Is clinically measured knee range of motion after total knee arthroplasty ‘good enough?’: A feasibility study using wearable inertial measurement units to compare knee range of motion captured during physical therapy versus at home
Total knee arthroplasty is highly successful, in part due to range of motion (RoM) recovery. This is typically estimated goniometrically/visually by physical therapists (PTs) in the clinic, which is imprecise. Accordingly, a validated inertial measurement unit (IMU) method for capturing knee RoM was...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-09-01
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| Series: | Medicine in Novel Technology and Devices |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590093521000291 |
| _version_ | 1819124441757515776 |
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| author | Ryan M. Chapman Wayne E. Moschetti Douglas W. Van Citters |
| author_facet | Ryan M. Chapman Wayne E. Moschetti Douglas W. Van Citters |
| author_sort | Ryan M. Chapman |
| collection | DOAJ |
| description | Total knee arthroplasty is highly successful, in part due to range of motion (RoM) recovery. This is typically estimated goniometrically/visually by physical therapists (PTs) in the clinic, which is imprecise. Accordingly, a validated inertial measurement unit (IMU) method for capturing knee RoM was deployed assessing postoperative RoM both in and outside of the clinical setting. The study's objectives were to evaluate the feasibility of continuously capturing knee RoM pre-/post-op via IMUs, dividing data into PT/non-PT portions of each day, and comparing PT/non-PT metrics. We hypothesized IMU-based clinical knee RoM would differ from IMU-based knee RoM captured outside clinical settings. 10 patients (3 M, 69 ± 13 years) completed informed consent documents following ethics board approval. A validated IMU method captured long duration (8–12 h/day, ~50 days) knee RoM pre-/post-op. Post-op metrics were subdivided (PT versus non-PT). Clinical RoM and patient reported outcome measures were also captured. Compliance and clinical disruption were evaluated. ANOVA compared post-op PT and non-PT means and change scores. Maximum flexion during PT was less than outside PT. PT stance/swing RoM and activity level were greater than outside PT. No temporal variable differences were found PT versus non-PT. IMU RoM measurements capture richer information than clinical measures. Maximum PT flexion was likely less than non-PT due to the exercises completed (i.e. high passive RoM vs. low RoM gait). PT gait flexion likely exceed non-PT because of ‘white coat effects’ wherein patients are closely monitored clinically. This implies data captured clinically represents optimum performance whereas data captured non-clinically represents realistic performance. |
| first_indexed | 2024-12-22T07:24:18Z |
| format | Article |
| id | doaj.art-21970514a265456084618b8b24b72e09 |
| institution | Directory Open Access Journal |
| issn | 2590-0935 |
| language | English |
| last_indexed | 2024-12-22T07:24:18Z |
| publishDate | 2021-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Medicine in Novel Technology and Devices |
| spelling | doaj.art-21970514a265456084618b8b24b72e092022-12-21T18:34:10ZengElsevierMedicine in Novel Technology and Devices2590-09352021-09-0111100085Is clinically measured knee range of motion after total knee arthroplasty ‘good enough?’: A feasibility study using wearable inertial measurement units to compare knee range of motion captured during physical therapy versus at homeRyan M. Chapman0Wayne E. Moschetti1Douglas W. Van Citters2Dartmouth College, Thayer School of Engineering, 14 Engineering Drive, Hanover, NH, 03755, USA; University of Rhode Island, Department of Kinesiology, 25 W Indendence Way, Kingston, RI, 02881, USA; Corresponding author.Dartmouth Hitchcock Medical Center, Department of Orthopaedics, 1 Medical Center Drive, Lebanon, NH, 03766, USADartmouth College, Thayer School of Engineering, 14 Engineering Drive, Hanover, NH, 03755, USATotal knee arthroplasty is highly successful, in part due to range of motion (RoM) recovery. This is typically estimated goniometrically/visually by physical therapists (PTs) in the clinic, which is imprecise. Accordingly, a validated inertial measurement unit (IMU) method for capturing knee RoM was deployed assessing postoperative RoM both in and outside of the clinical setting. The study's objectives were to evaluate the feasibility of continuously capturing knee RoM pre-/post-op via IMUs, dividing data into PT/non-PT portions of each day, and comparing PT/non-PT metrics. We hypothesized IMU-based clinical knee RoM would differ from IMU-based knee RoM captured outside clinical settings. 10 patients (3 M, 69 ± 13 years) completed informed consent documents following ethics board approval. A validated IMU method captured long duration (8–12 h/day, ~50 days) knee RoM pre-/post-op. Post-op metrics were subdivided (PT versus non-PT). Clinical RoM and patient reported outcome measures were also captured. Compliance and clinical disruption were evaluated. ANOVA compared post-op PT and non-PT means and change scores. Maximum flexion during PT was less than outside PT. PT stance/swing RoM and activity level were greater than outside PT. No temporal variable differences were found PT versus non-PT. IMU RoM measurements capture richer information than clinical measures. Maximum PT flexion was likely less than non-PT due to the exercises completed (i.e. high passive RoM vs. low RoM gait). PT gait flexion likely exceed non-PT because of ‘white coat effects’ wherein patients are closely monitored clinically. This implies data captured clinically represents optimum performance whereas data captured non-clinically represents realistic performance.http://www.sciencedirect.com/science/article/pii/S2590093521000291Knee replacementPostoperative rehabilitationWearableInertial measurement unitTotal joint arthroplastyRange of motion |
| spellingShingle | Ryan M. Chapman Wayne E. Moschetti Douglas W. Van Citters Is clinically measured knee range of motion after total knee arthroplasty ‘good enough?’: A feasibility study using wearable inertial measurement units to compare knee range of motion captured during physical therapy versus at home Medicine in Novel Technology and Devices Knee replacement Postoperative rehabilitation Wearable Inertial measurement unit Total joint arthroplasty Range of motion |
| title | Is clinically measured knee range of motion after total knee arthroplasty ‘good enough?’: A feasibility study using wearable inertial measurement units to compare knee range of motion captured during physical therapy versus at home |
| title_full | Is clinically measured knee range of motion after total knee arthroplasty ‘good enough?’: A feasibility study using wearable inertial measurement units to compare knee range of motion captured during physical therapy versus at home |
| title_fullStr | Is clinically measured knee range of motion after total knee arthroplasty ‘good enough?’: A feasibility study using wearable inertial measurement units to compare knee range of motion captured during physical therapy versus at home |
| title_full_unstemmed | Is clinically measured knee range of motion after total knee arthroplasty ‘good enough?’: A feasibility study using wearable inertial measurement units to compare knee range of motion captured during physical therapy versus at home |
| title_short | Is clinically measured knee range of motion after total knee arthroplasty ‘good enough?’: A feasibility study using wearable inertial measurement units to compare knee range of motion captured during physical therapy versus at home |
| title_sort | is clinically measured knee range of motion after total knee arthroplasty good enough a feasibility study using wearable inertial measurement units to compare knee range of motion captured during physical therapy versus at home |
| topic | Knee replacement Postoperative rehabilitation Wearable Inertial measurement unit Total joint arthroplasty Range of motion |
| url | http://www.sciencedirect.com/science/article/pii/S2590093521000291 |
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