Patients’ experiences of video-based assessment of the knee in contrast to conventional face-to-face assessment: a focus group study

BackgroundDigital health technologies are advancing rapidly, with an increasing number of physiotherapists favoring real-time, video-based platforms over telephone-based modalities. Osteoarthritis affects an estimated 595 million individuals worldwide, with approximately 62% of cases involving the knee joint. However, evidence regarding the validity and reliability of video-based assessments for knee osteoarthritis (KOA) remains scarce. The purpose of this pilot study was to explore the feasibility of video-based physiotherapy assessment of KOA in patients with knee pain. Additionally, we aimed to provide preliminary data on its concurrent validity and interrater reliability compared with conventional face-to-face assessment.MethodsA cross-sectional validity and reliability pilot study was conducted in June 2024. Participants were recruited through public advertisements. Eligible individuals were aged 45 years or older and reported knee pain. Each participant underwent both a real-time video-based physiotherapy assessment and a conventional, face-to-face assessment. The video-based assessments were recorded for later analysis. Concurrent validity was examined by determining the exact or potential agreement between the video-based and face-to-face assessments. Interrater reliability was evaluated by comparing the live video-based assessments with those obtained from the recorded video-based assessments.ResultsFor concurrent validity, exact agreement was observed in 28 of 35 cases (80%; κ = 0.35), indicating fair agreement. Potential agreement was achieved in 33 of 35 cases (94%; κ = 0.64), indicating substantial agreement. Interrater reliability demonstrated exact agreement in 25 of 29 cases (86%; κ = 0.52), corresponding to moderate agreement. Potential agreement for interrater reliability was observed in 27 of 29 cases (93%; κ = 0.63), corresponding to substantial agreement.ConclusionsVideo-based physiotherapy assessment appears feasible and may provide preliminary indications of validity for diagnosing KOA in individuals with nontraumatic knee pain. The results suggest acceptable interrater agreement and highlight the need for more standardized digital assessment protocols to ensure consistent and reliable use in clinical practice.Trial registrationISRCTN Registry (ISRCTN41057250), 09/05/2025. Retrospectively registered. Prospectively registered in FoU in VGR (researchweb.org) 282608, Date of registration 26/03/2024.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12891-025-09201-x.

Managing non-traumatic Adolescent knee Pain: feasibility of using the MAP-Knee Tool in secondary care.

ObjectiveTo use individual patient data (IPD) to investigate if the effect of pain on sports-related disability is mediated through physical (lower extremity isometric strength) or psychological (depression/anxiety and knee confidence)...

IntroductionEffective communication is essential for building trust, reducing diagnostic uncertainty and supporting adolescents with knee pain. The experiences of the adolescents during the clinical encounter can influence their acceptance, pain...

Development of a clinical decision-support tool for management of adolescent knee pain (The MAP-Knee tool).

BackgroundDespite the commonality of adolescent knee pain, there are no tools to support medical doctors to correctly diagnose knee pain. This study aimed to develop and evaluate a support tool for diagnosing the most common types of non-traumatic adolescent knee pain.MethodA systematic search on Medline identified the literature on clinical tests and diagnoses of adolescent knee pain. The search was supplemented by textbooks and transformed into a diagnostic flowchart based on onset, symptoms, and pain localisation. This tool was revised based on feedback from general practitioners and experts in sports medicine. The tool was evaluated on two separate days with blinded assessors. Overall, 27 participants (aged 10–17 years) with non-traumatic knee pain were included. All participants were diagnosed by medical doctors or medical students, without and with the use of the tool. Diagnoses were compared to a gold standard (expert clinician). An interview to inform optimisations of the tool was performed with the assessors. Percentage agreement with the gold standard, and Kappa statistic for interrater reliability were calculated.ResultsThe final tool improved diagnostic agreement with the gold standard from 22.7% (95% CI 10.3–35.1) to 77.3% (95% CI 64.9–89.7). Inter-rater reliability increased from poor agreement k = − 0.04 (95% CI, − 0.12-0.04) to moderate agreement k = 0.56 (95% CI, 0.40–0.72).ConclusionThis simple diagnostic tool is quick to use and may assist doctors in diagnosing non-traumatic knee pain in adolescents.

Perceived diagnostic uncertainty can leave adolescents confused about their condition and impede their ability to understand "what's wrong with me". Our aim is to develop credible explanations about the condition for adolescents suffering from non-traumatic knee pain. This multiple-method study integrated findings from two systematic literature searches of qualitative and quantitative studies, an Argumentative Delphi with international experts (n = 16) and think-aloud interviews with adolescents (n = 16). Experts provided feedback with arguments on how to communicate credible explanations to meet adolescents' needs; we analysed feedback using thematic analysis. The explanations were tailored based on the adolescent end-users' input. We screened 3239 titles/abstracts and included 16 papers exploring diagnostic uncertainty from adolescents' and parents' perspectives. Five themes were generated: (1) understanding causes and contributors to the pain experience, (2) feeling stigmatized for having an invisible condition, (3) having a name for pain, (4) controllability of pain, and (5) worried about something being missed. The Argumentative Delphi identified the following themes: (1) multidimensional perspective, (2) tailored to adolescents, (3) validation and reassurance, and (4) careful wording. Merging findings from the systematic search and the Delphi developed three essential domains to address in credible explanations: "What is non-traumatic knee pain and what does it mean?", "What is causing my knee pain?" and "How do I manage my knee pain?" Six credible explanations for the six most common diagnoses of non-traumatic knee pain were developed. We identified three domains to consider when tailoring credible explanations to adolescents experiencing non-traumatic knee pain. This study provides credible explanations for the six most common diagnoses of non-traumatic knee pain. Additionally, we identified three key domains that may need to be addressed to reduce diagnostic uncertainty in adolescents suffering from pain complaints. Based on our findings, we believe that clinicians will benefit from exploring adolescents' own perceptions of why they experience pain and perceived management strategies, as this information might capture important clinical information when managing these young individuals.

Aim:Using the Theoretical Domains Framework (TDF) and COM-B model, this study aimed to determine the facilitators to a support tool for adolescent non-traumatic knee pain in general practice.Background:Many children and adolescents with non-traumatic knee pain consult their general practice. Currently, there are no tools to support general practitioners in the diagnosis and management of this group. There is a need to identify behavioural targets that would facilitate further development and implementation of such a tool.Methods:This study was designed as a qualitative study using focus group interviews with 12 medical doctors working in general practice. The semi-structured focus group interviews conducted online and followed an interview guide based on the TDF and COM-B model. Data were analysed via thematic text analysis.Findings:One of the biggest challenges from the general practitioner’s perspective was how to manage and guide adolescents with non-traumatic knee pain. The doctors had doubts in their capability to diagnose knee pain and saw opportunity to help structure the consultation. The doctors felt motivated to use a tool but considered access a potential barrier. Increasing opportunity and motivation by creating access in the community among general practitioners was considered important. We identified several barriers and facilitators for a support tool for the management of adolescent non-traumatic knee pain in general practice. To align with user needs, future tools should support diagnostic workup, structure the consultation and be easily available among doctors working in general practice.

What is the Role of Video-Based Assessment of Laparoscopic Surgical Skill in Residency Training? A Qualitative Study of Trainee and Faculty Perspectives

Study Design Systematic review and validation study. Background Many prognostic models of knee pain outcomes have been developed for use in primary care. Variability among published studies with regard to patient population, outcome measures, and relevant prognostic factors hampers the generalizability and implementation of these models. Objectives To summarize existing prognostic models in patients with knee pain in a primary care setting and to develop and internally validate new summary prognostic models. Methods After a sensitive search strategy, 2 reviewers independently selected prognostic models for patients with nontraumatic knee pain and assessed the methodological quality of the included studies. All predictors of the included studies were evaluated, summarized, and classified. The predictors assessed in multiple studies of sufficient quality are presented in this review. Using data from the Musculoskeletal System Study (BAS) cohort of patients with a new episode of knee pain, recruited consecutively by Dutch general medical practitioners (n = 372), we used predictors with a strong level of evidence to develop new prognostic models for each outcome measure and internally validated these models. Results Sixteen studies were eligible for inclusion. We considered 11 studies to be of sufficient quality. None of these studies validated their models. Five predictors with strong evidence were related to function and 6 to recovery, and were used to compose 2 prognostic models for patients with knee pain at 1 year. Running these new models in another data set showed explained variances (R2) of 0.36 (function) and 0.33 (recovery). The area under the curve of the recovery model was 0.79. After internal validation, the adjusted R2 values of the models were 0.30 (function) and 0.20 (recovery), and the area under the curve was 0.73. Conclusion We developed 2 valid prognostic models for function and recovery for patients with nontraumatic knee pain, based on predictors with strong evidence. A longer duration of complaints predicted poorer function but did not adequately predict chance of recovery. Level of Evidence Prognosis, levels 1a and 1b. J Orthop Sports Phys Ther 2017;47(8):518-529. Epub 16 Jun 2017. doi:10.2519/jospt.2017.7142.

IntroductionPatient decision aids can support patient-clinician shared decision-making, yet little is known about the underlying change-mechanisms which facilitates patient-clinician collaboration in clinical settings. The MAP-Knee Tool was developed with GPs...

IntroductionPerceived diagnostic uncertainty emerges during consultations because of miscommunication, potentially leaving adolescents confused and unable to understand ‘what’s wrong with me’. Repeated interviews are a valuable method to facilitate a...

Introduction: The knee joint is a hinge synovial joint that allows flexion and extension; which are complemented with gliding and rolling, as well as rotation about a vertical axis. Magnetic resonance imaging is a non-invasive and operator-independent imaging modality that offers the advantage of greater soft tissue details and multiplanar imaging characteristics. The aim of this study was to find out the frequent lesions documented in the magnetic resonance imaging of the knee joint among patients presenting with non traumatic knee pain. Methods: A descriptive cross-sectional study was conducted in the Department of Radiology after obtaining ethical approval from the Institutional Review Board. Whole sampling method was used. Patients with a history of non-traumatic knee pain presenting for magnetic resonance imaging were included in the study, who underwent imaging in Philips Achieva 1.5 Tesla magnetic resonance scanner machine using our institutional protocol. Data were entered and analysed in Excel 2016. Results: Among 216 cases, there were 117 (54.17%) males and 99 (45.83%) females. Majority of them, 80 (37.04%) cases had meniscal tears. Among them, horizontal tears were the most common type seen in 36 (16.67%) cases. Conclusions: In our study, the findings are similar to other studies published in the past.

Computerized thermography was used to evaluate eight patients with the complaint of non-traumatic anterior knee pain. Computerized thermograms were recorded before and after subjects performed a specific rehabilitation program. Thermographic imaging was then repeated 4 weeks to 8 weeks after the initial thermogram. Among the subject group, thermal asymmetries were noted in the involved knees, but a specific abnormal thermal pattern could not be recognized. Changes in temperature and thermal patterns after exercise and over time were consistent within each subject, but were not consistent between subjects. Thermal asymmetries did not appear to resolve over time. It is felt that the pathology investigated by this study may involve many etiologies, therefore making it difficult to establish a single abnormal thermal pattern with regard to non-traumatic anterior knee pain.

The reported characteristics of child and adolescent participants in research on non-traumatic anterior knee pain: a scoping review.