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Robert H. Wellmon, Dawn T. Gulick, Mark L. Paterson and Colleen N. Gulick

Context:

Smartphones are being used in a variety of practice settings to measure joint range of motion (ROM). A number of factors can affect the validity of the measurements generated. However, there are no studies examining smartphone-based goniometer applications focusing on measurement variability and error arising from the electromechanical properties of the device being used.

Objective:

To examine the concurrent validity and interrater reliability of 2 goniometric mobile applications (Goniometer Records, Goniometer Pro), an inclinometer, and a universal goniometer (UG).

Design:

Nonexperimental, descriptive validation study.

Setting:

University laboratory.

Participants:

3 physical therapists having an average of 25 y of experience.

Main Outcome Measures:

Three standardized angles (acute, right, obtuse) were constructed to replicate the movement of a hinge joint in the human body. Angular changes were measured and compared across 3 raters who used 3 different devices (UG, inclinometer, and 2 goniometric apps installed on 3 different smartphones: Apple iPhone 5, LG Android, and Samsung SIII Android). Intraclass correlation coefficients (ICCs) and Bland-Altman plots were used to examine interrater reliability and concurrent validity.

Results:

Interrater reliability for each of the smartphone apps, inclinometer and UG were excellent (ICC = .995–1.000). Concurrent validity was also good (ICC = .998–.999). Based on the Bland-Altman plots, the means of the differences between the devices were low (range = –0.4° to 1.2°).

Conclusions:

This study identifies the error inherent in measurement that is independent of patient factors and due to the smartphone, the installed apps, and examiner skill. Less than 2° of measurement variability was attributable to those factors alone. The data suggest that 3 smartphones with the 2 installed apps are a viable substitute for using a UG or an inclinometer when measuring angular changes that typically occur when examining ROM and demonstrate the capacity of multiple examiners to accurately use smartphone-based goniometers.