M.W., Noe D.A., Askew M.J., Measuring flexion in knee arthroplasty patients, Journal of Arthroplasty, 19, 3, pp. 369-372, (2004)
  • [9] Eliasziw M., Young S.L., Woodbury M.G., Fryday-Field K., Statistical methodology for the concurrent assessment of interrater and intrarater reliability: using goniometric measurements as an example, Physical Therapy, 74, 8, pp. 777-788, (1994)
  • [10] Goodwin P.C., Morrissey M.C., Omar R.Z., Brown M., Southall K., McAuliffe T.B., Effectiveness of supervised physical therapy in the early period after arthroscopic partial meniscectomy, Physical Therapy, 83, 6, pp. 520-535, (2003)
123