Reliability and concurrent validity of a new iPhone(®) goniometric application for measuring active wrist range of motion: a cross-sectional study in asymptomatic subjects.

Measurement of wrist range of motion (ROM) is often considered to be an essential component of wrist physical examination. The measurement can be carried out through various instruments such as goniometers and inclinometers. Recent smartphones have been equipped with accelerometers and magnetometers, which, through specific software applications (apps) can be used for goniometric functions. This study, for the first time, aimed to evaluate the reliability and concurrent validity of a new smartphone goniometric app (Goniometer Pro©) for measuring active wrist ROM. In all, 120 wrists of 70 asymptomatic adults (38 men and 32 women; aged 18-40 years) were assessed in a physiotherapy clinic located at the School of Rehabilitation Sciences, Iran University of Medical Science and Health Services, Tehran, Iran. Following the recruitment process, active wrist ROM was measured using a universal goniometer and iPhone® 5 app. Two blinded examiners each utilized the universal goniometer and iPhone® to measure active wrist ROM using a volar/dorsal alignment technique in the following sequences: flexion, extension, radial deviation, and ulnar deviation. The second (2 h later) and third (48 h later) sessions were carried out in the same manner as the first session. All the measurements were conducted three times and the mean value of three repetitions for each measurement was used for analysis. Intraclass correlation coefficient (ICC) models (3, k) and (2, k) were used to determine the intra-rater and inter-rater reliability, respectively. The Pearson correlation coefficients were used to establish concurrent validity of the iPhone® app. Good to excellent intra-rater and inter-rater reliability was demonstrated for the goniometer with ICC values of ≥ 0.82 and ≥ 0.73 and the iPhone® app with ICC values of ≥ 0.83 and ≥ 0.79, respectively. Minimum detectable change at the 95% confidence level (MDC95 ) was computed as 1.96 × standard error of measurement × √2. The MDC95 ranged from 1.66° to 5.35° for the intra-rater analysis and from 1.97° to 6.15° for the inter-rater analysis. The concurrent validity between the two instruments was high, with r values of ≥ 0.80. From the results of this cross-sectional study, it can be concluded that the iPhone® app possesses good to excellent intra-rater and inter-rater reliability and concurrent validity. It seems that this app can be used for the measurement of wrist ROM. However, further research is needed to evaluate symptomatic subjects using this app.

Pourahmadi MR ，Ebrahimi Takamjani I ，Sarrafzadeh J ，Bahramian M ，Mohseni-Bandpei MA ，Rajabzadeh F ，Taghipour M ... -  《-》

Reliability and validity of an iPhone(®) application for the measurement of lumbar spine flexion and extension range of motion.

Pourahmadi MR ，Taghipour M ，Jannati E ，Mohseni-Bandpei MA ，Ebrahimi Takamjani I ，Rajabzadeh F ... -  《-》

A new iPhone application for measuring active craniocervical range of motion in patients with non-specific neck pain: a reliability and validity study.

Measurement of cervical spine range of motion (ROM) is often considered to be an essential component of cervical spine physiotherapy assessment. This study aimed to investigate the reliability and validity of an iPhone application (app) (Goniometer Pro) for measuring active craniocervical ROM (ACCROM) in patients with non-specific neck pain. A cross-sectional study was conducted at the musculoskeletal biomechanics laboratory located at Iran University of Medical Sciences. Forty non-specific neck pain patients participated in this study. The outcome measure was the ACCROM, including flexion, extension, lateral flexion, and rotation. Following the recruitment process, ACCROM was measured using a universal goniometer (UG) and iPhone 7 app. Two blinded examiners each used the UG and iPhone to measure ACCROM in the following sequences: flexion, extension, lateral flexion, and rotation. The second (2 hours later) and third (48 hours later) sessions were carried out in the same manner as the first session. Intraclass correlation coefficient (ICC) models were used to determine the intra-rater and inter-rater reliability. The Pearson correlation coefficients were used to establish concurrent validity of the iPhone app. Minimum detectable change at the 95% confidence level (MDC95) was also computed. Good intra-rater and inter-rater reliability was demonstrated for the goniometer with ICC values of ≥0.66 and ≥0.70 and the iPhone app with ICC values of ≥0.62 and ≥0.65, respectively. The MDC95 ranged from 2.21° to 12.50° for the intra-rater analysis and from 3.40° to 12.61° for the inter-rater analysis. The concurrent validity between the two instruments was high, with r valuesof ≥0.63. The magnitude of the differences between the UG and iPhone app values (effect sizes) was small, with Cohen d values of ≤0.17. The iPhone app possesses good reliability and high validity. It seems that this app can be used for measuring ACCROM.

Pourahmadi MR ，Bagheri R ，Taghipour M ，Takamjani IE ，Sarrafzadeh J ，Mohseni-Bandpei MA ... -  《-》

Validity and reliability of inertial sensors for elbow and wrist range of motion assessment.

Elbow and wrist chronic conditions are very common among musculoskeletal problems. These painful conditions affect muscle function, which ultimately leads to a decrease in the joint's Range Of Motion (ROM). Due to their portability and ease of use, goniometers are still the most widespread tool for measuring ROM. Inertial sensors are emerging as a digital, low-cost and accurate alternative. However, whereas inertial sensors are commonly used in research studies, due to the lack of information about their validity and reliability, they are not widely used in the clinical practice. The goal of this study is to assess the validity and intra-inter-rater reliability of inertial sensors for measuring active ROM of the elbow and wrist. Measures were taken simultaneously with inertial sensors (Werium™ system) and a universal goniometer. The process involved two physiotherapists ("rater A" and "rater B") and an engineer responsible for the technical issues. Twenty-nine asymptomatic subjects were assessed individually in two sessions separated by 48 h. The procedure was repeated by rater A followed by rater B with random order. Three repetitions of each active movement (elbow flexion, pronation, and supination; and wrist flexion, extension, radial deviation and ulnar deviation) were executed starting from the neutral position until the ROM end-feel; that is, until ROM reached its maximum due to be stopped by the anatomy. The coefficient of determination (r 2) and the Intraclass Correlation Coefficient (ICC) were calculated to assess the intra-rater and inter-rater reliability. The Standard Error of the Measurement and the Minimum Detectable Change and a Bland-Altman plots were also calculated. Similar ROM values when measured with both instruments were obtained for the elbow (maximum difference of 3° for all the movements) and wrist (maximum difference of 1° for all the movements). These values were within the normal range when compared to literature studies. The concurrent validity analysis for all the movements yielded ICC values ≥0.78 for the elbow and ≥0.95 for the wrist. Concerning reliability, the ICC values denoted a high reliability of inertial sensors for all the different movements. In the case of the elbow, intra-rater and inter-rater reliability ICC values range from 0.83 to 0.96 and from 0.94 to 0.97, respectively. Intra-rater analysis of the wrist yielded ICC values between 0.81 and 0.93, while the ICC values for the inter-rater analysis range from 0.93 to 0.99. Inertial sensors are a valid and reliable tool for measuring elbow and wrist active ROM. Particularly noteworthy is their high inter-rater reliability, often questioned in measurement tools. The lowest reliability is observed in elbow prono-supination, probably due to skin artifacts. Based on these results and their advantages, inertial sensors can be considered a valid assessment tool for wrist and elbow ROM.

Costa V ，Ramírez Ó ，Otero A ，Muñoz-García D ，Uribarri S ，Raya R ... -  《PeerJ》

The reliability and concurrent validity of a new iPhone® application for measuring active lumbar spine flexion and extension range of motion in patients with low back pain.

Pourahmadi M ，Momeni E ，Mohseni N ，Hesarikia H ，Ghanjal A ，Shamsoddini A ... -  《-》