Validity and reliability of a smartphone application for self-measurement of active shoulder range of motion in a standing position among healthy adults.

Shoulder range of motion (ROM) is one of the most important indicators of shoulder disease severity, function, and physical assessment. A universal goniometer (UG) was used as a gold standard for ROM measurement. Recently, smartphone applications for ROM measurement have attracted attention as alternatives to UG. This study aimed to investigate the validity and reliability of active ROM measurements using a smartphone application goniometer that can be used by patients in a standing position. The dominant shoulders of 19 healthy participants were included in the study. The 2 observers who were physical therapists used the UG, whereas the participants used a smartphone application goniometer to measure the shoulder ROM. A recorder, who is a physical therapist independent of the observer and participant, read and recorded the shoulder ROM measurements. The order of the measurement movements and devices used was randomized. Agreement between the smartphone application goniometer and UG (percentage of participants for whom the difference between the UG and application measurements was within ±20% of the mean of the goniometer and application measurements) ranged between 42% and 100%. The intraclass correlation coefficient values (3, 1) for the agreement between the smartphone application goniometer and UG was between 0.72 and 0.97, showing significant and approximately perfect correlations. High agreement with the UG showed excellent validity, indicating that the smartphone application goniometer used by the participants in the standing position is an excellent method and instrument. The results suggest a simpler, more reliable, practical, and inexpensive method for measuring ROM required for telerehabilitation.

Shimizu H ，Saito T ，Kouno C ，Shimoura K ，Kawabe R ，Shinohara Y ，Mukaiyama K ，Changyu C ，Kato M ，Nagai-Tanima M ，Aoyama T ... -  《-》

Accuracy of a Smartphone Software Application Compared With a Handheld Goniometer for Measuring Shoulder Range of Motion in Asymptomatic Adults.

Typically, shoulder range of motion (ROM) measurements are performed in a clinic setting, where physicians, physical therapists (PTs), and occupational therapists make use of a goniometer. To determine the accuracy of a smartphone-based ROM software application (app) in assessing active shoulder ROM and compare the measurements with traditional goniometry as measured by a PT. Cohort study (diagnosis); Level of evidence, 2. This prospective, nonblinded study was conducted at a single institution with adult asymptomatic participants with full active ROM of both shoulders. Participants were enrolled between June 1 and 15, 2021. Each participant self-assessed their active shoulder ROM using the PeerWell smartphone app. A single PT concurrently measured each participant's active shoulder ROM using a handheld universal goniometer. Bilateral shoulder ROM (forward flexion, abduction [AB], external rotation, internal rotation [IR], and extension) was measured 2 times for each participant. Interrater reliability between the smartphone app and PT measurements as well as intrarater reliability for each method of measurement were assessed using the intraclass correlation coefficient (ICC), and limits of agreement were analyzed for the difference in measurement methods. Data were analyzed for 60 shoulders (30 right, 30 left) from 30 participants (mean age, 31.4 ± 11.7 years; 73% female). The interrater reliability between the 2 methods was excellent for all movements (ICCs, 0.90-0.96). For all movements except shoulder AB, the mean difference in the measurements between the 2 methods was <1.3°; the mean difference in AB ROM was 2.08°. For all movements except IR, both PTs and the app showed excellent intrarater reliability (ICCs >0.90); for IR, good intrarater reliability (ICC ≥0.75) was observed. The PeerWell smartphone app provided measurements comparable with manual measurements taken by a PT using a goniometer. These data provide evidence that the smartphone app is a reliable and valid tool for measuring shoulder ROM and show promise for measuring and monitoring patient ROM remotely.

Soeters R ，Damodar D ，Borman N ，Jacobson K ，Shi J ，Pillai R ，Mehran N ... -  《Orthopaedic Journal of Sports Medicine》

RELIABILITY AND VALIDITY OF THE HALO DIGITAL GONIOMETER FOR SHOULDER RANGE OF MOTION IN HEALTHY SUBJECTS.

Correll S ，Field J ，Hutchinson H ，Mickevicius G ，Fitzsimmons A ，Smoot B ... -  《-》

Validation of an innovative method of shoulder range-of-motion measurement using a smartphone clinometer application.

An accurate and reliable measurement of shoulder range of motion (ROM) is important in the evaluation of the shoulder. A smartphone digital clinometer application is a potentially simpler method for measuring shoulder ROM. The goal of this study was to establish the reliability and validity of shoulder ROM measurements among varying health care providers using a smartphone clinometer application in healthy and symptomatic adults. An attending surgeon, fellow, resident, physician assistant, and student served as examiners. Bilateral shoulders of 24 healthy subjects were included. Fifteen postoperative patients served as the symptomatic cohort. Examiners measured ROM of each shoulder, first using visual estimation and then using a goniometer and smartphone clinometer in a randomized fashion. The interobserver reliability among examiners showed significant correlation, with average intraclass correlation coefficient [ICC(2,1)] values of 0.61 (estimation), 0.69 (goniometer), and 0.80 (smartphone). All 5 examiners had substantial agreement with the gold standard in healthy subjects, with average ICC(2,1) values ranging from 0.62 to 0.79. The interobserver reliability in symptomatic patients showed significant correlation, with average ICC(2,1) values of 0.72 (estimation), 0.79 (goniometer), and 0.89 (smartphone). Examiners had excellent agreement with the gold standard in symptomatic patients, with an average ICC(2,1) value of 0.98. The smartphone clinometer has excellent agreement with a goniometer-based gold standard for measurement of shoulder ROM in both healthy and symptomatic subjects. There is good correlation among different skill levels of providers for measurements obtained using the smartphone. A smartphone-based clinometer is a good resource for shoulder ROM measurement in both healthy subjects and symptomatic patients.

Werner BC ，Holzgrefe RE ，Griffin JW ，Lyons ML ，Cosgrove CT ，Hart JM ，Brockmeier SF ... -  《-》

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

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. 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). This is a comparative study with repeated measurement design. 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. 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. 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.

Johnson LB ，Sumner S ，Duong T ，Yan P ，Bajcsy R ，Abresch RT ，de Bie E ，Han JJ ... -  《-》