Cordell Kathleen C, Wilke Benjamin K, Haupt Edward T, Dohse Nicolas M, Berger Thomas G, Heckman Michael G, Shi Glenn G
Exercise and Sport Science, University of Georgia, Athens, USA.
Orthopaedic Surgery, Mayo Clinic, Jacksonville, USA.
Cureus. 2025 Apr 9;17(4):e81964. doi: 10.7759/cureus.81964. eCollection 2025 Apr.
Introduction Many studies focused on the positive impact of virtual visits during the COVID-19 pandemic. In the post-pandemic era, research exploring telemedicine's impact on the orthopedic physical examination, particularly for the lower extremities, continues to expand. This research evaluates the validity and reliability of telemedicine measuring ankle and great toe range of motion (ROM). Methods In this prospective study, 59 ankles and 59 great toes were measured by a researcher trained by a licensed occupational therapist for goniometer use both in-person and through telemedicine. Telemedicine measurements were also made by a second researcher. Mean differences and intraclass correlation coefficients (ICCs) were used to assess validity by comparing the ROM between in-person and telemedicine ROM measures. ICCs were used to evaluate reliability by assessing agreement in telemedicine ROM measures between the two different researchers. Results In the evaluation of validity, in-person and telemedicine measurements for both ankle dorsiflexion and plantarflexion revealed ICCs of 0.81, with mean differences equal to -0.64 and -0.93 degrees, respectively. In-person and still-shot photography for ankle dorsiflexion had an ICC of 0.83 and plantarflexion had an ICC of 0.82, with respective mean differences of -1.39 and -0.24 degrees. Hallux extension measurements between in-person and telemedical visits had an ICC of 0.87 (mean difference: 2.34 degrees), whereas still-shot showed an ICC of 0.86 (mean difference: 2.58 degrees). Hallux flexion had an ICC of 0.93 (mean difference: -0.98 degrees) for in-person and telemedical visits and an ICC of 0.95 (mean difference: -1.51 degrees) for in-person and still-shot measures. Conclusion Ankle and great toe joint ROM can be measured effectively during an orthopedic telemedicine visit equivalent to that of an in-person measurement. This supports the idea that a virtual physical ROM exam can increase efficiency for both patients and providers.
引言 许多研究聚焦于2019冠状病毒病大流行期间虚拟问诊的积极影响。在大流行后的时代,探索远程医疗对骨科体格检查,特别是对下肢检查影响的研究仍在不断扩展。本研究评估远程医疗测量踝关节和拇趾活动范围(ROM)的有效性和可靠性。方法 在这项前瞻性研究中,由一名经持牌职业治疗师培训过使用量角器的研究人员,对59个踝关节和59个拇趾进行了现场和通过远程医疗的测量。另一名研究人员也进行了远程医疗测量。通过比较现场和远程医疗ROM测量之间的ROM,使用平均差异和组内相关系数(ICC)来评估有效性。通过评估两位不同研究人员的远程医疗ROM测量结果的一致性,使用ICC来评估可靠性。结果 在有效性评估中,踝关节背屈和跖屈的现场和远程医疗测量显示ICC为0.81,平均差异分别为-0.64度和-0.93度。踝关节背屈的现场测量与静态摄影的ICC为0.83,跖屈的ICC为0.82,各自的平均差异为-1.39度和-0.24度。现场和远程医疗问诊之间的拇趾背伸测量的ICC为0.87(平均差异:2.34度),而静态摄影显示ICC为0.86(平均差异:2.58度)。拇趾跖屈的现场和远程医疗问诊的ICC为0.93(平均差异:-0.98度),现场和静态摄影测量的ICC为0.95(平均差异:-1.51度)。结论 在骨科远程医疗问诊期间,可以有效地测量踝关节和拇趾关节的ROM,其效果与现场测量相当。这支持了虚拟物理ROM检查可以提高患者和医疗服务提供者效率的观点。
J Orthop Sports Phys Ther. 2011-4-1
J Dance Med Sci. 2012-9
J Back Musculoskelet Rehabil. 2018
Int J Sports Phys Ther. 2012-6
Int J Sports Phys Ther. 2023-8-1
Appl Clin Inform. 2023-1
Telemed J E Health. 2022-5
Arch Orthop Trauma Surg. 2021-10
Am J Infect Control. 2021-8
J Am Med Inform Assoc. 2021-2-15
Curr Rev Musculoskelet Med. 2020-12
Mayo Clin Proc. 2020-8
Curr Allergy Asthma Rep. 2020-7-27