Reliability of a Digital-Photographic-Goniometric Method for Coronal-Plane Lower Limb Measurements

in Journal of Sport Rehabilitation
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Structural and coronal-plane-alignment characteristics of the lower limb are frequently cited as factors contributing to knee pathologies.


The purpose of this study was to determine the accuracy and reliability characteristics of a digital-photographic-goniometric method (DPGM) of measurement for 2-dimensional (2D) coronal-plane lower limb measurements of the quadriceps (Q) angle, tibiofemoral (TF) angle, and femur length in human participants adopting a self-selected- or Romberg-stance position.


Reliability study.


University motion-analysis laboratory.


A convenience sample of 20 healthy young adult men and women.

Main Outcome Measures:

Intraclass correlation coefficients (ICCs), 95% confidence intervals, and standard error of the measurements.


Intratester- and intertester-reliability coefficients for the Q angle (ICCs .458–845 and .257–737) were consistently lower than those for the TF angle (ICCs .627–.904 and .700–.839) or femur length (ICCs .867–.958 and .866–.944). Q angles were also significantly larger (13.4%) in the Romberg- vs self-selected-stance position (P < .001) and larger (20.2%) in the left limb than the right limb.


The DPGM has the potential to produce accurate and reliable measurements of selected 2D lower limb measures. However, the reliability characteristics depend on the ability of the testers to correctly and repeatably landmark the anatomical sites used to define the measurements of interest and might be influenced by other factors such as the stance position adopted, the complexity of the variable (ie, number of anatomical landmarks and segments), and the size of the captured image. Further investigation of these latter factors is warranted.

The authors are with the School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada.