Reliability and criterion validity of two applications of the iPhone™ to measure cervical range of motion in healthy participants

Summary of background dataRecent smartphones, such as the iPhone, are often equipped with an accelerometer and magnetometer, which, through software applications, can perform various inclinometric functions. Although these applications are intended for recreational use, they have the potential to measure and quantify range of motion. The purpose of this study was to estimate the intra and inter-rater reliability as well as the criterion validity of the clinometer and compass applications of the iPhone in the assessment cervical range of motion in healthy participants.MethodsThe sample consisted of 28 healthy participants. Two examiners measured cervical range of motion of each participant twice using the iPhone (for the estimation of intra and inter-reliability) and once with the CROM (for the estimation of criterion validity). Estimates of reliability and validity were then established using the intraclass correlation coefficient (ICC).ResultsWe observed a moderate intra-rater reliability for each movement (ICC = 0.65-0.85) but a poor inter-rater reliability (ICC < 0.60). For the criterion validity, the ICCs are moderate (>0.50) to good (>0.65) for movements of flexion, extension, lateral flexions and right rotation, but poor (<0.50) for the movement left rotation.ConclusionWe found good intra-rater reliability and lower inter-rater reliability. When compared to the gold standard, these applications showed moderate to good validity. However, before using the iPhone as an outcome measure in clinical settings, studies should be done on patients presenting with cervical problems.

[1]  T. R. Garrett,et al.  Normal range of motion of the cervical spine: an initial goniometric study. , 1992, Physical therapy.

[2]  Z Dvir,et al.  Reproducibility and instrument validity of a new ultrasonography-based system for measuring cervical spine kinematics. , 2000, Clinical biomechanics.

[3]  R. Adams,et al.  Cervical Range of Motion Associations With Subclinical Neck Pain , 2004, Spine.

[4]  Edward D. Lemaire,et al.  Change-of-state determination to recognize mobility activities using a BlackBerry smartphone , 2011, 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[5]  A. Chambers Introduction to Research in the Health Sciences , 2002 .

[6]  J. Zwart Neck Mobility in Different Headache Disorders , 1997, Headache.

[7]  Paolo Cornacchia,et al.  Interexaminer and intraexaminer reliability ofcervical passiverangeofmotion usingtheCROM and Cybex 320 EDI , 1998 .

[8]  Herbert F. Voigt,et al.  IEEE Engineering in Medicine and Biology Society , 2019, IEEE Transactions on Biomedical Engineering.

[9]  Tamara Prushansky,et al.  Reproducibility and validity of digital inclinometry for measuring cervical range of motion in normal subjects. , 2010, Physiotherapy research international : the journal for researchers and clinicians in physical therapy.

[10]  A. Peolsson,et al.  Intra- and inter-tester reliability and range of motion of the neck , 2000 .

[11]  Lex M Bouter,et al.  Reproducibility of cervical range of motion in patients with neck pain , 2005, BMC musculoskeletal disorders.

[12]  R. Buchbinder,et al.  The epidemiology of neck pain. , 2010, Best practice & research. Clinical rheumatology.

[13]  J. Côté,et al.  Validity and between-day reliability of the cervical range of motion (CROM) device. , 2010, The Journal of orthopaedic and sports physical therapy.

[14]  H. Corriveau,et al.  Criterion validity study of the cervical range of motion (CROM) device for rotational range of motion on healthy adults. , 2006, The Journal of orthopaedic and sports physical therapy.

[15]  D. P. O'connor,et al.  Tender point sensitivity, range of motion, and perceived disability in subjects with neck pain. , 2000, The Journal of orthopaedic and sports physical therapy.

[16]  J. Bolton,et al.  Reliability and concurrent validity of two instruments for measuring cervical range of motion: effects of age and gender. , 1995, Manual therapy.

[17]  W Rheault,et al.  Intertester reliability of the cervical range of motion device. , 1992, The Journal of orthopaedic and sports physical therapy.

[18]  Jeonghee Kim,et al.  Cell phone based balance trainer , 2012, Journal of NeuroEngineering and Rehabilitation.

[19]  J. Fleiss The design and analysis of clinical experiments , 1987 .

[20]  R L Lieber,et al.  Skeletal muscle mechanics: implications for rehabilitation. , 1993, Physical therapy.

[21]  K. W. Bush,et al.  Validity and Intertester Reliability of Cervical Range of Motion Using Inclinometer Measurements , 2000 .

[22]  J. Hartvigsen,et al.  The interexaminer reliability of measuring passive cervical range of motion, revisited. , 1996, Journal of manipulative and physiological therapeutics.

[23]  P. Sarzi-Puttini,et al.  The genetics of fibromyalgia syndrome. , 2007, Pharmacogenomics.

[24]  T. R. Garrett,et al.  Reliability of measurements of cervical spine range of motion--comparison of three methods. , 1991, Physical therapy.

[25]  M. Tousignant,et al.  Criterion Validity of the Cervical Range of Motion (CROM) Goniometer for Cervical Flexion and Extension , 2000, Spine.

[26]  Stephen Polgar,et al.  Introduction to Research in the Health Sciences , 1991 .

[27]  M. Williams,et al.  A systematic review of reliability and validity studies of methods for measuring active and passive cervical range of motion. , 2010, Journal of manipulative and physiological therapeutics.

[28]  J. Danoff,et al.  Cervical motion assessment: a new, simple and accurate method. , 1986, Archives of physical medicine and rehabilitation.

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

[30]  Joseph L. Fleiss,et al.  The Design and Analysis of Clinical Experiments: Fleiss/The Design , 1999 .

[31]  T. Mayer,et al.  Noninvasive measurement of cervical tri-planar motion in normal subjects. , 1993, Spine.

[32]  William D. Bandy,et al.  Joint Range of Motion and Muscle Length Testing , 2009 .

[33]  L. Brosseau,et al.  Intratester and intertester reliability of the Cybex electronic digital inclinometer (EDI-320) for measurement of active neck flexion and extension in healthy subjects. , 2001, Manual therapy.