Joint Position Sense Error (JPSE) is a measure of cervical spine proprioception, and a simple method for measuring the JPSE could help in monitoring and evaluating the outcomes of rehabilitation of people with neck pain.
In this study we demonstrate preliminary results of a method for measuring JPSE that does not require the participant to wear any equipment. Based on free publicly available head tracking software, compatible with any webcam, we developed a webpage which instructs the participant in performing a self-administered version of the test. The aim of this proof-of-concept study was to demonstrate the viability of this system.
We compared our absolute error values (3.68 ± 1.2° after extension, 3.46 ± 1.66° after flexion, 3.89 ± 2.34° after rotation to the left and 4.02 ± 1.82°after rotation to the right) to values from literature, finding that our results do not differ from those of 6 out of 11 studies (which used more complex and expensive setups).
The results indicate that our system allows assessment of the JPSE with a standard computer. Being based on a website, the system has potential for telemedicine use. Further research is required to validate the system before it can be recommended for use in clinical practice.
Alterations in central somatosensory function (e.g. cortical reorganisation) occurs secondary to chronic knee pain. The reorganization can be quantified using a clinical signatory measure, the two-point discrimination threshold (TPDT). In order to differentiate normal variability of TPDT against abnormal thresholds for clinical practice, development of body region specific reference values are required and the factors that determine the TPDT have to be established.
To establish reference values for TPDT of the knee region in healthy individuals and to determine the factors that influence the TPDT of the knee regions.
Participants across four decades (18–59 years; n = 79) were recruited. TPDT estimates for medial and lateral knee regions were determined using a mechanical calliper. Descriptive statistics, and linear regression analyses were performed to establish reference TPDT values, and to investigate associations between demographics, anthropometric variables, and TPDT estimates respectively.
Participants' Mean (SD) age = 38.3 (12.2); females (n = 56); and right lower limb dominant (n = 72). Mean TPDT threshold ranges included: lateral right knee, 36.7 (14.3); medial right knee, 28.6 (9.7); lateral left knee, 37.7 (12.9); and medial left knee, 27.9 (11.4). Fifteen percent of the threshold variance (R2 = 0.148) of TPDT estimates was explained by the medial aspect (β = −8.9; p = 0.000) and male gender (β = 3.1; p = 0.057), weighted by anthropometric factors.
Age-stratified knee TPDT estimates have been reported to aid clinical interpretation. Regional asymmetry, gender, and obesity indices are factors that determine the TPDT of the knee. Normal TPDT asymmetry observed at medial aspect of the knee has significantly greater acuity compared to the lateral knee.
Clinicians often rely on physical examination tests to guide them in the diagnostic process of knee disorders. However, reliability of these tests is often overlooked and may influence the consistency of results and overall diagnostic validity. Therefore, the objective of this study was to systematically review evidence on the reliability of physical examination tests for the diagnosis of knee disorders. A structured literature search was conducted in databases up to January 2016. Included studies needed to report reliability measures of at least one physical test for any knee disorder. Methodological quality was evaluated using the QAREL checklist. A qualitative synthesis of the evidence was performed. Thirty-three studies were included with a mean QAREL score of 5.5 ± 0.5. Based on low to moderate quality evidence, the Thessaly test for meniscal injuries reached moderate inter-rater reliability (k = 0.54). Based on moderate to excellent quality evidence, the Lachman for anterior cruciate ligament injuries reached moderate to excellent inter-rater reliability (k = 0.42 to 0.81). Based on low to moderate quality evidence, the Tibiofemoral Crepitus, Joint Line and Patellofemoral Pain/Tenderness, Bony Enlargement and Joint Pain on Movement tests for knee osteoarthritis reached fair to excellent inter-rater reliability (k = 0.29 to 0.93). Based on low to moderate quality evidence, the Lateral Glide, Lateral Tilt, Lateral Pull and Quality of Movement tests for patellofemoral pain reached moderate to good inter-rater reliability (k = 0.49 to 0.73). Many physical tests appear to reach good inter-rater reliability, but this is based on low-quality and conflicting evidence. High-quality research is required to evaluate the reliability of knee physical examination tests.
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：