Patellofemoral Ağrının Değerlendirilmesinde Akıllı Telefon Uygulamalarının Geleneksel Araçlarla Karşılaştırılması: Geçerlilik ve Güvenirlik çalışması

Öz

Amaç: Patellofemoral ağrı (PFA) en kafa karıştırıcı ve klinik olarak zorlayıcı kronik hastalıklardan biridir. Akıllı telefon gonyometre uygulamasının PFA hastalarda geçerlilik ve güvenilirliğinin universal gonyometre ve dijital inklinometre ile karşılaştırılarak belirlenmesi planlanmıştır. Materyal ve Metod: Bu çalışmaya PFA yirmi yedi hasta dahil edildi. Diz eklemi için fleksiyon hareket açıklığı ve kalça eklemi için fleksiyon/ekstansiyon, abdüksiyon, iç/dış rotasyon hareket açıklığı akıllı telefon uygulaması, dijital inklinometre ve üniversal gonyometre kullanılarak iki denetçi tarafından ölçüldü. Değerlendiriciler arası güvenilirliği değerlendirmek için, ilk gözlemci tarafından yapılan iki ölçüm 24-48 saat aralıklarla değerlendirilmiştir. Değerlendirici içi güvenilirliği değerlendirmek için her iki gözlemcinin ölçümleri karşılaştırılmıştır. Bulgular: Her üç yöntemle de, PFA hastalarında aktif diz ve kalça hareket açıklığı ölçümleri yüksek gözlemci içi ve gözlemciler arası güvenilirlik göstermiştir (ICC = 0.69-0.97). Eşzamanlı geçerlilik analizi de üç yöntem arasında istatistiksel olarak anlamlı, orta ila güçlü korelasyonlar gösterdi (r = 0.562-0.993). SEM ve MDC en yüksek gonyometre ölçümünde olduğu ve gözlemciler içi (sırasıyla, 3.77-7.94° ve 10.44-21.99°), gözlemciler arasında (sırasıyla, 2.61-9.45° ve 7.23-27.54°) olduğu belirlenmiştir Sonuç: PFA hastalarında alt ekstremite ROM’ların ölçmek için akıllı telefon uygulaması, inclinometre ve universal gonyometre geçerli ve güvenirdir. Klinikte kullanılabilinir.

Anahtar Kelimeler

• Alt ekstremite
• diz önü ağrı sendromu
• hareket açıklığı
• mobil uygulama
• test-tekrar test güvenilirliği

Comparison of Smartphone Applications with Traditional Tools in the Assessment of Patellofemoral Pain: Validity and Reliability Study

Öz

Objectives: Patellofemoral pain (PFP) is one of the most confusing and clinically challenging chronic diseases. The aim of this study was to determine the validity and reliability of the smartphone goniometer application in patients with PFP by comparing it with a universal and digital inclinometer. Materials and Methods: Twenty-seven patients with PFP were included in this study. Flexion range of motion for the knee joint and flexion/extension, abduction, and internal/external rotation range of motion for the hip joint were measured by two examiners using a smartphone application, a digital inclinometer, and a universal goniometer. To assess inter-rater reliability, the two measurements made by the first observer were evaluated at 24-48 hour intervals. To assess intra-rater reliability, the measurements of both observers were compared. Results: With all three methods, active knee and hip range of motion measurements in PSS patients showed high intra-rater and inter-rater reliability (ICC = 0.69-0.97). Concurrent validity analysis also showed statistically significant, moderate to strong correlations between the three methods (r = 0.562-0.993). SEM and MDC were highest in the goniometer measurement and were intra-observer (3.77-7.94° and 10.44-21.99°, respectively) and inter-observer (2.61-9.45° and 7.23-27.54°, respectively). Conclusion: The smartphone app, inclinometer, and universal goniometer are valid and reliable for measuring lower limb ROM in PFA patients. They can be used in the clinic.

Anahtar Kelimeler

• Lower extremity
• anterior knee pain syndrome
• range of motion
• mobile application
• test-retest reliability

Kaynakça

1. 1. Kamel AMK, Ghuiba DS, Abd Allah DA, Fayaz, NA, Abdelkader NA. Effect of adding short foot exercise to hip- and knee-focused exercises for the treatment of patients with patellofemoral pain syndrome: a randomized controlled trial. J Orthop Surg Res, 2024;19(1):207. doi:10.1186/s13018-024-04688-x
2. 2. Xie P, István B, Liang, M. The relationship between patellofemoral pain syndrome and hip biomechanics: a systematic review and meta-analysis. In Healthcare. 2022;11(1):99 doi:0.3390/healthcare11010099
3. 3. Willy RW, Hoglund LT, Barton CJ, et al. Patellofemoral Pain. J Orthop Sports Phys Ther. 2019;49(9):CPG1-95 doi:10.2519/jospt.2019.0302
4. 4. Davis IS, Tenforde AS, Neal BS, Roper JL, Willy RW. Gait retraining as an intervention for patellofemoral pain. Curr Rev Musculoskelet Med. 2020;13:103–114 doi: 10.1007/s12178-020-09605-3
5. 5. Mohammad WS, Elattar FF, Elsais WM, AlDajah SO. Validity and reliability of a smartphone and digital ınclinometer in measuring the lower extremity joint range of motion. Monten J Sports Sci Med, 2021;10(2). doi: 10.26773/mjssm.210907
6. 6. Longoni L, Brunati R, Sale P, Casale R, Ronconi G, Ferriero G. Smartphone applications validated for joint angle measurement: a systematic review. Int Journal Rehabil Res, 2019:42(1):11-19. doi: 10.1097/MRR.0000000000000332
7. 7. Svensson M, Lind V, Löfgren Harringe M. Measurement of knee joint range of motion with a digital goniometer: A reliability study. Physiother Res Int, 2019;24(2):e1765. Doi: 10.1002/pri.1765
8. 8. Keogh JWL, Cox A, Anderson S, et al. Reliability and validity of clinically accessible smartphone applications to measure joint range of motion: A systematic review. PLoS One. 2019;14(5):e0215806. doi: 10.1371/journal.pone.0215806

9. 9. Hanks J, Myers B. Validity, reliability, and efficiency of a standard goniometer, medical inclinometer, and builder’s inclinometer. Int J Sports Phys Ther, 2023;18(4):989. doi: 10.26603/001c.83944
10. 10. Tozzo MC, Ansanello W, Martins J, Zatiti SC, de Oliveira AS. Inclinometer reliability for shoulder ranges of motion in individuals with subacromial impingement syndrome. J Manipulative Physiol Ther, 2021;44(3):236-243. doi: 10.1016/j.jmpt.2020.12.001
11. 11. Keogh JW, Espinosa HG, Grigg J. Evolution of smart devices and human movement apps: recommendations for use in sports science education and practice. J Fit Res, 2016;5:14-15.
12. 12. Han SK. Reliability Test of smartphone-based leg-joint position-sense measurement in people of all ages. Age. 2022;53: 21-30. doi: 10.17817/2022.01.30.1111706
13. 13. Romero-Franco N, Jiménez-Reyes P, González-Hernández JM, Fernández-Domínguez JC. Assessing the concurrent validity and reliability of an iPhone application for the measurement of range of motion and joint position sense in the knee and ankle joints of young adults. Phys Ther Sport. 2020;44:136-142. doi:10.1016/j.ptsp.2020.05.003
14. 14. Kinney AR, Eakman AM, Graham JE. Novel effect size interpretation guidelines and an evaluation of statistical power in rehabilitation research. Arch Phys Med Rehabil., 2020;101(12):2219-2226. doi:10.1016/j.apmr.2020.02.017
15. 15. Roach SJG, San Juan DN, Suprak M, Lyda M. Concurrent validity of digital inclinometer and universal goniometer in assessing passive hip mobility in healthy subjects. Int J Sports Phys Ther, 2013;8(5): 680.
16. 16. Vaidya SM. Effect of foam rolling of the quadriceps, hamstring, and IT band on knee passive range of motion and physical function in patients with patellofemoral pain syndrome-randomized controlled trial. Arch Med Health Science, 2022;10(1):37-41. doi:10.4103/amhs.amhs_305_20
17. 17. Crossley KM, van Middelkoop M, Callaghan MJ, Collins NJ, Rathleff MS, Barton CJ. Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses, and combined interventions). Br J Sports Med, 2016;50(14):844-852. doi:10.1136/bjsports-2016-096268
18. 18. Priore LB, Azevedo FM, Pazzinatto MF, et al. Influence of kinesiophobia and pain catastrophism on objective function in women with patellofemoral pain. Phys Ther Sport, 2019;35:116-121. doi:10.1016/j.ptsp.2018.11.013
19. 19. Acar S, Aljumaa H, Şevi K, Karatosun V, Ünver B. The Intrarater and Interrater Reliability and Validity of Universal Goniometer, Digital Inclinometer, and Smartphone Application Measuring Range of Motion in Patients with Total Knee Arthroplasty. Indian J Orthop, 2024;58(6):732-739. doi:10.1007/s43465-024-01129-z.
20. 20. Çankaya,M, Karakaya İÇ, Yargıç, PM. Reliability and validity of the Turkish version of the patellofemoral pain severity scale in patients with patellofemoral pain syndrome. Disabil Rehab, 2024;1-8. doi:10.1080/09638288.2024.2312258
21. 21. Sarac DC, Yalcinkaya G, Unver B. Validity and reliability of a smartphone goniometer application for measuring hip range of motions. Work, 2022;71(1):275-280. doi: 10.3233/WOR-213626.
22. 22. Otman AS, Demirel H, Sade A. Basic evaluation principles in treatment movements. 6nd ed. Ankara. Pelikan publishing. 2024
23. 23. Koo TK, Li MY. A guideline for selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155-163. doi:10.1016/j.jcm.2016.02.012
24. 24. Mardia, K. V., Kent, J. T., & Taylor, C. C. (2024). Multivariate analysis (Vol. 88). John Wiley and Sons
25. 25. Alawna MA, Unver BH, Yuksel EO. The reliability of a smartphone goniometer application compared with a traditional goniometer for measuring ankle joint range of motion. J Am Podiatr Med Assoc, 2019;109(1): 22-29. doi: 10.7547/16-128