Validity and Intrarater Reliability Using a Smartphone Clinometer Application to Measure Active Cervical Range of Motion Including Rotation Measurements in Supine

in Journal of Sport Rehabilitation
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Context: Technological advances have given smartphones the capabilities of sensitive clinical measurement equipment at lesser cost and higher availability. The Clinometer is a smartphone application that can be used to measure the joint range of motion in a clinical setting, but psychometric properties of the tool’s use measuring cervical range of motion (CROM) are not established. Objectives: The purpose of this study was to examine the validity and intrarater reliability of the Clinometer application for the measurement of CROM (ie, flexion, extension, rotation, lateral flexion) and to determine the minimal detectable change and SEM. Design: A blinded, repeated-measures correlational design was employed. Setting: The study was conducted collaboratively between 2 athletic training clinics. Participants: A convenience sample of healthy adults ages 18–30 years were recruited. Participants with any history in the last 3 months of cervical or thoracic pathology, pain, or any musculoskeletal injury were excluded. Main Outcome Measures: Three repetitions of each motion were measured by a primary researcher with a goniometer. The same researcher then conducted 3 blinded measurements with the Clinometer application following the same procedure. A second researcher, blinded to the goniometer measurements, recorded the results. Thirty minutes later, testing was repeated with the application. The Pearson correlation was calculated to determine validity of the application compared with goniometry. Results: The measurements between devices had moderate to excellent concurrent validity, with the coefficients ranging between 0.544 and 0.888, P < .01. Test–retest reliability of the CROM measurement using the application was moderate to excellent, with intraclass correlation coefficients ranging between .774 and .928. Across all movements, the SEM ranged from 1.17° to 2.01°, and the minimal detectable change ranged from 1.18° to 2.02°. Conclusion: The Clinometer application is a valid and reliable instrument for measuring active CROM. Level of evidence: clinical measurement, level 1b.

Monreal is with Midwestern State University, Wichita Falls, TX, USA. Luinstra is with Wichita State University, Wichita, KS, USA. Larkins and May are with the Athletic Training Program, University of Idaho, Moscow, ID, USA.

Larkins (llarkins@uidaho.edu) is corresponding author.
  • 1.

    Quek J, Brauer S, Treleaven J, Pua Y, Mentiplay B, Clark R. Validity and intra-rater reliability of an android phone application to measure cervical range-of-motion. J Neuroeng Rehabil. 2014;11(1):16 . PubMed ID: 24742001 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Ferriero G, Vercelli S, Sartorio F, Foti C. Accelerometer-and photographic-based smartphone applications for measuring joint angle: are they reliable? J Arthroplasty. 2014;29(2):448449. PubMed ID: 23910818 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Jones A, Sealey R, Crowe M, Gordon S. Concurrent validity and reliability of the Simple Goniometer iPhone app compared with the Universal Goniometer. Physiother Theory Pract. 2014;30(7):512516. PubMed ID: 24666408 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Milani P, Coccetta CA, Rabini A, Sciarra T, Massazza G, Ferriero G. Mobile smartphone applications for body position measurement in rehabilitation: a review of goniometric tools. PM R. 2014;6(11):10381043. PubMed ID: 24844445 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Mourcou Q, Fleury A, Diot B, Franco C, Vuillerme N. Mobile phone-based joint angle measurement for functional assessment and rehabilitation of proprioception. Biomed Res Int. 2015;2015:328142. PubMed ID: 26583101 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Cox R, Martinez R, Baker R, Larkins L. Validity of a smartphone application for measuring ankle plantar flexion. J Sport Rehabil. 2017;27(3):111.

    • Search Google Scholar
    • Export Citation
  • 7.

    Tousignant-Laflamme Y, Boutin N, Dion A, Vallée C. Reliability and criterion validity of two applications of the iPhone to measure cervical range of motion in healthy participants. J Neuroeng Rehabil. 2013;10(1):69. doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Norkin CC, White DJ, Torres J, Molleur JG, Littlefield LG, Malone TW. Measurement of Joint Motion: A Guide to Goniometry. Philadelphia, PA: F.A. Davis Company; 2016.

    • Search Google Scholar
    • Export Citation
  • 9.

    Leech NL, Barrett KC, Morgan GA. IBM SPSS for Intermediate Statistics—Use and Interpretation. 5th ed. New York, NY: Routledge; 2015.

  • 10.

    Vincent WJ, Weir JP. Statistics in Kinesiology. 4th ed. Champaign, IL: Human Kinetics; 2012.

  • 11.

    Hallgren KA. Computing inter-rater reliability for observational data: an overview and tutorial. Tutor Quant Methods Psychol. 2012;8(1):2334. PubMed ID: 22833776 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Hopkins WG. A new view of statistics. Internet Society for Sport Science.

    • Crossref
    • Export Citation
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