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Shen X, Wang S, Chen J, Li J, Li C, Xiang R, Zhao C, Xu X. Inter-rater reliability and test-retest reliability of the foot posture index (FPI-6) for assessing static foot posture in elderly female patients with knee osteoarthritis and its association with quadriceps muscle tone and stiffness. Front Bioeng Biotechnol 2024; 12:1385986. [PMID: 38983600 PMCID: PMC11232489 DOI: 10.3389/fbioe.2024.1385986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/29/2024] [Indexed: 07/11/2024] Open
Abstract
Objective 1. To assess the Inter-rater reliability and test-retest reliability of FPI-6 total score and individual scores in static foot posture evaluation among elderly female patients with knee osteoarthritis (KOA), aiming to establish the reliability of the FPI-6 scale. 2. To investigate the disparity between dominant and non-dominant quadriceps characteristics in elderly female KOA patients, as well as explore the correlation between quadriceps characteristics and abnormal foot posture, thereby offering novel insights for the prevention and treatment of KOA. Methods The study enrolled a total of 80 lower legs of 40 participants (all female) with unilateral or bilateral KOA, who were assessed by two raters at three different time points. The inter-rater and test-retest reliability of the FPI-6 was evaluated using the intra-class correlation coefficient (ICC), while the absolute reliability of FPI-6 was examined using the standard error of measurement (SEM), minimum detectable change (MDC), and Bland-Altman analysis. The internal consistency of FPI-6 was assessed using Spearman's correlation coefficient. Additionally, MyotonPRO was employed to assess quadriceps muscle tone and stiffness in all participants, and the association between quadriceps muscle tone/stiffness and the total score of FPI-6 was analyzed. Result Our study found excellent inter-rater and test-retest reliability (ICC values of 0.923 and 0.931, respectively) for the FPI-6 total score, as well as good to excellent reliability (ICC values ranging from 0.680 to 0.863 and 0.739-0.883) for individual items. The SEM and MDC values for the total score of FPI-6 among our study inter-rater were 0.78 and 2.15, respectively. and the SEM and MDC values for the test-retest total score of FPI-6 were found to be 0.76 and 2.11, respectively. Furthermore, the SEM and MDC values between inter-rater and test-retest across six individual items ranged from 0.30 to 0.56 and from 0.84 to 1.56. The Bland-Altman plots and respective 95% LOA showed no evidence of systematic bias. In terms of the mechanical properties of the quadriceps on both sides, the muscle tone and stiffness of rectus femoris (RF), vastus medialis (VM), and vastus lateralis (VL) were significantly higher in the non-dominant leg compared to the dominant leg. Additionally, in the non-dominant leg, there was a significant positive correlation between the muscle tone and stiffness of VM, VL, RF and the total score of FPI-6. However, in the dominant leg, only VM's muscle tone and stiffness showed a significant positive correlation with the total score of FPI-6. Conclusion The reliability of the FPI-6 total score and its six individual items was good to excellent. Our findings offer a straightforward and dependable approach for researchers to assess foot posture in elderly female patients with KOA. Furthermore, we observed significantly greater quadriceps tension and stiffness in the non-dominant leg compared to the dominant leg. The FPI-6 total score exhibited a significant correlation with changes in quadriceps muscle performance among KOA patients. These observations regarding the relationship between changes in quadriceps muscle performance and foot posture in elderly female KOA patients may provide novel insights for disease prevention, treatment, and rehabilitation.
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Affiliation(s)
- XingXing Shen
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shuai Wang
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiahao Chen
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junyi Li
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Congcong Li
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ruian Xiang
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chuanxi Zhao
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Xuemeng Xu
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
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Chen W, Li C, Wang Y, Shen X, Wu Z, Li J, Ye Z, Xiang R, Xu X. Comparison of the asymmetries in muscle mass, biomechanical property and muscle activation asymmetry of quadriceps femoris between patients with unilateral and bilateral knee osteoarthritis. Front Physiol 2023; 14:1126116. [PMID: 37284540 PMCID: PMC10239935 DOI: 10.3389/fphys.2023.1126116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 04/25/2023] [Indexed: 06/08/2023] Open
Abstract
Background: More and more attention has been paid to the research of muscle mass and muscle quality of quadriceps femoris (QF) in knee osteoarthritis (KOA). This study aimed to explore the asymmetric changes of muscle mass, biomechanical property and muscle activation in the inter-limbs QF of KOA patients, and tried to provide a novel insight for the evaluation, prevention and treatment of KOA. Methods: A total of 56 Participants with unilateral or bilateral KOA were included in this study: 30 patients with unilateral pain and 26 patients with bilateral pain were assigned to the bilateral group (BG) and unilateral group (UG), respectively. The symptom severity of bilateral lower limbs was evaluated by visual analogue scale, and the relatively serious leg (RSL) and relatively moderate leg (RML) were classified. The thickness of rectus femoris (RF), vastus intermedius (VI), vastus medialis (VM) and vastus lateralis (VL) were measured by ultrasound. The Shear wave elastography (SWE) techniqie was used to measure the shear modulus of RF, VM and VL. Surface electromyography (sEMG) was used to assess the root mean square (RMS) of the RF, VM, and VL during straight leg raising in a sitting position and squatting task. We calculated the asymmetry indexes of inter-limbs for the corresponding indices of the measured muscles. Result: Thickness of RF, VI and VL of RSL was lower than those on RML (p < 0.05), and thickness of VM was lower more significant (p < 0.01). Thickness of RF, VI and VL of RSL was also lower than those of RML in BG (p < 0.05), however, there was no significant difference in VM thickness (p > 0.05). There were no significant difference in Asymmetry indexes of all measured muscle thickness between the two groups (p > 0.05). The Shear modulus of RF, VM, and VL in the RML of UG and BG was higher than those in the RSL (p < 0.05). In sitting and straight leg raising task, the RMS of RF, VM and VL in RML were higher than those in RSL, UG and BG both showed this trend (p < 0.05). About squatting task, in UG, the RMS of the three muscles in RML of patients were also higher than those in the RSL (p < 0.05). However, the difference was not significant in BG (p > 0.05). In the straight leg raising task, the asymmetry indexes of RMS in RF, VM, and VL of both the two groups were positively correlated with VAS scores (p < 0.05). Conclusion: The muscle thickness, shear modulus and muscle activation electromyography of QF in RML were higher than those of RSL in unilateral KOA patients. The VM of RML in bilateral KOA patients may show muscle thickness degeneration earlier, which is closer to the VM of RSL. The shear modulus of RF, VM, and VL were higher on the RML side during the single-leg task, but there may be passive compensation for muscle activation in both lower limbs during the bipedal task. In conclusion, there is a general asymmetry of QF muscle mass, biomechanics Characteristic and performance in patients with KOA, which may provide new ideas for the assessment, treatment and rehabilitation of the disease.
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Affiliation(s)
- Weijian Chen
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Congcong Li
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Wang
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xingxing Shen
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zugui Wu
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junyi Li
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zixuan Ye
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ruian Xiang
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xuemeng Xu
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China
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Oliveira LASD, Pontes-Silva A, Damasceno KLB, Apahaza GHS, Oliveira ARD, Dibai-Filho AV, Avila MA, Fidelis-de-Paula-Gomes CA. Comparison between pain intensity, functionality, central sensitization, and self-efficacy in individuals with unilateral or bilateral knee osteoarthritis: a cross-sectional study. Rev Assoc Med Bras (1992) 2022; 68:1048-1052. [PMID: 36134833 PMCID: PMC9574988 DOI: 10.1590/1806-9282.20220170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/10/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE: This study aimed to compare pain intensity, stiffness, functionality, central sensitization, and self-efficacy, between individuals with bilateral knee osteoarthritis and unilateral knee osteoarthritis. METHODS: We included sedentary participants with knee osteoarthritis. The diagnosis was defined by a specialist, in which there was a complaint of pain and/or altered function in the lower limbs (duration ≥3 months); morning stiffness; pain intensity ≥3; Kellgren-Lawrence 2–3° associated with X-ray; persistence of symptoms >3 months. We used the following tools: Western Ontario and McMaster Universities Arthritis Index, Numerical Pain Scale, Central Sensitization Inventory, and Pain Self-Efficacy Questionnaire. Intergroup comparisons were performed using the t-test. RESULTS: The sample consisted of 118 adult individuals, divided into two groups: bilateral knee osteoarthritis (n=59) and unilateral knee osteoarthritis (n=59). We observed a significant difference (p<0.05) and a large effect size (d≥0.8), in the comparisons between: stature, body mass index, physical function, central sensitization, and self-efficacy. CONCLUSION: Individuals with bilateral knee osteoarthritis have higher levels of central sensitization, impaired functionality, and a lower level of self-efficacy.
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Affiliation(s)
| | - André Pontes-Silva
- Universidade Federal de São Carlos, Department of Physical Therapy, Study Group on Chronic Pain, Laboratory of Research on Electrophysical Agents - São Carlos (SP), Brazil.,Universidade Federal do Maranhão, Postgraduate Program in Adult Health, Research Group on Rehabilitation, Exercise, and Movement - São Luís (MA), Brazil
| | | | | | | | - Almir Vieira Dibai-Filho
- Universidade Federal do Maranhão, Postgraduate Program in Adult Health, Research Group on Rehabilitation, Exercise, and Movement - São Luís (MA), Brazil.,Universidade Federal do Maranhão, Postgraduate Program in Physical Education - São Luís (MA), Brazil
| | - Mariana Arias Avila
- Universidade Federal de São Carlos, Department of Physical Therapy, Study Group on Chronic Pain, Laboratory of Research on Electrophysical Agents - São Carlos (SP), Brazil
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Intelligent Algorithm-Based Magnetic Resonance for Evaluating the Effect of Platelet-Rich Plasma in the Treatment of Intractable Pain of Knee Arthritis. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:9223928. [PMID: 35685660 PMCID: PMC9162865 DOI: 10.1155/2022/9223928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 12/11/2022]
Abstract
The application of intelligent algorithms in the treatment of intractable pain of patients with platelet-rich plasma (PRP) knee osteoarthritis by magnetic resonance was investigated. The automatic diagnosis of magnetic resonance knee osteoarthritis was established with multiple intelligent algorithms, including gray projection algorithm, adaptive binarization algorithm, and active shape model (ASM). The difference between automatic magnetic resonance detection indexes of the patients with knee osteoarthritis and artificial measurement results was analyzed. The included patients received PRP treatment. Knee osteoarthritis MRI osteoarthritis knee scores (KOA MOAKS) and Western Ontario and McMaster Universities arthritis index (WOMAC) before and after treatment were compared. The results showed that the results of knee osteoarthritis scores, inferior angle of femur, superior angle of tibia, and tibiofemoral angle (TFA) by automatic magnetic resonance diagnostic model were entirely consistent with artificial detection results. After the treatment, the total scores of knee lateral area, interior area, central area, and patellar area were all remarkably lower than those before the treatment (P < 0.05). After the treatment, knee KOA MOAKS scores and WOMAC scores were both lower than those before the treatment (P < 0.05). Visual analogue scale (VAS) scores 1 week, 2 weeks, and 3 weeks after the treatment were decreased compared with those before the treatment (P < 0.05). Relevant studies indicated that intelligent algorithm-based automatic magnetic resonance diagnostic knee osteoarthritis model showed good utilization values, which could provide the reference and basis for the treatment of the patients with knee osteoarthritis.
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Deep Learning-Based CT Imaging to Evaluate the Therapeutic Effects of Acupuncture and Moxibustion Therapy on Knee Osteoarthritis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:1135196. [PMID: 35637844 PMCID: PMC9148233 DOI: 10.1155/2022/1135196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/19/2022] [Accepted: 04/23/2022] [Indexed: 11/18/2022]
Abstract
The study was aimed at analyzing the application value of deep learning-based computed tomography (CT) in evaluating the effect of acupuncture for knee osteoarthritis (KOA). Specifically, 124 patients with KOA were selected in the test group (warm acupuncture and moxibustion) and the control group (simple acupuncture), with 62 cases in each group. Deep learning-based CT scanning was performed before and after treatment to compare the Lequesne-Mery, Visual Analog Scale (VAS), Western Ontario and McMaster Universities (WOMAC), Hospital Special Surgery (HSS), and Knee Society Score (KSS) scores as well as the overall effective rate. The results showed that the trabecular thickness, quantity, bone mineral density (BMD), connection density, structural model index, and articular cartilage thickness were different significantly between the two groups (P < 0.05). After treatment, the Lequesne-Mery was 4.78, the VAS was 0.87, and the WOMAC score was 14.89 of the test group, which were reduced (P < 0.05). The KSS and HSS scores of the test group were improved significantly after treatment (P < 0.05). The total effective rate of the test group was 85.48%, and that of the control group was 51.61%; the former was significantly higher than the latter (P < 0.05). In conclusion, acupuncture could improve the clinical effect on KOA patients, and CT scanning under deep learning algorithm could evaluate the clinical effect of acupuncture for KOA.
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