Patient Self-Assessed Passive Range of Motion of the Knee Cannot Replace Health Professional Measurements

2017 ◽  
Vol 30 (08) ◽  
pp. 829-834
Author(s):  
Frank Madsen ◽  
Anders Odgaard ◽  
Jens Borgbjerg
Keyword(s):  
Range Of Motion ◽  
Knee Extension ◽  
Flexion Contracture ◽  
Patient Assessment ◽  
Limits Of Agreement ◽  
Self Assessment ◽  
Knee Motion ◽  
Bland Altman Method ◽  
Flexion And Extension ◽  
Patient Self Assessment

AbstractThe purpose of this study was to investigate whether patients can accurately self-assess their knee passive range of motion (PROM). A picture-based questionnaire for patient self-assessment of knee PROM was developed and posted to patients. The self-assessed PROM from 58 patients was compared with surgeon-assessed PROM using a short-arm goniometer. Agreement between the measurement methods was calculated with the Bland-Altman method. We calculated the sensitivity and specificity of patient-assessed PROM in dichotomously detecting knee motion impairment in both flexion (≤ 100 degrees) and extension (≥ 10-degree flexion contracture). Surgeon- and patient-assessed knee PROM showed a mean difference (95% limits of agreement) of −2.1 degrees (−42.5 to 38.3 degrees) for flexion and −8.1 degrees (−28.8 to 12.7 degrees) for extension. The sensitivity of patient self-assessed PROM in identifying knee flexion and extension impairments was 86 and 100%, respectively, whereas its specificity was 84 and 43%, respectively. Although wide limits of agreement were observed between surgeon- and patient-assessed knee PROM, the picture-based questionnaire for patient assessment of knee ROM was found to be a valid tool for dichotomously detecting knee motion impairment in flexion (≤ 100 degrees). However, the specificity of the questionnaire for detection of knee extension impairments (≥ 10-degree flexion contracture) was low, which limits is practical utility for this purpose.

Reliability of patient self-assessment of shoulder range of motion and strength after shoulder arthroplasty

2015 ◽  
Vol 24 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Justin S. Yang ◽  
Jay D. Keener ◽  
Ken Yamaguchi ◽  
Jiajing Chen ◽  
Georgia Stobbs-Cucchi ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Self Assessment ◽  
Shoulder Range Of Motion ◽  
Shoulder Range ◽  
Patient Self Assessment

scholarly journals The judet quadricepsplasty for elderly traumatic knee extension contracture: a case report and review of the literature

BioMedicine ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 21
Author(s):  
Benjamin Tze Keong Ding ◽  
Suheal Ali Khan
Keyword(s):  
Range Of Motion ◽  
Conservative Management ◽  
Age Groups ◽  
Knee Extension ◽  
Flexion Contracture ◽  
Adult Males ◽  
Review Of The Literature ◽  
Traumatic Injuries ◽  
Sequential Release ◽  
Knee Contracture

Traumatic injuries to the knee are frequently complicated by extension contractures. The Judet Quadricepsplasty allows for controlled, sequential release of extrinsic and intrinsic knee contracture components while reducing the potential for iatrogenic quadriceps rupture. We document our institutions experience with this procedure and a systematic review of the current literature. We followed up on an elderly patient with posttraumatic flexion contracture that failed conservative management and underwent Judet Quadricepsplasty. Her knee range of motion improve dramatically from 20 degrees of flexion to 100 degrees of flexion. There was a residual extension lag of 5 degrees which did not impede on the patients daily activities. A review of the literature was performed and relevant data from 12 articles was extracted. The procedure was mainly performed in young adult males in most previous studies and the range of motion improvement ranged from 51° to 110°. Wound infections were the most common complication but otherwise other complications and severe extension lag were rare. The Judet Quadricepsplasty is a useful procedure for severe extension knee contractures that has failed conservative management in all age groups of patients. It is associated with significant increases in range of motion with low rates of complication or extension lag. Diagnostic IV

scholarly journals The foot abduction characteristics following Steenbeek foot abduction brace

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668408
Author(s):  
Anil Agarwal ◽  
Anubrat Kumar ◽  
Madhusudan Mishra
Keyword(s):  
Range Of Motion ◽  
Knee Flexion ◽  
External Rotation ◽  
Knee Extension ◽  
Tibial Rotation ◽  
Significant Component ◽  
Only Children ◽  
Knee Position ◽  
Hip Range Of Motion ◽  
Flexion And Extension

Purpose: We prospectively investigated the foot abduction characteristics following Steenbeek foot abduction brace (SFAB) use in corrected clubfeet. The foot abduction achievable in SFAB with knee flexion and extension was calculated to find the effectiveness and stretch exerted by it. Methods: Only children with corrected idiopathic clubfeet using SFAB for greater than 3 months were enrolled. The foot abduction with and without brace in knee extended and flexed positions was measured. Hip range of motion (ROM) with and without brace was also recorded. Results: The average age of 42 children ( 62 feet) was 24.25 months (range: 5–48 months). There was difference in foot abduction of 22.2° in knee extension and flexion with SFAB on. A significant change in foot stretch of 25.5° observed when the knee was moved from extended to flexed position indicated SFAB dynamicity. The SFAB was found to be an effective orthosis as it brought the corrected clubfoot into maximum abduction permissible in the foot during the phase of knee flexion. The tibial rotation accounted for a major component (61%) of apparent foot abduction with the brace on. A hip ROM of 52.2° was required for SFAB function. Conclusion: SFAB is a dynamic brace that functions better in flexed knee position. It is able to induce a near equivalent actual abduction available in the foot in flexed position of knee. There is a significant component of tibial external rotation in SFAB-induced foot abduction. SFAB function is also dependent on hip mechanics.

scholarly journals Novel Approach to Improving Knee Range of Motion in Arthrogryposis with a New Working Classification

Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 546
Author(s):  
David S. Feldman ◽  
Troy J. Rand ◽  
Aaron J. Huser
Keyword(s):  
Range Of Motion ◽  
Rare Condition ◽  
Knee Extension ◽  
Flexion Contracture ◽  
Arthrogryposis Multiplex Congenita ◽  
Surgical Interventions ◽  
Flexion Contractures ◽  
Novel Approach ◽  
Femoral Shortening ◽  
The Mean

Arthrogryposis multiplex congenita (AMC) is a rare condition defined as contrac-tures in multiple joints. Surgical interventions for severe knee flexion contractures have included posterior release, distraction and extension with external fixation and distal femoral extension osteotomies. These operations have been able to achieve knee extension, but not increase the range of motion. The purpose of this study was to review our experience with peroneal nerve decompression, posterior knee release and proximal femoral shortening. We retrospectively reviewed the medical charts and radiographs of all patients with a diagnosis of arthrogryposis who underwent aforementioned procedure. There were 39 patients with 73 knees included in the analysis with a mean follow-up of 21 months. The mean preoperative arc of motion was 45° and last followup arc of motion was 79° (p < 0.0001). The mean last followup flexion contracture was 8° (p < 0.0001). Additional subanalyses were performed on those with followup greater than 24 months and those with flexion contractures > 60°; there were no differences found in these groups. This study demonstrates that it is possible to achieve a functional range of motion of the knees in patients with AMC while improving ambulatory function.

Agreement between patient self-assessment and physician assessment of shoulder range of motion

2016 ◽  
Vol 25 (10) ◽  
pp. 1649-1654 ◽  
Author(s):  
Bastian Uribe ◽  
Youssef El Bitar ◽  
Brian R. Wolf ◽  
Matthew Bollier ◽  
John E. Kuhn ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Self Assessment ◽  
Shoulder Range Of Motion ◽  
Physician Assessment ◽  
Shoulder Range ◽  
Patient Self Assessment

Assessment of Shoulder Range of Motion: Introduction of a Novel Patient Self-Assessment Tool

2008 ◽  
Vol 24 (6) ◽  
pp. 712-717 ◽  
Author(s):  
Cordelia W. Carter ◽  
William N. Levine ◽  
Conor P. Kleweno ◽  
Louis U. Bigliani ◽  
Christopher S. Ahmad
Keyword(s):  
Range Of Motion ◽  
Assessment Tool ◽  
Self Assessment ◽  
Shoulder Range Of Motion ◽  
Shoulder Range ◽  
Patient Self Assessment

Reliability of Heel-Height Measurement for Documenting Knee Extension Deficits

2002 ◽  
Vol 30 (4) ◽  
pp. 479-482 ◽  
Author(s):  
Theodore F. Schlegel ◽  
Martin Boublik ◽  
Richard J. Hawkins ◽  
J. Richard Steadman
Keyword(s):  
Range Of Motion ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Flexion Contracture ◽  
Height Measurement ◽  
Height Difference ◽  
Thigh Circumference ◽  
Flexion Contractures ◽  
Heel Height ◽  
Knee Flexion Contracture

Background Heel-height difference has been used to detect subtle knee flexion contractures, but the effects of thigh circumference differences and patient positioning during testing have not been evaluated. Hypothesis Differences in thigh circumference measurements and whether the patient's patellae are on or off the examination table during heel-height difference measurement will not affect the accuracy of detecting knee flexion contracture. Study Design Prospective cohort study. Methods Bilateral knee range of motion, prone heel-height difference with the patellae on and off the table, and thigh circumference at 5 and 15 cm proximal to the proximal pole of the patella were measured by one investigator on 50 consecutive patients who had undergone unilateral anterior cruciate ligament reconstruction. Results A high degree of correlation was demonstrated between the heel-height difference and the standard range of motion measurement. Differences in thigh girth and patellar position did not statistically affect the accuracy of the heel-height difference as an indicator of knee flexion contracture. Conclusion Heel-height difference is a valid method of documenting knee flexion contractures. Compared with traditional goniometer assessment, this test is a more meaningful and easier way for detecting subtle knee flexion contractures of less than 10°.

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