Dietz Matthew J, Sprando Daniel, Hanselman Andrew E, Regier Michael D, Frye Benjamin M
Department of Orthopaedics, West Virginia University, PO Box 9196, Morgantown, WV 26506-9196, USA.
Washington and Jefferson College, 60 South Lincoln Street, Washington, PA 15301, USA.
Knee. 2017 Mar;24(2):224-230. doi: 10.1016/j.knee.2016.11.014. Epub 2017 Feb 5.
Measuring knee range of motion (ROM) is an important assessment for the outcomes of total knee arthroplasty. Recent technological advances have led to the development and use of accelerometer-based smartphone applications to measure knee ROM. The purpose of this study was to develop, standardize, and validate methods of utilizing smartphone accelerometer technology compared to radiographic standards, visual estimation, and goniometric evaluation.
Participants used visual estimation, a long-arm goniometer, and a smartphone accelerometer to determine range of motion of a cadaveric lower extremity; these results were compared to radiographs taken at the same angles.
The optimal smartphone position was determined to be on top of the leg at the distal femur and proximal tibia location. Between methods, it was found that the smartphone and goniometer were comparably reliable in measuring knee flexion (ICC=0.94; 95% CI: 0.91-0.96). Visual estimation was found to be the least reliable method of measurement.
The results suggested that the smartphone accelerometer was non-inferior when compared to the other measurement techniques, demonstrated similar deviations from radiographic standards, and did not appear to be influenced by the person performing the measurements or the girth of the extremity.
测量膝关节活动范围（ROM）是全膝关节置换术疗效的一项重要评估指标。最近的技术进步促使了基于加速度计的智能手机应用程序的开发与使用，以测量膝关节ROM。本研究的目的是开发、规范并验证与X线标准、视觉估计和角度测量评估相比，利用智能手机加速度计技术的方法。
参与者使用视觉估计、长臂测角仪和智能手机加速度计来确定一具尸体下肢的活动范围；这些结果与在相同角度拍摄的X线片进行比较。
确定智能手机的最佳放置位置是在股骨远端和胫骨近端的腿部上方。在各种方法之间，发现智能手机和测角仪在测量膝关节屈曲方面具有相当的可靠性（组内相关系数=0.94；95%置信区间：0.91-0.96）。视觉估计被发现是最不可靠的测量方法。
结果表明，与其他测量技术相比，智能手机加速度计并不逊色，与X线标准显示出相似的偏差，并且似乎不受进行测量的人员或肢体周长的影响。
