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Properties of tests for knee joint threshold to detect passive motion following anterior cruciate ligament injury: a systematic review and meta-analysis
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.ORCID iD: 0000-0002-6715-6208
Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.ORCID iD: 0000-0001-5859-4284
Department of Health, Learning and Technology, Physiotherapy Section, Luleå University of Technology, Luleå, Sweden.
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2022 (English)In: Journal of Orthopaedic Surgery and Research, E-ISSN 1749-799X, Vol. 17, no 1, article id 134Article, review/survey (Refereed) Published
Abstract [en]

BACKGROUND: Threshold to detect passive motion (TTDPM) tests of the knee joint are commonly implemented among individuals with anterior cruciate ligament (ACL) injury to assess proprioceptive acuity. Their psychometric properties (PMPs), i.e. reliability, validity and responsiveness, are however unclear. This systematic review aimed to establish the PMPs of existing knee joint TTDPM tests among individuals with ACL injury.

METHODS: The databases PubMed, AMED, CINAHL, SPORTDiscus, Web of Science, Scopus, CENTRAL and ProQuest were searched to identify studies that assessed the properties of knee joint TTDPM tests in individuals with ACL injury. The risk of bias for each included study was assessed at the outcome level for each test. Overall quality and levels of evidence for each property were rated according to established criteria. Meta-analyses with mean differences were conducted using random-effects models when adequate data were available.

RESULTS: Fifty-one studies covering 108 TTDPM tests and 1632 individuals with unilateral ACL injury were included. A moderate-to-strong level of evidence indicated insufficient quality for all of the following: convergent validity, known-groups validity, discriminative validity, responsiveness between subgroups, and responsiveness to intervention. Subgroup meta-analyses for known-groups validity did however find that a starting angle of 15° resulted in significantly worse TTDPM for knees with ACL injury compared to those of asymptomatic persons (mean difference 0.28°; 95% CI 0.03 to 0.53; P = 0.03), albeit based on only three studies. Due to the lack of evidence, it was not possible to estimate the quality of reliability, measurement error, and criterion validity, nor responsiveness from a criterion and construct approach.

CONCLUSIONS: Among persons with ACL injury, existing tests of knee joint TTDPM lack either sufficient quality or evidence for their reliability, validity and responsiveness. Significantly worse thresholds for ACL-injured knees compared to those of asymptomatic controls from a 15° starting angle and trends towards significance for some validity measures nevertheless encourage the development of standardised tests. Further research investigating the influence of modifiable test components (e.g. starting angle and motion direction) on the PMPs of knee joint TTDPM tests following ACL injury is warranted.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2022. Vol. 17, no 1, article id 134
Keywords [en]
Kinesthesia, Proprioception, Reliability, Responsiveness, Validity
National Category
Physiotherapy
Identifiers
URN: urn:nbn:se:umu:diva-193157DOI: 10.1186/s13018-022-03033-4ISI: 000764709200007PubMedID: 35246192Scopus ID: 2-s2.0-85125868799OAI: oai:DiVA.org:umu-193157DiVA, id: diva2:1645764
Funder
Swedish Research Council, 2017-00892Region Västerbotten, 7003575Region Västerbotten, 7002795Swedish National Centre for Research in Sports, P2019-0068Konung Gustaf V:s och Drottning Victorias FrimurarestiftelseAvailable from: 2022-03-18 Created: 2022-03-18 Last updated: 2024-03-14Bibliographically approved

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Strong, AndrewTengman, EvaHäger, Charlotte

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