The effect of proficiency level on measurement error of range of motion

[Purpose] The aims of this study were to evaluate the type and extent of error in the measurement of range of motion and to evaluate the effect of evaluators’ proficiency level on measurement error. [Subjects and Methods] The participants were 45 university students, in different years of their physical therapy education, and 21 physical therapists, with up to three years of clinical experience in a general hospital. Range of motion of right knee flexion was measured using a universal goniometer. An electrogoniometer attached to the right knee and hidden from the view of the participants was used as the criterion to evaluate error in measurement using the universal goniometer. The type and magnitude of error were evaluated using the Bland-Altman method. [Results] Measurements with the universal goniometer were not influenced by systematic bias. The extent of random error in measurement decreased as the level of proficiency and clinical experience increased. [Conclusion] Measurements of range of motion obtained using a universal goniometer are influenced by random errors, with the extent of error being a factor of proficiency. Therefore, increasing the amount of practice would be an effective strategy for improving the accuracy of range of motion measurements.

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

[2]  J M Rothstein,et al.  Goniometric reliability in a clinical setting. Elbow and knee measurements. , 1984, Physical therapy.

[3]  M. Moore,et al.  The measurement of joint motion; the technic of goniometry. , 1949, The Physical therapy review.

[4]  Robert J. Crutcher,et al.  The role of deliberate practice in the acquisition of expert performance. , 1993 .

[5]  J. Sim,et al.  Measurement validity in physical therapy research. , 1993, Physical therapy.

[6]  A W Parker,et al.  Active and Passive Mobility of Lower Limb Joints in Elderly Men and Women , 1989, American journal of physical medicine & rehabilitation.

[7]  P. Fitts The information capacity of the human motor system in controlling the amplitude of movement. , 1954, Journal of experimental psychology.

[8]  M. Aoki,et al.  The accuracy of goniometric measurements of proximal interphalangeal joints in fresh cadavers: comparison between methods of measurement, types of goniometers, and fingers. , 2007, Journal of hand therapy : official journal of the American Society of Hand Therapists.

[9]  K. Rome,et al.  A Reliability Study of the Universal Goniometer, Fluid Goniometer, and Electrogoniometer for the Measurement of Ankle Dorsiflexion , 1996, Foot & ankle international.

[10]  M. Guadagnoli,et al.  Challenge Point: A Framework for Conceptualizing the Effects of Various Practice Conditions in Motor Learning , 2004, Journal of motor behavior.

[11]  Margaret L. Moore The Measurement of Joint Motion: Part II: The Technic of Goniometry , 1949 .

[12]  Laurent Degos,et al.  HISTOCOMPATIBILITY DETERMINANTS IN MULTIPLE SCLEROSIS , 1974 .

[13]  Peter Schuck,et al.  The ‘smallest real difference’ as a measure of sensitivity to change: a critical analysis , 2003, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.

[14]  M. Province,et al.  Reliability of goniometric measurements in patients with Duchenne muscular dystrophy. , 1985, Physical therapy.

[15]  E. Chao,et al.  An electrogoniometric study of knee motion in normal gait. , 1970, The Journal of bone and joint surgery. American volume.

[16]  J. M. Rothstein,et al.  Goniometric Reliability in a Clinical Setting , 1983 .

[17]  C. Rowe Joint measurement in disability evaluation. , 1964, Clinical orthopaedics and related research.

[18]  Kazunori Akizuki,et al.  Measurement of functional task difficulty during motor learning: What level of difficulty corresponds to the optimal challenge point? , 2015, Human movement science.

[19]  Leslie G. Portney Dpt PhD Fapta,et al.  Foundations of Clinical Research: Applications to Practice , 2015 .

[20]  M. Wiles Elements of Research in Physical Therapy. , 1980 .

[21]  K. Roach,et al.  Normal hip and knee active range of motion: the relationship to age. , 1991, Physical Therapy.

[22]  J. Cornell,et al.  Modeling impairment: Using the disablement process as a framework to evaluate determinants of hip and knee flexion , 2000, Aging.

[23]  E. R. Crossman A THEORY OF THE ACQUISITION OF SPEED-SKILL∗ , 1959 .

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

[25]  D. Downham,et al.  How to assess the reliability of measurements in rehabilitation. , 2005, American journal of physical medicine & rehabilitation.

[26]  Karpovich Pv,et al.  Electrogoniometric study of joints. , 1960 .

[27]  Francesco Sartorio,et al.  Reliability of a smartphone-based goniometer for knee joint goniometry , 2013, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.

[28]  S. O’Driscoll,et al.  Validation of a photography-based goniometry method for measuring joint range of motion. , 2012, Journal of shoulder and elbow surgery.

[29]  S. Azen,et al.  Reliability of goniometric measurements. , 1978, Physical therapy.

[30]  Pagamas Piriyaprasarth,et al.  The reliability of knee joint position testing using electrogoniometry , 2008, BMC musculoskeletal disorders.

[31]  P. A. van den Brandt,et al.  Reproducibility of goniometric measurement of the knee in the in-hospital phase following total knee arthroplasty , 2007, BMC musculoskeletal disorders.

[32]  T. M. Wood,et al.  Measurement Concepts in Physical Education and Exercise Science , 1989 .

[33]  M. Sumitani,et al.  Novel 3-Dimensional Motion Analysis Method for Measuring the Lumbar Spine Range of Motion: Repeatability and Reliability Compared With an Electrogoniometer , 2013, Spine.

[34]  J L Low,et al.  The reliability of joint measurement. , 1976, Physiotherapy.

[35]  D. Burdon,et al.  Clinical methods of goniometry: a comparative study. , 1992, Disability and rehabilitation.

[36]  Heleen Beckerman,et al.  Smallest real difference, a link between reproducibility and responsiveness , 2001, Quality of Life Research.

[37]  G Atkinson,et al.  Statistical Methods For Assessing Measurement Error (Reliability) in Variables Relevant to Sports Medicine , 1998, Sports medicine.

[38]  S. Rose,et al.  Reliability and validity of goniometric measurements at the knee. , 1987, Physical therapy.

[39]  C. Enwemeka,et al.  Radiographic verification of knee goniometry. , 1986, Scandinavian journal of rehabilitation medicine.

[40]  W G Hopkins,et al.  Measures of Reliability in Sports Medicine and Science , 2000, Sports medicine.