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Prill R, Walter M, Królikowska A, Becker R. A Systematic Review of Diagnostic Accuracy and Clinical Applications of Wearable Movement Sensors for Knee Joint Rehabilitation. SENSORS 2021; 21:s21248221. [PMID: 34960315 PMCID: PMC8707010 DOI: 10.3390/s21248221] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 11/18/2022]
Abstract
In clinical practice, only a few reliable measurement instruments are available for monitoring knee joint rehabilitation. Advances to replace motion capturing with sensor data measurement have been made in the last years. Thus, a systematic review of the literature was performed, focusing on the implementation, diagnostic accuracy, and facilitators and barriers of integrating wearable sensor technology in clinical practices based on a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. For critical appraisal, the COSMIN Risk of Bias tool for reliability and measurement of error was used. PUBMED, Prospero, Cochrane database, and EMBASE were searched for eligible studies. Six studies reporting reliability aspects in using wearable sensor technology at any point after knee surgery in humans were included. All studies reported excellent results with high reliability coefficients, high limits of agreement, or a few detectable errors. They used different or partly inappropriate methods for estimating reliability or missed reporting essential information. Therefore, a moderate risk of bias must be considered. Further quality criterion studies in clinical settings are needed to synthesize the evidence for providing transparent recommendations for the clinical use of wearable movement sensors in knee joint rehabilitation.
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Affiliation(s)
- Robert Prill
- Center of Orthopaedics and Traumatology, Brandenburg Medical School, University Hospital Brandenburg/Havel, 14770 Brandenburg an der Havel, Germany;
- Correspondence:
| | - Marina Walter
- Hasso-Plattner-Institut, University of Potsdam, 14469 Potsdam, Germany;
| | - Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wrocław, Poland;
| | - Roland Becker
- Center of Orthopaedics and Traumatology, Brandenburg Medical School, University Hospital Brandenburg/Havel, 14770 Brandenburg an der Havel, Germany;
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Sirisena D, Papi E, Tillett E. Clinical assessment of antero-medial rotational knee laxity: a systematic review. Knee Surg Sports Traumatol Arthrosc 2017; 25:1068-1077. [PMID: 27787588 DOI: 10.1007/s00167-016-4362-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 10/13/2016] [Indexed: 12/26/2022]
Abstract
PURPOSE To inventory the examination methods available to assess antero-medial rotational laxity (AMRL) of the knee following medial collateral ligament injury. METHODS Searches were conducted in accordance with the PRISMA guidelines and using four online databases: WEB OF SCIENCE, MEDLINE, EMBASE, and AMED. The Critical Appraisal Skills Programme guidelines for Diagnostic Test Studies were used for the quality assessment of the articles. RESULTS A total of 2241 articles were identified from the database searches. From this, four articles were included in the final review. All were case-control studies, considered a combined ACL/MCL injury and had small study populations. Specialised equipment was required in all studies, and one needed additional imaging support before measurements could be taken. Two employed commercially available measuring equipment as part of the assessment process. CONCLUSION Clinical assessment of AMRL in relation to a MCL injury remains challenging. Although methods have been developed to support clinical examination, they are limited by a number of factors, including the need for additional time in the clinical environment when setting up equipment, the need for specific equipment to produce and measure rotational movement and imaging support. In addition, there are patient safety concerns from the repeated imaging. A reliable and valid clinical examination remains to be found to truly assess antero-medial rotational laxity of the knee. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Dinesh Sirisena
- Institute for Sport, Exercise and Health, University College London, London, UK. .,Khoo Teck Puat Hospital, 90 Yishun Central, Yishun, 768828, Singapore.
| | - Enrica Papi
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Eleanor Tillett
- Institute for Sport, Exercise and Health, University College London, London, UK
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Yao ZL, Wang SB, Zhang Y, Huang WH, Shen HY, Ma LM, Huang HY, Xia H. Clinical Significance of a Novel Knee Joint Stability Assessment System for Evaluating Anterior Cruciate Ligament Deficient Knees. Orthop Surg 2017; 8:75-80. [PMID: 27028384 DOI: 10.1111/os.12225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 12/08/2015] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE To investigate the six degrees of freedom (6DOF) kinematics of anterior cruciate ligament (ACL) deficient knees during gait and to explore the clinical significance of a novel knee joint stability assessment system (Opti_Knee, Innomotion, Shanghai, China) in comparison with imaging and arthroscopic examination. METHODS Three subjects diagnosed with ACL deficient knees on the basis of preoperative MRI and CT findings were subjected to treadmill gait analysis. Motion of both knees in 6DOF was measured and analyzed with an optical joint kinematics measurement system. Arthroscopic examination, the gold standard, was performed to confirm the final diagnosis and the clinical diagnosis of ACL deficiency by imaging and motion marker techniques compared with this gold standard. RESULTS Only two of the three subjects diagnosed with ACL deficiency by imaging techniques were later confirmed to have this condition by arthroscopic examination; the third was found to have an intact ACL. When the kinematics of their injured and contralateral knees were compared, abnormalities were found in the two subjects confirmed by arthroscopy to be ACL deficient However, no kinematic difference between the two knees was found in the ACL intact subject. CONCLUSIONS Opti_Knee (Innomotion) can detect abnormal kinematics in ACL deficient knees and thus provides an effective way of assisting the diagnosis of this condition and has potential for clinical application.
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Affiliation(s)
- Zi-long Yao
- Southern Medical University, Guangzhou, Guangdong, China.,Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China.,Department of Orthopedics, Guangdong Key Lab of Orthopaedic Technology and Implant, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China
| | - Shao-bai Wang
- Key Laboratory of Exercise and Health Science, Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Yu Zhang
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China.,Department of Orthopedics, Guangdong Key Lab of Orthopaedic Technology and Implant, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China
| | - Wen-han Huang
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China.,Department of Orthopedics, Guangdong Key Lab of Orthopaedic Technology and Implant, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China
| | - Hong-yuan Shen
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China.,Department of Orthopedics, Guangdong Key Lab of Orthopaedic Technology and Implant, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China
| | - Li-min Ma
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China.,Department of Orthopedics, Guangdong Key Lab of Orthopaedic Technology and Implant, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China
| | - Hua-yang Huang
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China.,Department of Orthopedics, Guangdong Key Lab of Orthopaedic Technology and Implant, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China
| | - Hong Xia
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China.,Department of Orthopedics, Guangdong Key Lab of Orthopaedic Technology and Implant, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China
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Motion Task Selection for Kinematic Evaluation After Anterior Cruciate Ligament Reconstruction: A Systematic Review. Arthroscopy 2016; 32:1453-65. [PMID: 27103604 DOI: 10.1016/j.arthro.2016.01.057] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 11/26/2015] [Accepted: 01/15/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE To examine the different motion tasks and the protocols used to objectively quantify dynamic stability in terms of knee kinematics at different stages of anterior cruciate ligament reconstruction (ACLR) recovery. METHODS A systematic search was done using OVID in Embase, Cochrane Central Register of Controlled Trials, Medline, PsychINFO, and AMED. A combination of the following keywords and their variations were used: anterior cruciate ligament, motion tasks (e.g., jump, hop, gait), and stability. The inclusion criteria were as follows: (1) ACLR subjects were recruited, (2) at least 1 motion task was performed and kinematics data were recorded, and (3) uninjured subjects or the contralateral uninjured limbs were included as a control group. Exclusion criteria were as follows: (1) non-English language publications, (2) retrospective studies and review articles, (3) animal studies, and (4) cadaveric studies. RESULTS The search returned 2,195 studies, and 56 were included in this review according to the criteria. A total of 1,086 ACLR subjects were included. Pivoting, landing, walking, running, stair negotiation, and squats were assessed using optoelectronic motion capture, electrogoniometry, or video-radiography. CONCLUSIONS The appropriate selection of motion tasks is an integral factor in dynamic stability testing as it evokes different kinematic outcomes in relation to the different stages of ACLR recovery. Stair negotiation and landing tasks are best performed during the early stages of recovery, and landing and pivoting are recommended 6 months after ACLR surgery. LEVEL OF EVIDENCE Level II, systematic review of Level I and II studies.
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Chen HN, Yang K, Dong QR, Wang Y. Assessment of tibial rotation and meniscal movement using kinematic magnetic resonance imaging. J Orthop Surg Res 2014; 9:65. [PMID: 25142267 PMCID: PMC4237875 DOI: 10.1186/s13018-014-0065-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 07/15/2014] [Indexed: 11/17/2022] Open
Abstract
Objective This work aimed to assess tibial rotations, meniscal movements, and morphological changes during knee flexion and extension using kinematic magnetic resonance imaging (MRI). Methods Thirty volunteers with healthy knees were examined using kinematic MRI. The knees were imaged in the transverse plane with flexion and extension angles from 0° to 40° and 40° to 0°, respectively. The tibial interior and exterior rotation angles were measured, and the meniscal movement range, height change, and side movements were detected. Results The tibia rotated internally (11.55° ± 3.20°) during knee flexion and rotated externally (11.40° ± 3.0°) during knee extension. No significant differences were observed between the internal and external tibial rotation angles (P > 0.05), between males and females (P > 0.05), or between the left and right knee joints (P > 0.05). The tibial rotation angle with a flexion angle of 0° to 24° differed significantly from that with a flexion angle of 24° to 40° (P < 0.01). With knee flexion, the medial and lateral menisci moved backward and the height of the meniscus increased. The movement range was greater in the anterior horn than in the posterior horn and greater in the lateral meniscus than in the medial meniscus (P < 0.01). During backward movements of the menisci, the distance between the anterior and posterior horns decreased, with the decrease more apparent in the lateral meniscus (P < 0.01). The side movements of the medial and lateral menisci were not obvious, and a smaller movement range was found than that of the forward and backward movements. Conclusion Knee flexion and extension facilitated internal and external tibial rotations, which may be related to the ligament and joint capsule structure and femoral condyle geometry.
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Affiliation(s)
| | | | - Qi-Rong Dong
- Department of Orthopaedics, Second Affiliated Hospital of Soochow University, Suzhou 215004, China.
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Fong DTP, Lam MH, Lai PK, Yung PSH, Fung KY, Chan KM. Effect of anticipation on knee kinematics during a stop-jump task. Gait Posture 2014; 39:75-9. [PMID: 23810337 DOI: 10.1016/j.gaitpost.2013.05.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Revised: 03/04/2013] [Accepted: 05/31/2013] [Indexed: 02/02/2023]
Abstract
Knee stability during a functional assessment of the stop-jump task is a key factor to determine if an athlete is adequately rehabilitated after knee ligamentous injury. This study aimed to investigate knee stability due to the effect of anticipation on landing maneuvers during planned and unplanned stop-jump tasks. Knee kinematics of ten healthy male participants were collected using an optical motion analysis system during stop-jump tasks. Stop jumps were performed in four different landing positions either in planned movement or in an unplanned movement on a signal triggered as participants passed through a photocell gate. Kinematic data at the time of foot strike at landing in the stop-jump considered for investigating the anticipation effect during the stop-jump tasks. Two-way multivariate analysis of variance (MANOVA) with repeated measures and stratified paired t-tests were conducted to compare the knee kinematics data between planned and unplanned tasks. Statistical significance was set at the p<0.05 level. External rotational angle showed a significant decrease in unplanned stop-jump tasks during forward (p<0.05) and right (p<0.05) jumps when compared to that of planned tasks. Flexion angle and abduction angle during forward, vertical and right jumps were significantly decreased in the unplanned tasks. Anticipation significantly influenced the landing maneuvers of stop-jump task. The results indicated that both planned and unplanned stop-jump tasks should be considered when monitoring the rehabilitation progress after a ligamentous injury.
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Affiliation(s)
- Daniel Tik-Pui Fong
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; The Hong Kong Jockey Club Sports Medicine and Health Sciences Centre, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
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