Reliability of knee arthrometer DYNEELAX® : master's thesis

Mihalinec, Katja (author), Vauhnik, Renata (mentor), Martinez-Cepa, Carmen B. (comentor), Gošnak Dahmane, Raja (reviewer)

Introduction: Increased knee laxity is an important risk factor to be considered when dealing with knee ligament injuries. Both anterior and rotational laxity when increased can lead to instability and may be one of the most important factors leading to delayed return to sport activity in both amateur and professional athletes. This means that anterior laxity testing alone, which is still the most commonly used, might not be sufficient for addressing persisting functional deficits following ligament injuries, particularly when a collateral ligament injury is present. Purpose: To our knowledge, there was no device previously described in the literature that can measure laxity first in the sagittal and then in the horizontal planes within one device, without moving the leg being tested between measurements. The DYNEELAX® arthrometer can be used to measure anterior knee laxity and rotational knee laxity. The main aim of our study was to test the intra-rater of the DYNEELAX® arthrometer. Also, gender differences in laxity, menstrual cycle affection on laxity and intake of oral contraceptives in female were studied. As rotational laxity will be measured for the first time in humans, indications of normative values will also be presented. Methods: Knee anterior laxity and rotational laxity were measured with a DYNEELAX® arthrometer in 73 subjects (39 women and 34 men). An intraclass correlation coefficient was calculated to evaluate the intra-rater reliability of the DYNEELAX® arthrometer. Results: The intraclass correlation coefficients for intra-rater reliability ranged from 0.631 (95% CI: 0.47-0.75) to 0.699 (95% CI: 0.56-0.80) and from 0.916 (95% CI: 0.87-0.95) to 0.94 (95% CI: 0.91-0.96) for anterior knee laxity and rotational knee laxity, respectively. Discussion and conclusions: This is the first study to investigate the intra-rater reliability of the DYNEELAX® arthrometer in humans. The DYNEELAX® arthrometer has good to excellent intra-rater reliability for rotational knee laxity testing and moderate intra-rater reliability for anterior knee laxity testing in healthy subjects. Also, a trend towards greater rotational laxity in women has been seen. Future studies should investigate the clinical significance of anterior and rotational laxity measured with the DYNEELAX® arthrometer in patients with knee pathology, as both laxities are critical for assessing the integrity of the intra-articular structures of the knee in clinical practice.

• Language: English
• Keywords: master's theses, physiotherapy, arthrometry, knee laxity, anterior laxity, rotational laxity, reliability
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [K. Mihalinec]
• Year: 2024
• Number of pages: 49 str., [1] str. pril.
• PID: 20.500.12556/RUL-164017
• UDC: 615.8
• COBISS.SI-ID: 211805187
• Publication date in RUL: 16.10.2024

Secondary language

• Language: Slovenian
• Title: Zanesljivosti kolenskega artrometra DYNEELAX® : magistrsko delo

Abstract

Uvod: Povečana anteriorna laksnost kolena je pomemben dejavnik tveganja pri obravnavi poškodb kolenskih vezi. Tako prekomerna anteriorna kot rotacijska laksnost, lahko vodita v nestabilnost kolena in sta med najpogostejšimi vzroki poznejše vrnitve k športni dejavnosti kot sicer, tako pri amaterskih kot tudi profesionalnih športnikih. Ocenjevanje izolirane anteriorne laksnosti, ki se v praksi najpogosteje uporablja, morda ni dovolj za obravnavo funkcijskih pomanjkljivosti po poškodbah kolenskih vezi, zlasti ob prisotnosti tudi poškodbe kolateralnega ligamenta. Namen: Kolikor nam je znano, v literaturi do sedaj še ni bilo opisanega artrometra, s katerim bi laksnost kolena lahko merili najprej v sagitalni in nato v horizontalni ravnini z istim artrometrom, ne da bi med meritvami premikali merjen spodnji ud. Artrometer DYNEELAX® se uporablja za merjenje tako anteriorne laksnosti kolena in tudi rotacijske laksnosti kolena. Glavni cilj naše raziskave je bil ugotoviti zanesljivost preiskovalca artrometra DYNEELAX®. Proučevali smo tudi razlike med spoloma v laksnosti, vpliv menstrualnega cikla na laksnost in vpliv uživanja oralnih kontraceptivov pri ženskah. Rotacijsko laksnost smo na ljudeh z artrometrom DYNEELAX® merili prvič, zato bodo prikazane tudi normativne vrednosti. Metode: Anteriorno laksnost kolena in rotacijsko laksnost kolena smo merili z artrometrom DYNEELAX® pri 73 osebah (39 ženskah in 34 moških). Za ovrednotenje zanesljivosti preiskovalca artrometra DYNEELAX® je bil izračunan interklasni koeficient korelacije. Rezultati: Interklasni koeficienti korelacije za zanesljivost preiskovalca so bili od 0,631 (95 % IZ: 0,47–0,75) do 0,699 (95 % IZ: 0,56–0,80) in od 0,916 (95 % IZ: 0,87–0,95) do 0,94 (95 % IZ: 0,91–0,96) za anteriorno laksnost oziroma rotacijsko laksnost kolena. Razprava in zaključek:To je prva študija, ki raziskuje zanesljivost preiskovalca artrometra DYNEELAX® na ljudeh. Artrometer DYNEELAX® ima dobro do odlično zanesljivost posameznega preiskovalca pri ocenjevanju rotacijske laksnosti kolena in zmerno zanesljivost preiskovalca pri ocenjevanju anteriorne laksnosti kolena na zdravih osebah. Opažen je bil trend večje rotacijske laksnosti pri osebah ženskega spola. V prihodnjih raziskavah bi se bilo smiselno osredotočiti na raziskovanje klinične pomembnosti anteriorne in rotacijske laksnosti kolena, na ocenjevane z artrometrom DYNEELAX® pri osebah s patologijo kolena, saj sta omenjeni laksnosti kritični za celovito oceno intraartikularnih struktur kolena v klinični praksi.

• Keywords: magistrska dela, fizioterapija, artrometer, laksnost kolena, anteriorna laksnost kolena, rotacijska laksnost kolena, zanesljivost