scholarly journals Range of Motion Measurements of the Fingers Via Smartphone Photography

Hand ◽  
2019 ◽  
Vol 15 (5) ◽  
pp. 679-685 ◽  
Author(s):  
John Z. Zhao ◽  
Philip E. Blazar ◽  
Ariana N. Mora ◽  
Brandon E. Earp
Keyword(s):  
Range Of Motion ◽  
Intraclass Correlation ◽  
Software Analysis ◽  
Significant Difference ◽  
Physical Examinations ◽  
Dupuytren Contracture ◽  
The Mean ◽  
Motion Measurements ◽  
High Consistency ◽  
Dupuytren Disease

Background: Range of motion (ROM) measurements of the fingers are frequently obtained during hand physical examinations. While traditionally measured by manual goniometry, smartphone photography introduces an alternative method of ROM measurement that also has potential telemedicine applications. The purpose of this study was to evaluate the reliability of smartphone photography measurements as an alternative to traditional goniometry, using the patient with Dupuytren disease as a model. Methods: Patients with a confirmed Dupuytren contracture were prospectively enrolled in this study. Range of motion measurements of the affected joints were obtained prior to any invasive treatments. Two sets of photographs were taken by both a clinical staff member and a nonclinical individual unaffiliated with the study. Both sets of photos were analyzed for degree of contracture via software analysis and compared against traditional goniometer measurements. Results: The study prospectively enrolled 50 consecutive patients with Dupuytren disease, comprising 123 affected joints. The mean contractures of all affected joints as measured by manual goniometry, trained photograph goniometry, and untrained photograph goniometry were 38.5, 35.3, and 35.5, respectively. The mean difference in contracture measurement was 3.2° between manual and trained photograph goniometry and 3.0° between manual and untrained photograph goniometry. There was no statistically significant difference between trained and untrained photo set measurements. Photograph measurements between separate raters demonstrated high consistency (intraclass correlation coefficient = 0.92). Conclusions: Smartphone photography provides contracture measurements equivalent to the accepted error of a finger goniometer (3.2° compared with 5°). The accuracy of smartphone photography in measuring contractures offers potential telemedicine applications for both clinical and research needs.

Reliability of Intraoperative Knee Range of Motion Measurements by Goniometer Compared with Robot-Assisted Arthroplasty

2018 ◽  
Vol 32 (03) ◽  
pp. 233-238 ◽  
Author(s):  
Hyuck Kwon ◽  
Ick-Hwan Yang ◽  
Woo-Suk Lee ◽  
Alvin Yu ◽  
Sang Oh ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Intraclass Correlation ◽  
Robotic System ◽  
Mean Values ◽  
Before And After ◽  
Passive Flexion ◽  
The Mean ◽  
Motion Measurements ◽  
Flexion And Extension ◽  
Good Agreement

AbstractAccurate measurement of knee range of motion (ROM) is critical to predict the outcomes of knee surgery and prognosis. We investigated the reliability of knee ROM measurements by goniometer compared with robotic system. Fifty-three patients with medial osteoarthritis who were planning to undergo unicompartmental knee arthroplasty (UKA) with robotic UKA were prospectively enrolled. During the operation, knee ROM measurement was performed in both flexion and extension before and after insertion of the implant using both a goniometer and robotic system. The intraclass correlation coefficient (ICC) of extension measured by the goniometer and robotic system showed good agreement; however, the ICC of flexion did not show good agreement. During passive flexion, the mean values measured before insertion of the implant were significantly lower by goniometer (134.6 ± 6.43) than by robot (145.4 ± 6.80; p = 0.017); likewise, the mean values after insertion of the implant were significantly lower by goniometer (138.6 ± 6.07) than by robotic system (147.0 ± 6.60; p = 0.045). A goniometer can underestimate knee ROM measurements compared with robotic system, especially in flexion. Orthopaedic surgeons should be cautious when measuring the flexion angle with a goniometer.

Effects of bathing, passive range-of-motion exercises, and turning on oxygen consumption in healthy men and women

1994 ◽  
Vol 3 (5) ◽  
pp. 374-381 ◽  
Author(s):  
A Verderber ◽  
KJ Gallagher
Keyword(s):  
Oxygen Consumption ◽  
Range Of Motion ◽  
Appreciable Effect ◽  
Convenience Sample ◽  
Men And Women ◽  
Healthy Men ◽  
Significant Difference ◽  
The Mean ◽  
Oxygen Requirements ◽  
Back Care

BACKGROUND: Baseline data are needed to provide a foundation for future studies investigating the effects of various nursing interventions on the oxygen requirements of critically ill patients. OBJECTIVES: To establish reference values for the oxygen requirements of adults in response to three common patient events: a nurse-administered bed bath, passive range-of-motion exercises, and turning from side to side; and to determine whether the order in which the interventions were administered had an effect on oxygen consumption. METHODS: A convenience sample of 30 healthy men and women were randomly assigned to one of three treatment groups, for which the order in which interventions were to be administered had previously been designated. Data were analyzed using analysis of variance with repeated measures. RESULTS: There was a significant difference in the mean oxygen consumption among activities, as well as between men and women, with men having a significantly higher mean oxygen consumption than that of the women. For both men and women, the mean oxygen consumption during unassisted turning and back care was significantly higher than at baseline. The oxygen consumption for men averaged 4.25 mL/kg per minute, SD = .71 at baseline, 5.08 mL/kg per minute, SD = .98 for turning, and 4.72 mL/kg per minute, SD = .90 during back care. Women averaged 3.74 mL/kg per minute, SD = .49 at baseline, 4.48 mL/kg per minute, SD = .85 for turning, and 3.89 mL/kg per minute, SD = 1.15 during back care. Changes in oxygen consumption for other interventions were nonsignificant and negligible. Oxygen consumption returned to near baseline within 15 minutes of cessation of activity. The order in which interventions were administered did not have a significant effect on oxygen consumption. CONCLUSIONS: The anterior bath and passive range of motion exercises have minimal effect on oxygen consumption. Turning and back care significantly increase oxygen consumption from the baseline value. The order in which interventions are administered does not have any appreciable effect on oxygen consumption.

scholarly journals Analysis of the Hindfoot Alignment Measured in 3D After a Medializing Calcaneal Osteotomy Using a Pre- and Postoperative Weightbearing CT

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0003
Author(s):  
Arne Burssens ◽  
Alexej Barg ◽  
Timothy Leenders ◽  
Stefan Clockaerts ◽  
Peter Burssens ◽  
...  
Keyword(s):  
Valgus Deformity ◽  
Stage Ii ◽  
Tibial Rotation ◽  
Flat Foot ◽  
Hindfoot Alignment ◽  
Software Analysis ◽  
Calcaneal Osteotomy ◽  
Significant Difference ◽  
Significant Correction ◽  
The Mean

Category: Hindfoot Introduction/Purpose: An adult acquired flat foot (AAFD) is a complex 3D deformity. A medializing calcaneal osteotomy (MCO) is a surgical procedure frequently performed to correct the valgus alignment of the hindfoot in a stage II AAFD, when conservative measurements fail. However currently little is known on its accurate influence regarding the hindfoot alignment (HA). The aim is therefore to assess the influence of a MCO on the 3D HA using computer aided software analysis of the images retrieved from a weightbearing cone beam CT (WBCT). Methods: Twelve patients with a mean age of 49,4 years (range 18-67yrs) were prospectively included in a pre-post study design. Indications for surgical correction by a MCO with a solitary translation consisted of an AAFD stage II (N=10) and a posttraumatic valgus deformity (N=2). Fixation of the osteotomy was performed by a step-plate or double screw. WBCT was obtained pre- and post-operative. Images were subsequently segmented to allow a HA calculation in 3D(HA3D) by an angle between the anatomical tibia axis and the axis connecting the computed inferior calcaneuspoint and the centroid of the talus in the coronal plane based on a Cartesian coordinatesystem(Fig 1A, C). The tibia in the HA3D was separately assessed by the anatomical tibia axis (TAx 3D) and the axis to determine the tibial rotation(TR 3D) in the axial plane by connecting the computed most outer point of the anterior and posterior tubercle of the incisura fibularis(Fig 2A, D). Results: The mean medial translation of the calcaneal osteotomy during surgery was 5.72 mm (SD = 3.9). The mean HA3D pre-operatively equaled 18.21 degrees of valgus (SD = 6.6) and post-operatively 9.31 degrees of valgus (SD = 6.18). The Paired Student’s t-test showed a significant correction of 8.89 degrees (95%CI [5.99, 11.80], P<0.001). The mean TAX 3D pre-operatively was 6.80 degrees of valgus (SD = 3.38) and post-operatively 4.11 degrees of valgus (SD = 2.77), with a significant difference of 2.69 degrees (95%CI [1.79, 3.59], P <0.001). The mean TR3D pre-operatively was -27.11 degrees (SD = 4.77) and post-operatively - 28.80 degrees (SD = 5.98) and showed a significant difference of 1.69 degrees (95%CI [0.41, 2.97], P = 0,016). Conclusion: This study shows an effective correction of the valgus hindfoot in an AAFD. It appears that the correction is not only situated in the calcaneus but also to a lesser extent in the tibia and this resulted in 15% of the achieved HA correction. The novelty is the 3D weightbearing assessment of a hindfoot correction and the shown influence on the tibia. This information could be of use to take in to account when performing a pre-operative planning of a hindfoot deformity.

scholarly journals Influence of Contrast Media on Bone Mineral Density (BMD) Measurements from Routine Contrast-Enhanced MDCT Datasets using a Phantom-less BMD Measurement Tool

2017 ◽  
Vol 189 (06) ◽  
pp. 537-543 ◽  
Author(s):  
Andrea Toelly ◽  
Constanze Bardach ◽  
Michael Weber ◽  
Rui Gong ◽  
Yanbo Lai ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Intraclass Correlation ◽  
Arterial Phase ◽  
Measurement Tool ◽  
Mineral Density ◽  
Contrast Enhanced ◽  
Significant Difference ◽  
Venous Phase ◽  
The Mean

Aim To evaluate the differences in phantom-less bone mineral density (BMD) measurements in contrast-enhanced routine MDCT scans at different contrast phases, and to develop an algorithm for calculating a reliable BMD value. Materials and Methods 112 postmenopausal women from the age of 40 to 77 years (mean age: 57.31 years; SD 9.61) who underwent a clinically indicated MDCT scan, consisting of an unenhanced, an arterial, and a venous phase, were included. A retrospective analysis of the BMD values of the Th12 to L4 vertebrae in each phase was performed using a commercially available phantom-less measurement tool. Results The mean BMD value in the unenhanced MDCT scans was 79.76 mg/cm³ (SD 31.20), in the arterial phase it was 85.09 mg/cm³ (SD 31.61), and in the venous phase it was 86.18 mg/cm³ (SD 31.30). A significant difference (p < 0.001) was found between BMD values on unenhanced and contrast-enhanced MDCT scans. There was no significant difference between BMD values in the arterial and venous phases (p = 0.228). The following conversion formulas were calculated using linear regression: unenhanced BMD = -2.287 + 0.964 * [arterial BMD value] and -4.517 + 0.978 * [venous BMD value]. The intrarater agreement of BMD measurements was calculated with an intraclass correlation (ICC) of 0.984 and the interobserver reliability was calculated with an ICC of 0.991. Conclusion Phantom-less BMD measurements in contrast-enhanced MDCT scans result in increased mean BMD values, but, with the formulas applied in our study, a reliable BMD value can be calculated. However, the mean BMD values did not differ significantly between the arterial and venous phases. Key points  Citation Format

scholarly journals Variability of Serial Lipoprotein-Associated Phospholipase A2 Measurements in Post–Myocardial Infarction Patients: Results from the AIRGENE Study Center Augsburg

2008 ◽  
Vol 54 (1) ◽  
pp. 124-130 ◽  
Author(s):  
Natalie Khuseyinova ◽  
Sonja Greven ◽  
Regina Rückerl ◽  
Gerlinde Trischler ◽  
Hannelore Loewel ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Phospholipase A2 ◽  
Individual Variation ◽  
Intraclass Correlation ◽  
Post Myocardial Infarction ◽  
Promising Candidate ◽  
Significant Difference ◽  
The Mean ◽  
Study Participants ◽  
Study Center

Abstract Background: Of the numerous emerging biomarkers for coronary heart disease (CHD), lipoprotein-associated phospholipase A2 (Lp-PLA2), an enzyme involved in lipid metabolism and inflammatory pathways, seems to be a promising candidate. Implementation of Lp-PLA2 measurement into clinical practice, however, requires data on the reliability of such measurements. Methods: We measured Lp-PLA2 concentrations by ELISA in blood samples drawn from 200 post–myocardial infarction patients (39–76 years) at 6 monthly intervals between May 2003 and February 2004, for a total of 1143 samples. We estimated analytical, within-individual, and between-individual variation, the critical difference, and the intraclass correlation coefficient of reliability (ICC) to assess the reliability of serial Lp-PLA2 measurements. Results: The mean (SD) plasma Lp-PLA2 concentration for the study participants was 188.7 (41.8) μg/L, with no significant difference between men and women. The analytical CV for Lp-PLA2 was 4.4%, the within-individual biological CV was 15%, and the between-individual CV was 22%. The ICC was 0.66. An important part of the total variation in plasma Lp-PLA2 concentration was explained by the between-individual variation (as a percentage of the total variance, 66.1%), whereas the within-individual variance was 31.3%. The analytical variance was as low as 2.6%. Conclusions: Between-individual variation in Lp-PLA2 concentration was substantially greater than within-individual variation. In general, our data demonstrate considerable stability and good reproducibility of serial Lp-PLA2 measurements, results that compared favorably with those for the more commonly measured lipid markers.

scholarly journals Validation of the cultural adaptation of the Kujala score in Arabic

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Bassem I. Haddad ◽  
Mohammad Hamdan ◽  
Ula Isleem ◽  
Munther Ghassan Al-Saber ◽  
Fadi A. Al-Hadidi ◽  
...  
Keyword(s):  
Pearson Correlation ◽  
Intraclass Correlation ◽  
Calculated Data ◽  
Patellofemoral Pain ◽  
P Value ◽  
Multiple Choice Questions ◽  
Cross Sectional ◽  
Kujala Score ◽  
Significant Difference ◽  
The Mean

Abstract Background Patellofemoral pain is a common condition. The Kujala score is a well-established scoring system to assess anterior knee pain and has been translated into many languages including Arabic. The purpose of this cross-sectional study is to culturally adapt the Arabic version of the Kujala score and determine its validity. Methods The Kujala score is composed of 13 multiple-choice questions. We modified two questions in the score; running and squatting, and were replaced with questions related to walking on different terrain and prostration, each with the same number of answer choices as the original questions so as not to affect the final score. These modifications were written in Arabic by the same group who translated and validated the original score into Arabic. The original and modified Kujala scores was printed and given to patients complaining of patellofemoral pain to be filled during their visit to the orthopedic outpatient clinics. Final scores for the original and modified questionnaires were calculated. Data was analyzed using SPSS statistics version 21.0 measuring Cronbach’s alpha, intraclass correlation coefficient, and Pearson correlation. Results Ninety-four patients were included in the study, 28 (29.8%) men and 66 (70.2%) women. The mean age for the included patients was 43.67 (± 14.46) years. The mean score for the modified initial questionnaire was 63.91 (± 16.32), and the mean score for the modified re-test questionnaire was 66.52 (± 17.50). There was a statistically significant difference between the mean scores (p = 0.041), with a mean difference of 1.97 (95% CI 0.08 to 3.856). We found a significant strong correlation between the score before and after changing the questions with a p value of < 0.001. Conclusions The culturally modified Arabic Kujala questionnaire is shown to be a valid, well-designed tool and an appropriate method of measuring patellofemoral pain.

scholarly journals Comparison of color difference and reliability of two intraoral spectrophotometers

2021 ◽  
Vol 20 ◽  
pp. e211076
Author(s):  
Sanaa N. Al-Haj Ali ◽  
Ra'fat I, Farah ◽  
Abdullah Aldhefeeri ◽  
Ibrahim Alduraibi
Keyword(s):  
Intraclass Correlation ◽  
Color Difference ◽  
Central Incisor ◽  
Color Coordinates ◽  
Maxillary Central Incisor ◽  
Device Reliability ◽  
Significant Difference ◽  
Insignificant Difference ◽  
The Mean ◽  
Labial Surface

Aim: to evaluate the intra and inter-device reliability of two intraoral spectrophotometers in measuring the Commission Internationale de l’Éclairage (CIE) L*a*b* color coordinates and to compare the color difference (ΔE) between both devices. Methods: the central region of the labial surface of the maxillary central incisor of 31 participants was measured twice by each of the devices (VITA EasyShade and Degudent Shadepilot) by one examiner. CIE L*a*b* color coordinates were obtained for all teeth and ΔE was measured and compared. Intraclass correlation coefficient (ICC) and Mann-whitney U test were used to analyze the data (p<0.05). Results: inter-device reliability ICCs in measuring CIE L*a*b* color coordinates ranged between 0.08-0.49 with significant difference between devices only concerning the b coordinate (p<0.05). While intra device reliability ICCs ranged between 0.86-0.89 for VITA EasyShade and 0.81-0.86 for Degudent Shadepilot. The mean ΔE for CIE L*a*b* color coordinates of VITA EasyShade was 3.61 (±1.93) compared to 3.60 (± 1.45) for Degudent Shadepilot with insignificant difference between both devices (p>0.05). Conclusions: high intra device reliability in measuring CIE L*a*b* color coordinates was achieved particularly of Vita EasyShade, and both devices had clinically acceptable color difference (ΔE <3.7) however, inter device reliability was low to moderate. Consequently, the same spectrophotometer should be used throughout the steps of performing any tooth- colored restoration.

scholarly journals Transverse olecranon osteotomy with Gigli saw: A fast and reliable technique

2021 ◽  
Vol 6 (1) ◽  
pp. 17-21
Author(s):  
Bulent Karslioglu
Keyword(s):  
Range Of Motion ◽  
Articular Surface ◽  
Distal Humerus ◽  
Chevron Osteotomy ◽  
Elbow Fractures ◽  
Significant Difference ◽  
Transverse Osteotomy ◽  
Humerus Fractures ◽  
The Mean ◽  
Distal Humerus Fractures

Objective. Distal humerus fractures constitute of approximately 2% of all fractures and 30% of elbow fractures. Olecranon osteotomy provides excellent exposure of distal humerus and articular surface. In this study, we aimed to compare transverse osteotomy with gigli saw and classical chevron osteotomy techniques in terms of osteotomy duration and clinical results. Materials and Methods. 40 elbows of 40 patients with Type B intraarticular distal humerus fractures according to AO classification were included in our study. Patients were divided into 2 groups as transverse or chevron osteotomy groups. Patients were evaluated in terms of intraoperative osteotomy time, postoperative time to union, range of motion in the elbow joint and Quick Dash scores at 6th, 12th and 24th months. Results. The mean age of the patients was 45.6 years (19-62). 40% of the patients (8 patients) in the Chevron group had more than 2 mm stepping at articular surface, while this rate was 10% (2 patients) in the gigli saw group. Union was obtained in all patients for both techniques. There was no significant difference between the mean QuickDASH scores and range of motion of the elbow joints except flexion in both groups. Range of motion of flexion was statistically better in the gigli saw group (p<0.05). Conclusions. Transverse osteotomy technique significantly reduces osteotomy and fixation time and will not cause problems in fracture union. It may be preferred because it is simpler and faster to apply than chevron osteotomy and because intra-articular stepping is less common.

scholarly journals Posterior-stabilized Arthroplasty Versus Cruciate-retaining Arthroplasty in Treatment of Osteoarthritis: a 5-year Follow-up Study

2021 ◽  
Author(s):  
Yingzhen Niu ◽  
Weixia Bai ◽  
Gang Ji ◽  
Huijun Kang ◽  
Kang Piao ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Clinical Outcomes ◽  
Posterior Stabilized ◽  
Cruciate Retaining ◽  
Institutional Ethics ◽  
Significant Difference ◽  
Patellar Subluxation ◽  
The Mean ◽  
Patellar Stability

Abstract Backgroud: A prospective cohort study was performed to compare clinical outcomes between cruciate-retaining (CR) and posterior-stabilized (PS) arthroplasty.Methods: In total, 210 patients (210 knees) underwent CR arthroplasty (n=102) and PS arthroplasty (n=108) from January 2014 to January 2015. The Knee Society Score (KSS), range of motion, patellar stability, and complications were compared between the CR and PS groups 5 years postoperatively. Results: The CR group comprised 99 knees and the PS group comprised 105 knees at the 5-year follow-up. In the CR and PS groups, the mean postoperative KSS improved to 90±5 and 91±4, and the function score improved to 87±4 and 84±6, respectively (p>0.05). The mean postoperative range of motion was −2°±3° extension to 114°±8° flexion in the CR group and −2°±4° extension to 126°±7° flexion in the PS group, with no significant difference (p>0.05). In terms of patellofemoral complications, eight patients had patellar clunk syndrome, one had patellar subluxation, and one had patellar lateral facet fracture in the PS group. Three patients had patellar clunk syndrome, and one had symptomatic subluxation in the CR group. These patellofemoral complications were significantly different between the groups (p<0.05).Conclusions: CR and PS TKA can achieve good clinical outcomes with respect to the KSS. Better knee flexion but more patella complications in the PS arthroplasty than CR group 5 years postoperatively.Trail registration: This study was approved by our hospital institutional ethics committee.

scholarly journals Patients Undergoing Shoulder Stabilization Procedures Do Not Accurately Recall Their Preoperative Symptoms at Short- to Midterm Follow-up

2019 ◽  
Vol 7 (6) ◽  
pp. 232596711985108
Author(s):  
Danielle Hope ◽  
Jacqui French ◽  
Tania Pizzari ◽  
Greg Hoy ◽  
Shane Barwood
Keyword(s):  
Shoulder Instability ◽  
Intraclass Correlation ◽  
Absolute Difference ◽  
Minimal Detectable Change ◽  
Shoulder Stabilization ◽  
Specific Patient ◽  
Younger Patients ◽  
Significant Difference ◽  
Patient Reported ◽  
The Mean

Background: A patient’s ability to recall symptoms is poor in some elderly populations, but we considered that the recall of younger patients may be more accurate. The accuracy of recall in younger patients after surgery has not been reported to date. Purpose: To assess younger patients’ abilities to recall their preoperative symptoms after having undergone shoulder stabilization surgery. We used 2 disease-specific, patient-reported outcome measures (PROMs)—the Western Ontario Shoulder Instability Index (WOSI) and the Melbourne Instability Shoulder Score (MISS)—at a period of up to 2 years postoperatively. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Participants (N = 119) were stratified into 2 groups: early recall (at 6-8 months postoperatively; n = 58) and late recall (at 9-24 months postoperatively; n = 61). All patients completed the PROMs with instructions to recall preoperative function. The mean and absolute differences between the preoperative scores and recalled scores for each PROM were compared using paired t tests. Correlations between the actual and recalled scores of the subsections for each PROM were calculated using an intraclass correlation coefficient (ICC). The number of individuals who recalled within the minimal detectable change (MDC) of each PROM was calculated. Results: Comparison between the means of the actual and recalled preoperative scores for both groups did not demonstrate significant differences (early recall differences, MISS 1.05 and WOSI –38.64; late recall differences, MISS –0.25 and WOSI –24.02). Evaluation of the absolute difference, however, revealed a significant difference between actual and recalled scores for both the late and early groups (early recall absolute differences, MISS 12.26 and WOSI 216.71; late recall absolute differences, MISS 12.84 and WOSI 290.08). Average absolute differences were above the MDC scores of both PROMs at both time points. Subsections of each PROM demonstrated weak to moderate correlations between actual and recalled scores (ICC range, 0.17-0.61). Total scores for the PROMs reached moderate agreement between actual and recalled scores. Conclusion: Individual recall after shoulder instability surgery was not accurate. However, the mean recalled PROM scores of each group were not significantly different from the actual scores collected preoperatively, and recall did not deteriorate significantly over 2 years. This suggests that recall of the individual, even in this younger group, cannot be considered accurate for research purposes.

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