Ismail Shiek Abdullah, Simic Milena, Clarke Jillian L, Lopes Thiago Jambo Alves, Pappas Evangelos
Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
Knee. 2017 Dec;24(6):1307-1316. doi: 10.1016/j.knee.2017.08.053. Epub 2017 Sep 30.
This study reports the development and validation of a quantitative technique of assessing frontal knee joint laxity through a custom built device named KLICP. The objectives of this study were to determine: (i) the intra- and inter-rater reliability and (ii) the validity of the device when compared to real time ultrasound.
Twenty-five participants had their frontal knee joint laxity assessed by the KLICP, by manual varus/valgus tests and by ultrasound. Two raters independently assessed laxity manually by three repeated measurements, repeated at least 48h later. Results were validated by comparing them to the medial and lateral joint space opening measured by the ultrasound. Intraclass correlation coefficients and standard error of measurement reliability were calculated. Pearson's correlation coefficients were calculated to determine the correlation between the KLICP and the joint space.
Intra-rater reliability (intra-session) for each rater was good on both sessions (0.91-0.98), intra-rater reliability (inter-sessions) was moderate to good (0.62-0.87), and inter-rater reliability (intra-session) was good (0.75-0.80). There is low agreement for intra-rater (inter-session) and for inter-rater (intra-session) reliability. The KLICP measurement has a significant positive fair to moderate correlation to the ultrasound measurement at the left (r: 0.61, p: 0.01) and right (r: 0.48, p: 0.02) knee in the valgus direction and at the left (r: 0.51, p: 0.01) and right (r: 0.39, p: 0.05) knee in the varus direction. There is low agreement between the KLICP and the RTU.
Reliability and agreement was good only when measured for intra-rater, within session.
本研究报告了一种通过名为KLICP的定制设备评估膝关节前向松弛度的定量技术的开发与验证。本研究的目的是确定：（i）评估者内和评估者间的可靠性，以及（ii）与实时超声相比该设备的有效性。
25名参与者通过KLICP、手动内翻/外翻试验和超声对其膝关节前向松弛度进行评估。两名评估者通过三次重复测量独立手动评估松弛度，至少48小时后重复测量。通过将结果与超声测量的内侧和外侧关节间隙开口进行比较来验证结果。计算组内相关系数和测量可靠性的标准误差。计算Pearson相关系数以确定KLICP与关节间隙之间的相关性。
每位评估者的评估者内可靠性（同次测量）在两次测量中均良好（0.91 - 0.98），评估者内可靠性（不同次测量）为中等至良好（0.62 - 0.87），评估者间可靠性（同次测量）良好（0.75 - 0.80）。评估者内（不同次测量）和评估者间（同次测量）可靠性的一致性较低。KLICP测量与超声测量在左膝（r：0.61，p：0.01）和右膝（r：0.48，p：0.02）外翻方向以及左膝（r：0.51，p：0.01）和右膝（r：0.39，p：0.05）内翻方向上具有显著的正相关，相关性为中等至良好。KLICP与实时超声之间的一致性较低。
仅在评估者内同次测量时，可靠性和一致性良好。
