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Joint function measures feasible with use of electrogoniometer in patients with JIA
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Measuring dynamic joint function was feasible and objective using an electrogoniometer in patients with juvenile idiopathic arthritis, according to recently published study findings.
Researchers studied 73 children with complaints of joint pain during a period of 18 months, 54 of whom had a diagnosed rheumatic disease, including 44 patients with juvenile idiopathic arthritis (JIA). Patients with JIA were eligible for study inclusion if they were between 5 and 20 years of age and were 175 cm tall or shorter. Twenty-one patients were boys, and mean disease duration was 20.9 months. A total of 36 patients (24 girls) completed the study and were age-matched with a healthy control group with no history of trauma.
Patient data were collected, including age; gender; handedness; height; and circumference, length, height and width of the lower legs and feet to later calculate torque.
Joint angles during maximum flexion and extension were measured using a twin-axis electrogoniometer while splint-fixed to restrict knee movement to one plane. Patients were examined in a prone position with both knees extended beyond the stretcher to allow measurement of range of motion (ROM). Participants were instructed to repeat full movement cycles with maximum extension and flexion at the maximum velocity possible in three complete cycles during a period of about 15 to 20 minutes.
Acceleration was determined during movement from measured angles, and torque was calculated by the electrogoniometer measurements during the cycle, with maximum ROM using acceleration and extremity mass data relative to gravitational force with a standard mathematical formula.
No significant gender differences were seen among participants, although ROM was slightly lower at 152.4° for healthy boys vs. 162.8° in healthy girls, according to the researchers. Age was correlated with a decrease in both flexion and extension, whereas ROM increased.
Increased body weight decreased ROM, but flexion and extension torque increased with increased body weight. Only a slight influence of handedness was seen in higher torque in the dominant knee, but the differences were not significant, the researchers reported.
Compared with healthy children, participants with active knee arthritis had decreased dynamic joint function, with a median ROM of 139.1° in affected joints, compared with a median ROM of 152.9° in inactive joints. Extension and flexion torque was only 11.1 Nm in affected joints, compared with 21.5 Nm in unaffected joints and 21.2 Nm in inactive arthritis.
The researchers concluded the use of an electrogoniometer was easy and proved to demonstrate significant differences between healthy joints and joints with active disease, but that more research will be necessary to validate its use as a clinical tool for assessing patients with JIA. - by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.
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