College of Health Sciences, University of Missouri, Columbia, Missouri.
Department of Physical Therapy, University of Missouri, Columbia, Missouri.
J Knee Surg. 2024 Jul;37(8):577-585. doi: 10.1055/s-0043-1772222. Epub 2023 Aug 10.
Following knee surgery, clinicians have traditionally used visually rated or time-based assessments of lower extremity movement quality to measure surgical outcomes, plan rehabilitation interventions, and measure success. These methods of assessment are prone to error and do not fully capture a patient's inefficient movement patterns post surgery. Further, currently available systems which objectively measure kinematics during these tasks are expensive and unidimensional. For these reasons, recent research has called for the development of objective and low-cost precision rehabilitation tools to improve clinical measurement of movement tasks. The purpose of this article is to highlight two such tools and their applications to knee surgery. The systems highlighted within this article are the Mizzou Point-of-Care Assessment System (MPASS) and the Mizzou Knee Arthrometer Testing System (MKATS). MPASS has demonstrated high levels of agreement with the gold-standard Vicon system in measuring kinematics during sit-to-stand ( > 0.71), lateral step-down (intraclass correlation coefficient [ICC] > 0.55, apart from ankle flexion), and drop vertical jump tasks (ICC > 0.62), as well as gait ( > 0.87). MKATS has been used to quantify differences in tibiofemoral motion between groups during lateral step-down, step-up-and-over, and step-up/step-down tasks. Objective measurement of clinical tasks using portable and inexpensive instruments, such as the MPASS and MKATS, can help clinicians identify inefficient movement patterns and asymmetries which may damage and wear down supporting structures within the knee and throughout the kinetic chain causing pain and discomfort. Identifying these issues can help clinicians to plan interventions and measure their progress at a lower cost than currently available systems. The MPASS and MKATS are useful tools which have many applications to knee surgery.
膝关节手术后，临床医生传统上使用视觉评估或基于时间的下肢运动质量评估来衡量手术结果、制定康复干预计划和衡量手术成功。这些评估方法容易出错，并且不能完全捕捉到患者手术后的低效运动模式。此外，目前用于客观测量这些任务中的运动学的系统价格昂贵且是单维的。由于这些原因，最近的研究呼吁开发客观且低成本的精密康复工具，以改善对运动任务的临床测量。本文的目的是强调这两种工具及其在膝关节手术中的应用。本文中强调的系统是密苏里即时护理评估系统（MPASS）和密苏里膝关节关节测试仪系统（MKATS）。MPASS 在测量坐站（ > 0.71）、侧向下台阶（组内相关系数 [ICC] > 0.55，除了踝关节屈曲）和垂直跳下降任务（ICC > 0.62）期间的运动学方面与黄金标准 Vicon 系统具有高度一致性，以及步态（ > 0.87）。MKATS 已用于量化侧向下台阶、上步跨越和上/下台阶任务中胫骨股骨运动之间的差异。使用便携式和廉价仪器（如 MPASS 和 MKATS）对临床任务进行客观测量，可以帮助临床医生识别低效的运动模式和不对称性，这些模式和不对称性可能会损坏和磨损膝关节内和整个动力链中的支撑结构，导致疼痛和不适。识别这些问题可以帮助临床医生以比现有系统更低的成本计划干预措施并衡量其进展。MPASS 和 MKATS 是非常有用的工具，它们在膝关节手术中有许多应用。
