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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
A Journal on Physical Medicine and Rehabilitation after Pathological Events
Official Journal of the , , , ,
In association with
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
Europa Medicophysica 2003 June;39(2):87-94
Preliminary study on the validity of an instrumental method of evaluating proprioception in patients undergoing total knee arthroplasty
Felicetti G. 1, Chiappano G. 2, Molino A. 2, Brignoli E. 1, Maestri R. 3, Maini M. 1
1 Division of Rehabilitation, Salvatore Maugeri Foundation IRCCS, Scientific Institute, Montescano (PV)
2 Bioengineering Service, Salvatore Maugeri Foundation IRCCS, Scientific Institute, Montescano (PV)
3 School of Physical Medicine and Rehabilitation University of Pavia, Pavia, Italy
Aim. The aim of this study was to use a computerized proprioceptive footboard (Pro-Kin company) to verify: 1) whether patients who have undergone a total knee arthroplasty (TKA), admitted to our Centre during the postacute period to carry out post-operative rehabili-tation, have a proprioceptive deficit; 2) the reliability of the above mentioned equipment in recording the proprioceptive deficits.
Methods. Two groups of subjects were considered in this study: the 1st group was formed of 34 patients (mean age 60.5 years) who had undergone a TKA and the 2nd comprised 20 healthy subjects used as controls. All the individuals underwent a careful evaluation of proprioception in the operated limb, or in the dominant limb in the case of controls, using a computerised, electronic, stabilometer made of a mobile footboard with fluid oil dynamic piston rods. The parameters considered in order to evaluate the performances of our subjects were, for each of the 3 traces, the time necessary to carry out the test and the percentage of the route covered. In accordance with the advice of the equipment device’s manufacturer, 100% was considered optimal. The patients underwent 2 evaluation sessions on different days; the 1st session was performed about 10 days post-operatively and the 2nd 2 days after the first evaluation. This test-retest procedure was used in order to assess the reproducibility of the test. The parameters (TIME and %ROUTE) for each test in the 1st evaluation session were compared with the corresponding values of the same subject in the session on the 2nd day’s test. Subsequently, in order to verify the presence of any proprioceptive deficit in the group of patients, the mean of the data (TIME and %ROUTE) relating to each of the 3 tests carried out by this group of subjects was compared with that of the corresponding values of the control group.
Results. We found a reduction in the TIME parameter betweeen the 1st and the second day of measurement in both populations, but only in the control group it was statistically significant (p=0.013). Also the %ROUTE improved between the 1st and the 2nd day, but the difference was very little and not statistically significant. Comparing the 2 populations, both TIME and %ROUTE parameters were significantly better in controls than in patients (p<0.001 and p<0.007 respectively).
Conclusion. This type of evaluation is too strongly influenced by the subject’s general characteristics (age, mental lucidity, concentration, eyesight, speed of reflex reactions, overall motor performances, etc.) to provide a very reliable indicator of his or her proprioception. Despite the above mentioned statistical caveats, the data from this study were sufficiently valid and clear to be able to state with certainty that TKA has an effect on proprioception. This is demonstrated from both the greater time necessary for patients to complete the test, and the greater surface covered in order to trace the route.