ORIGINAL PAPER
Validation of non-radiographic APECS software in comparison with standard radiographic measurement of full-length lower limb hip-knee-ankle angle in elderly obese women
 
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Department of Orthopaedic Physiotherapy, KAHER Institute of Physiotherapy, Belagavi, India
 
 
Submission date: 2022-04-06
 
 
Acceptance date: 2022-08-25
 
 
Publication date: 2023-03-21
 
 
Physiother Quart. 2023;31(1):90-94
 
KEYWORDS
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ABSTRACT
Introduction:
Evidence suggests that obesity and ageing in women are linked to angular knee abnormalities. The hip-knee-ankle (HKA) angle on a full-limb radiograph is the gold standard measure of lower limb alignment. The AI Posture Evaluation and Correction System (APECS) software is a non-radiographic mobile application designed for whole-body posture assessment. Since exposure to X-ray is associated with harmful effects, there is a need to find a safe and valid alternative for measuring HKA angle. The objective of this research was to determine the validity of the non-radiographic APECS software in comparison with standard radiographic measurement of HKA angle.

Methods:
The present cross-sectional diagnostic accuracy study was conducted in a tertiary care hospital of Belagavi, Karnataka, India. Overall, 45 elderly obese females aged 60–80 years with a body mass index of 25 were included. HKA angle was marked bilaterally. Full-limb radiographs were taken and angles were marked with 2.0 version software, DXM model. For the APECS software, full-limb photographs were taken with landmarks indicated with radiant markers and angles were autogenerated by the software.

Results:
The Pearson correlation coefficient between the APECS application and the gold standard (X-ray) was 0.9874 (98.74% of matching). The agreement between standard radiograph and the average of all examiners’ APECS Pro measurements (including right and left sides) equalled 94.64% (kappa = 0.8323; p = 0.001), which suggests very good agreement.

Conclusions:
The APECS application demonstrated a high percentage of matching (98.74%) and agreement (94.64%), indicating its excellent validity in measuring HKA angle.

 
REFERENCES (23)
1.
Segula D. Complications of obesity in adults: a short review of the literature. Malawi Med J. 2014;26(1):20–24.
 
2.
Inoue Y, Qin B, Poti J, Sokol R, Gordon-Larsen P. Epidemiology of obesity in adults: latest trends. Curr Obes Rep. 2018;7(4):276–288; doi: 10.1007/s13679-018-0317-8.
 
3.
Ahluwalia N. Aging, nutrition and immune function. J Nutr Health Aging. 2004;8(1):2–6.
 
4.
Singh P, Kapil U, Dey AB. Prevalence of overweight and obesity amongst elderly patients attending a geriatric clinic in a tertiary care hospital in Delhi, India. Indian J Med Sci. 2004;58(4):162–163.
 
5.
Swami HM, Bhatia V, Gupta AK, Bhatia SPS. An epidemiological study of obesity among elderly in Chandigarh. Indian J Community Med. 2005;30(1):11–13.
 
6.
Rajkamal R, Singh Z, Stalin P, Muthurajesh E. Prevalence and determinants of overweight and obesity among elderly population in an urban area of Puducherry. Int J Med Sci Public Health. 2015;4(3):369–372; doi: 10.5455/ijmsph.2015.3110201477.
 
7.
Atapattu PM. Obesity at menopause: an expanding problem. J Pat Care. 2015;1(1):103; doi: 10.4172/2573-4598.1000103.
 
8.
Brealey S, Scally A, Hahn S, Thomas N, Godfrey C, Coo­marasamy A. Accuracy of radiographer plain radiograph reporting in clinical practice: a meta-analysis. Clin Radiol. 2005;60(2):232–241; doi: 10.1016/j.crad.2004.07.012.
 
9.
Treaster DE, Burr D. Gender differences in prevalence of upper extremity musculoskeletal disorder. Ergonomics. 2004;47(5):495–526; doi: 10.1080/00140130310001638171.
 
10.
Soheilipour F, Pazouki A, Mazaherinezhad A, Yagou­b­zadeh K, Dadgostar H, Rouhani F. The prevalence of genu varum and genu valgum in overweight and obese patients: assessing the relationship between body mass index and knee angular deformities. Acta Biomed. 2020;91(4):e2020121; doi: 10.23750/abm.v91i4.9077.
 
11.
Sheehy L, Felson D, Zhang Y, Niu J, Lam Y-M, Segal N, et al. Does measurement of the anatomic axis consistently predict hip-knee-ankle angle (HKA) for knee alignment studies in osteoarthritis? Analysis of long limb radiographs from the multicenter osteoarthritis (MOST) study. Osteoarthritis Cartilage. 2011;19(1):58–64; doi: 10.1016/j.joca.2010.09.011.
 
12.
Issa SN, Dunlop D, Chang A, Song J, Prasad PV, Guer­mazi A, et al. Full-limb and knee radiography assessments of varus-valgus alignment and their relationship to osteoarthritis disease features by magnetic resonance imaging. Arthritis Rheum. 2007;57(3):398–406; doi: 10.1002/art.22618.
 
13.
University Grenoble Alpes and Grenoble Ecole de Management. AI Posture Evaluation and Correction System Software (APECS). Grenoble; 2018. Available 12.12.2021 from: https://www.f6s.com/newbodytec....
 
14.
Streiner DL, Norman GR. Health measurement scales. A practical guide to their development and use. Oxford: Oxford University Press; 1995.
 
15.
Hulley SB, Cummings SR. Designing clinical research. Baltimore: Williams & Wilkins; 1988.
 
16.
Girdhar S, Sharma S, Chaudhrary A, Bansal P, Satija M. An epidemiological study of overweight and obesity among women in an urban area of North India. Indian J Community Med. 2016;41(2):154–157; doi: 10.4103/0970-0218.173492.
 
17.
Pelvis and upper femora. Radiology Key; 2016. Available 15.01.2022 from: https://radiologykey.com/pelvi....
 
18.
Mourcou Q, Fleury A, Diot B, Franco C, Vuillerme N. Mobile phone-based joint angle measurement for functional assessment and rehabilitation of proprioception. Biomed Res Int. 2015;2015:328142; doi: 10.1155/2015/328142.
 
19.
Wang K, Hussaini SH, Teasdall RD, Gwam CU, Scott AT. Smartphone applications for assessing ankle range of motion in clinical practice. Foot Ankle Orthop. 2019;4(3):2473011419874779; doi: 10.1177/2473011419874779.
 
20.
Raj B, An overview of human pose estimation with deep learning. 2019. Available 21.11.2021 from: https://medium.com/beyondminds....
 
21.
Gibson K, Sayers SP, Minor MA. Measurement of varus/valgus alignment in obese individuals with knee osteoarthritis. Arthritis Care Res. 2010;62(5):690–696; doi: 10.1002/acr.20084.
 
22.
Kraus VB, Vail TP, Worrell T, McDaniel G. A comparative assessment of alignment angle of the knee by radiographic and physical examination methods. Arthritis Rheum. 2005;52(6):1730–1735; doi: 10.1002/art.21100.
 
23.
Hazar Z, Karabicak GO, Tiftikci U. Reliability of photographic posture analysis of adolescents. J Phys Ther Sci. 2015;27(10):3123–3126; doi: 10.1589/jpts.27.3123.
 
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