35.
Can patients accurately assess their knee range of motion?
Development and validation of a picture based questionnaire
Jens Borgbjerg, Jens Odgaard
Department of Orthopaedic Surgery Aarhus University Hospital, Aarhus,
Denmark; Department of Orthopaedic Surgery, Aarhus University Hospital,
Aarhus, Denmark
Background:
The current practice for assessment of knee range of motion
(
ROM) implies involvement of trained personnel.
Purpose / Aim of Study:
The purpose of this study was to investigate whether
patients can accurately assess their knee passive ROM.
Materials and Methods:
A picture based questionnaire for patient assessment
of passive ROM was developed. The accuracy of patient assessed ROM was
compared to goniometric assessment by a health professional. The
questionnaire was posted to patients who completed the questionnaire at home
and subsequently had their knee ROM measured by a health professional with
a short arm goniometer. A total of 58 patients were evaluated. Agreement
between the measurement methods was calculated with the Bland-Altman
method. We calculated the sensitivity and specificity of patient assessed ROM
in dichotomously distinguishing between different ranges of motion.
Findings / Results:
The agreement between goniometric assessment and
patient assessment of knee flexion showed a mean difference of 1.9° (limits of
agreement -32.3° to 35.9°) for flexion and 5.8° (limits of agreement -26.5° to
14.8
°) for extension. The sensitivity of patient assessment in identifying knee
flexion less than or equal to 100° was 92%. Specificity was 85%. The
sensitivity of patient assessment in identifying a knee flexion contracture
greater than 10° was 100%. Specificity was 48%.
Conclusions:
Although the results of the study show wide limits of agreement
between goniometric assessment and patient assessment of knee ROM, the
picture based questionnaire for patient assessment of knee ROM was found to
be a valid tool for dichotomously distinguishing between different ranges of
motion.
