Near-Infrared Spectroscopy measurements are reliable for studying patellar bone hemodynamics and affected by venous occlusion, but not by skin compression.

Ophey, Martin J; Westerweel, Anne; van Oort, Maxime; van den Berg, Robert; Kerkhoffs, Gino M M J; Tak, Igor J R · J Exp Orthop · 2023

basic_science · Level V

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Abstract

According to the homeostasis model, patellofemoral pain (PFP) results from disturbed homeostasis due to vascular insufficiency in the anterior knee. Near-Infrared Spectroscopy (NIRS) measures relative changes in concentrations (in µmol/cm<sup>2</sup>) of (de-)oxygenated hemoglobine (HHb and O<sub>2</sub>Hb). The aims were to: 1) investigate the characteristics of the NIRS signal derived from the patella during experiments affecting hemodynamics in healthy controls, and 2) determine the test-retest reliability of NIRS in positions clinically relevant for PFP patients. Two experiments were conducted on 10 healthy controls and analysed using Student's t-test. Reliability (ICC<sub>2,1</sub>) was evaluated for two activities ('Prolonged Sitting' and 'Stair Descent') in five PFP patients and 15 healthy controls, performed twice within five days. The NIRS signal (HHb and O<sub>2</sub>Hb) showed a statistically significant increase (p < .001 - .002) on all optodes (30, 35, 40 mm) during 'Venous Occlusion' (M = 1.0 - 2.0), while it showed no statistically significant change (p = .075 - .61) during 'Skin Compression' (M = -0.9 - 0.9) on the 30 and 35 mm optode. Reliability of NIRS (HHb and O<sub>2</sub>Hb) ranged from moderate to almost perfect (ICC<sub>2,1</sub> = .47 - .95) on the 30 mm optode for 'Prolonged Sitting', and from moderate to substantial (ICC<sub>2,1</sub> = .50 - .68) on the 35 mm optode for 'Stair Descent'. Patella NIRS measurements are affected by venous occlusion, but not by skin compression, and are sufficiently reliable as research application to compare real-time patellar bone hemodynamics. These insights may assist to improve effectiveness of evidence-based treatment strategies for PFP. ISRCTN Trial Registration under number: 90377123.