Loyd Brian J, Burrows Kristine, Forster Jeri E, Stackhouse Scott K, Hogan Craig, Stevens-Lapsley Jennifer E
Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus , Aurora, CO, USA.
Department of Physical Therapy, University of New England , Portland, ME, USA.
Physiother Theory Pract. 2021 Jan;37(1):197-203. doi: 10.1080/09593985.2019.1619886. Epub 2019 May 29.
Total knee arthroplasty (TKA) is the most common elective orthopedic surgery performed in the United States. Following surgery patients experience significant lower extremity swelling that is related to poor satisfaction with surgery and is hypothesized to contribute to functional decline. However, in practice, precise and reliable methods for measuring lower extremity swelling do not exist. The purpose of this study was to provide reliability and precision parameters of an innovative approach, single frequency bioelectrical impedance assessment (SF-BIA), for measuring post-TKA lower extremity swelling. Swelling in 56 patients (64.3 ± 9.3 years; 29 males) was measured before and after TKA using SF-BIA and circumferential measures (CM). Reliability of the measures was calculated using Intraclass Correlation Coefficients (ICC). Precision of the measures was provided using standard error of the measurement and minimal detectable change (MDC90). Change values between time points for SF-BIA and CM are provided. SF-BIA was found to have greater reliability following surgery compared to CM (ICC = 0.99 vs 0.68). SF-BIA was found to have an MDC90 = 2% following surgery, indicating improved ability to detect minute fluctuations in swelling compared to CM (MDC90 = 6%) following surgery. These results indicate that SF-BIA improves the precision and reliability of swelling measurement compared to CM.
全膝关节置换术（TKA）是美国最常见的择期骨科手术。术后患者会出现明显的下肢肿胀，这与对手术的满意度低有关，并且据推测会导致功能下降。然而，在实际操作中，并不存在精确且可靠的测量下肢肿胀的方法。本研究的目的是提供一种创新方法——单频生物电阻抗评估（SF-BIA）用于测量全膝关节置换术后下肢肿胀的可靠性和精密度参数。使用SF-BIA和周径测量（CM）对56例患者（64.3±9.3岁；29例男性）在全膝关节置换术前和术后的肿胀情况进行测量。使用组内相关系数（ICC）计算测量的可靠性。使用测量标准误差和最小可检测变化（MDC90）提供测量的精密度。给出了SF-BIA和CM在不同时间点之间的变化值。结果发现，与CM相比，SF-BIA在术后具有更高的可靠性（ICC = 0.99对0.68）。术后SF-BIA的MDC90 = 2%，表明与术后CM（MDC90 = 6%）相比，其检测肿胀微小波动的能力有所提高。这些结果表明，与CM相比，SF-BIA提高了肿胀测量的精密度和可靠性。
