Validity and reliability of smartphone magnetometer-based goniometer evaluation of shoulder abduction--A pilot study.

BACKGROUND Goniometers are commonly used by physical therapists to measure range-of-motion (ROM) in the musculoskeletal system. These measurements are used to assist in diagnosis and to help monitor treatment efficacy. With newly emerging technologies, smartphone-based applications are being explored for measuring joint angles and movement. OBJECTIVE This pilot study investigates the intra- and inter-rater reliability as well as concurrent validity of a newly-developed smartphone magnetometer-based goniometer (MG) application for measuring passive shoulder abduction in both sitting and supine positions, and compare against the traditional universal goniometer (UG). DESIGN This is a comparative study with repeated measurement design. METHODS Three physical therapists utilized both the smartphone MG and a traditional UG to measure various angles of passive shoulder abduction in a healthy subject, whose shoulder was positioned in eight different positions with pre-determined degree of abduction while seated or supine. Each therapist was blinded to the measured angles. Concordance correlation coefficients (CCCs), Bland-Altman plotting methods, and Analysis of Variance (ANOVA) were used for statistical analyses. RESULTS Both traditional UG and smartphone MG were reliable in repeated measures of standardized joint angle positions (average CCC > 0.997) with similar variability in both measurement tools (standard deviation (SD) ± 4°). Agreement between the UG and MG measurements was greater than 0.99 in all positions. CONCLUSION Our results show that the smartphone MG has equivalent reliability compared to the traditional UG when measuring passive shoulder abduction ROM. With concordant measures and comparable reliability to the UG, the newly developed MG application shows potential as a useful tool to assess joint angles.

[1]  Joseph M Hart,et al.  Validation of an innovative method of shoulder range-of-motion measurement using a smartphone clinometer application. , 2014, Journal of shoulder and elbow surgery.

[2]  Giorgio Ferriero,et al.  Mobile smartphone applications for body position measurement in rehabilitation: a review of goniometric tools. , 2014, PM & R : the journal of injury, function, and rehabilitation.

[3]  Emiel van Trijffel,et al.  Inter-rater reliability for measurement of passive physiological range of motion of upper extremity joints is better if instruments are used: a systematic review. , 2010, Journal of physiotherapy.

[4]  D. J. White,et al.  Measurement Of Joint Motion A Guide To Goniometry , 2016 .

[5]  R. Buchbinder,et al.  Systematic review of randomised controlled trials of interventions for painful shoulder: selection criteria, outcome assessment, and efficacy , 1998, BMJ.

[6]  Susanne Fuchs-Winkelmann,et al.  Objective Assessment of shoulder mobility with a new 3D gyroscope - a validation study , 2011, BMC musculoskeletal disorders.

[7]  Francesco Sartorio,et al.  Reliability of a New Application for Smartphones (DrGoniometer) for Elbow Angle Measurement , 2011, PM & R : the journal of injury, function, and rehabilitation.

[8]  Susanne Fuchs-Winkelmann,et al.  Objective assessment, repeatability, and agreement of shoulder ROM with a 3D gyroscope , 2013, BMC Musculoskeletal Disorders.

[9]  D. Lubarsky,et al.  Goniometric assessment of shoulder range of motion: comparison of testing in supine and sitting positions. , 1998, Archives of physical medicine and rehabilitation.

[10]  Joo Han Oh,et al.  Within-day reliability of shoulder range of motion measurement with a smartphone. , 2012, Manual therapy.

[11]  G. Murrell,et al.  Reliability of five methods for assessing shoulder range of motion. , 2001, The Australian journal of physiotherapy.

[12]  Andrew R Karduna,et al.  Shoulder function and 3-dimensional scapular kinematics in people with and without shoulder impingement syndrome. , 2006, Physical therapy.

[13]  Morey J Kolber,et al.  The reliability and concurrent validity of shoulder mobility measurements using a digital inclinometer and goniometer: a technical report. , 2012, International journal of sports physical therapy.

[14]  Ruzena Bajcsy,et al.  mHealth Application for Upper Extremity Range of Motion and Reachable Workspace , 2013, MMVR.

[15]  J M Rothstein,et al.  Goniometric reliability in a clinical setting. Shoulder measurements. , 1987, Physical therapy.

[16]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[17]  Lex M Bouter,et al.  Interobserver reproducibility of the visual estimation of range of motion of the shoulder. , 2005, Archives of physical medicine and rehabilitation.

[18]  Susan Gordon,et al.  Reliability and concurrent validity of knee angle measurement: smart phone app versus universal goniometer used by experienced and novice clinicians. , 2014, Manual therapy.

[19]  Repeated Measurements of Arm Joint Passive Range of Motion After Stroke: Interobserver Reliability and Sources of Variation , 2012, Physical Therapy.

[20]  L. Lin,et al.  A concordance correlation coefficient to evaluate reproducibility. , 1989, Biometrics.

[21]  M. Ockendon,et al.  Validation of a Novel Smartphone Accelerometer-Based Knee Goniometer , 2012, The Journal of Knee Surgery.

[22]  Daniel S Anderson,et al.  Reliability and validity of an iPhone inclinometer as compared to a universal goniometer as a tool for measuring joint motion of the shoulder in apparently healthy subjects , 2013 .

[23]  Matthew L. Lyons,et al.  Shoulder Range of Motion , 2013, Orthopaedic Journal of Sports Medicine.

[24]  Richard W. Bohannon,et al.  Clinical measurement of range of motion. Review of goniometry emphasizing reliability and validity. , 1987, Physical therapy.

[25]  Stephanie Morton,et al.  Reliability and validity of goniometric iPhone applications for the assessment of active shoulder external rotation , 2014, Physiotherapy theory and practice.