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Joint mobilization forces and therapist reliability in subjects with knee osteoarthritis

OBJECTIVES: This study determined biomechanical force parameters and reliability among clinicians performing knee joint mobilizations. METHODS: Sixteen subjects with knee osteoarthritis and six therapists participated in the study. Forces were recorded using a capacitive-based pressure mat for three...

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Autores principales: Tragord, Bradley S, Gill, Norman W, Silvernail, Jason L, Teyhen, Deydre S, Allison, Stephen C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Maney Publishing 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3822319/
https://www.ncbi.nlm.nih.gov/pubmed/24421632
http://dx.doi.org/10.1179/2042618613Y.0000000033
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author Tragord, Bradley S
Gill, Norman W
Silvernail, Jason L
Teyhen, Deydre S
Allison, Stephen C
author_facet Tragord, Bradley S
Gill, Norman W
Silvernail, Jason L
Teyhen, Deydre S
Allison, Stephen C
author_sort Tragord, Bradley S
collection PubMed
description OBJECTIVES: This study determined biomechanical force parameters and reliability among clinicians performing knee joint mobilizations. METHODS: Sixteen subjects with knee osteoarthritis and six therapists participated in the study. Forces were recorded using a capacitive-based pressure mat for three techniques at two grades of mobilization, each with two trials of 15 seconds. Dosage (force–time integral), amplitude, and frequency were also calculated. Analysis of variance was used to analyze grade differences, intraclass correlation coefficients determined reliability, and correlations assessed force associations with subject and rater variables. RESULTS: Grade IV mobilizations produced higher mean forces (P<0.001) and higher dosage (P<0.001), while grade III produced higher maximum forces (P = 0.001). Grade III forces (Newtons) by technique (mean, maximum) were: extension 48, 81; flexion 41, 68; and medial glide 21, 34. Grade IV forces (Newtons) by technique (mean, maximum) were: extension 58, 78; flexion 44, 60; and medial glide 22, 30. Frequency (Hertz) ranged between 0.9–1.1 (grade III) and 1.4–1.6 (grade IV). Intra-clinician reliability was excellent (>0.90). Inter-clinician reliability was moderate for force and dosage, and poor for amplitude and frequency. DISCUSSION: Force measurements were consistent with previously reported ranges and clinical constructs. Grade III and grade IV mobilizations can be distinguished from each other with differences for force and frequency being small, and dosage and amplitude being large. Intra-clinician reliability was excellent for all biomechanical parameters and inter-clinician reliability for dosage, the main variable of clinical interest, was moderate. This study quantified the applied forces among multiple clinicians, which may help determine optimal dosage and standardize care.
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spelling pubmed-38223192014-11-01 Joint mobilization forces and therapist reliability in subjects with knee osteoarthritis Tragord, Bradley S Gill, Norman W Silvernail, Jason L Teyhen, Deydre S Allison, Stephen C J Man Manip Ther Original Article OBJECTIVES: This study determined biomechanical force parameters and reliability among clinicians performing knee joint mobilizations. METHODS: Sixteen subjects with knee osteoarthritis and six therapists participated in the study. Forces were recorded using a capacitive-based pressure mat for three techniques at two grades of mobilization, each with two trials of 15 seconds. Dosage (force–time integral), amplitude, and frequency were also calculated. Analysis of variance was used to analyze grade differences, intraclass correlation coefficients determined reliability, and correlations assessed force associations with subject and rater variables. RESULTS: Grade IV mobilizations produced higher mean forces (P<0.001) and higher dosage (P<0.001), while grade III produced higher maximum forces (P = 0.001). Grade III forces (Newtons) by technique (mean, maximum) were: extension 48, 81; flexion 41, 68; and medial glide 21, 34. Grade IV forces (Newtons) by technique (mean, maximum) were: extension 58, 78; flexion 44, 60; and medial glide 22, 30. Frequency (Hertz) ranged between 0.9–1.1 (grade III) and 1.4–1.6 (grade IV). Intra-clinician reliability was excellent (>0.90). Inter-clinician reliability was moderate for force and dosage, and poor for amplitude and frequency. DISCUSSION: Force measurements were consistent with previously reported ranges and clinical constructs. Grade III and grade IV mobilizations can be distinguished from each other with differences for force and frequency being small, and dosage and amplitude being large. Intra-clinician reliability was excellent for all biomechanical parameters and inter-clinician reliability for dosage, the main variable of clinical interest, was moderate. This study quantified the applied forces among multiple clinicians, which may help determine optimal dosage and standardize care. Maney Publishing 2013-11 /pmc/articles/PMC3822319/ /pubmed/24421632 http://dx.doi.org/10.1179/2042618613Y.0000000033 Text en © W. S. Maney & Son Ltd 2013 http://creativecommons.org/licenses/by/3.0/ This article was written and prepared by an officer and/or employee of the U.S. Government as part of their official duties and is not copyrightable
spellingShingle Original Article
Tragord, Bradley S
Gill, Norman W
Silvernail, Jason L
Teyhen, Deydre S
Allison, Stephen C
Joint mobilization forces and therapist reliability in subjects with knee osteoarthritis
title Joint mobilization forces and therapist reliability in subjects with knee osteoarthritis
title_full Joint mobilization forces and therapist reliability in subjects with knee osteoarthritis
title_fullStr Joint mobilization forces and therapist reliability in subjects with knee osteoarthritis
title_full_unstemmed Joint mobilization forces and therapist reliability in subjects with knee osteoarthritis
title_short Joint mobilization forces and therapist reliability in subjects with knee osteoarthritis
title_sort joint mobilization forces and therapist reliability in subjects with knee osteoarthritis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3822319/
https://www.ncbi.nlm.nih.gov/pubmed/24421632
http://dx.doi.org/10.1179/2042618613Y.0000000033
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