title: Patient Self-Assessed Passive Range of Motion of the Knee Cannot Replace Health Professional Measurements.
abstract: The purpose of this study was to investigate whether patients can accurately self-assess their knee passive range of motion (PROM). A picture-based questionnaire for patient self-assessment of knee PROM was developed and posted to patients. The self-assessed PROM from 58 patients was compared with surgeon-assessed PROM using a short-arm goniometer. Agreement between the measurement methods was calculated with the Bland-Altman method. We calculated the sensitivity and specificity of patient-assessed PROM in dichotomously detecting knee motion impairment in both flexion (≤ 100 degrees) and extension (≥ 10-degree flexion contracture). Surgeon- and patient-assessed knee PROM showed a mean difference (95% limits of agreement) of -2.1 degrees (-42.5 to 38.3 degrees) for flexion and -8.1 degrees (-28.8 to 12.7 degrees) for extension. The sensitivity of patient self-assessed PROM in identifying knee flexion and extension impairments was 86 and 100%, respectively, whereas its specificity was 84 and 43%, respectively. Although wide limits of agreement were observed between surgeon- and patient-assessed knee PROM, the picture-based questionnaire for patient assessment of knee ROM was found to be a valid tool for dichotomously detecting knee motion impairment in flexion (≤ 100 degrees). However, the specificity of the questionnaire for detection of knee extension impairments (≥ 10-degree flexion contracture) was low, which limits is practical utility for this purpose.
authors.affiliation: Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Jens
authors.initials: J
authors.lastname: Borgbjerg
authors.affiliation: Department of Orthopaedic Surgery, Aarhus Universty Hospital, Aarhus, Denmark.
authors.forename: Frank
authors.initials: F
authors.lastname: Madsen
authors.affiliation: Department of Orthopaedic Surgery, Copenhagen University Hospital Gentofte, Copenhagen, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Odgaard
mesh_terms: D000328:Adult; D000368:Aged; D053587:Arthrometry, Articular; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D016059:Range of Motion, Articular / Q000502:physiology*; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires