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

2020 ◽  
pp. 1-5
Author(s):  
Christanie Monreal ◽  
Lindsay Luinstra ◽  
Lindsay Larkins ◽  
James May
Keyword(s):  
Range Of Motion ◽  
Repeated Measures ◽  
Pearson Correlation ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Intrarater Reliability ◽  
Convenience Sample ◽  
Clinical Measurement ◽  
Cervical Range Of Motion ◽  
Flexion Extension

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.

scholarly journals Validity and reliability of Veloflex to measure active cervical range of motion in asymptomatic and symptomatic subjects

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11228
Author(s):  
Germán Cánovas-Ambit ◽  
José A. García-Vidal ◽  
Rodrigo Martín-San Agustín ◽  
Aurelio Arenas Dalla-Vecchia ◽  
Mariana Sánchez-Barbadora ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Pearson Correlation ◽  
Minimal Detectable Change ◽  
Validity And Reliability ◽  
Intra Class Correlation ◽  
Cervical Range Of Motion ◽  
Active Range Of Motion ◽  
Flexion Extension ◽  
Test Retest Reliability ◽  
Standard Error Of Measurement

Background Neck pain has a high annual incidence and decreases the cervical active range of motion (ROM). Clinicians use various methods to evaluate cervical range of motion (CROM) that some of them have also been proposed to give instant feedback. Accordingly, this study aimed to examine the validity and reliability of Veloflex (VF) to measure the CROM by comparison with the cervical range of motion (CROM) device, and to examine their test-retest reliability. Methods Thirty-eight healthy and 20 symptomatic participants were evaluated. Cervical flexion-extension, side bending, and rotations were tested in two sessions, first by the CROM and VF and in the second only with the VF. To evaluate the concurrent validity and agreement between CROM and VF, Pearson correlation coefficient (r) and Bland–Altmann plots were used. Reliability were evaluated using intra-class correlation (ICC), standard error of measurement (SEM) and minimal detectable change (MDC). Results CROM and VF showed excellent correlation for all movements (r > 0.960). Both devices provided small mean ‘bias’ (≤1.29%) in all movements regarding CROM measures. The intra-rater and inter-rater reliability of the VF was excellent (ICC > 0.98). SEMs ranging from 0.72% to 2.38% and the MDC ranging from 1.22° to 2.60° in all participants. The results support the validity and reliability of VF to measure CROM. For its use, with a basic training is enough to get reliable measurements.

The Reliability of Strength Tests Performed In Elevated Shoulder Positions Using a Handheld Dynamometer

2016 ◽  
Vol 25 (2) ◽  
Author(s):  
Sally J. McLaine ◽  
Karen A. Ginn ◽  
Cecilia M. Kitic ◽  
James W. Fell ◽  
Marie-Louise Bird
Keyword(s):  
Repeated Measures ◽  
External Rotation ◽  
Body Position ◽  
Movement Control ◽  
Minimal Detectable Change ◽  
Intrarater Reliability ◽  
Strength Change ◽  
Flexion Extension ◽  
Strength Tests ◽  
Shoulder Strength

Context: The reliable measurement of shoulder strength is important when assessing athletes involved in overhead activities. Swimmers' shoulders are subject to repetitive humeral elevation and consequently have a high risk of developing movement-control issues and pain. Shoulder-strength tests performed in positions of elevation assist with the detection of strength deficits that may affect injury and performance. The reliability of isometric strength tests performed in positions of humeral elevation without manual stabilization, which is a typical clinical scenario, has not been established. Objective: To establish the relative and absolute intrarater reliability of shoulder-strength tests functional to swimming in 3 body positions commonly used in the clinical setting. Design: Repeated-measures reliability study. Setting: Research laboratory. Subjects: 15 university students and staff (mean ± SD age 24 ± 8.2 y).Intervention: Isometric shoulder-strength tests were performed in positions of humeral elevation (flexion and extension in 140° abduction in the scapular plane, internal and external rotation in 90° abduction) on subjects without shoulder pain in supine, prone, and sitting. Subjects were tested by 1 examiner with a handheld dynamometer and retested after 48 h. Main Outcome Measures: Relative reliability (ICC3,1) values with 95% CI. Absolute reliability was reported by minimal detectable change (MDC). Results: Good to excellent intrarater reliability was found for all shoulder-strength tests (ICC .87-.99). Intrarater reliability was not affected by body position. MDC% was <16% for every test and ≤11% for tests performed in supine. Conclusions: Shoulder flexion, extension, and internal- and external-rotation strength tests performed in humeral elevation demonstrated excellent to good intrarater reliability regardless of body position. A strength change of more than 15% in any position can be considered meaningful.

Measurement of Ankle Dorsiflexion: A Comparison of Active and Passive Techniques in Multiple Positions

2011 ◽  
Vol 20 (3) ◽  
pp. 333-344 ◽  
Author(s):  
David A. Krause ◽  
Beth A. Cloud ◽  
Lindsey A. Forster ◽  
Jennifer A. Schrank ◽  
John H. Hollman
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
Interrater Reliability ◽  
Emg Activity ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Intrarater Reliability ◽  
Significant Difference ◽  
Anterior Tibialis ◽  
Passive Techniques

Context:Limited ankle DF (DF) range of motion (ROM) resulting from restricted gastrocnemius and soleus mobility is associated with a variety of lower extremity pathologies. Several techniques are used clinically to measure ankle DF.Objectives:To evaluate the reliability and minimal detectable change of DF ROM measurement, determine whether there is a difference in measured DF between techniques, and quantify the electromyographic (EMG) activity of the soleus and tibialis anterior muscles associated with the techniques.Design:Repeated measures.Setting:Controlled laboratory setting.Participants:39 healthy subjects, age 22–33.Main Outcome Measures:DF measurements using 5 different techniques including active and passive DF with the knee extended and flexed to 90° and a modified lunge. EMG activity of the soleus and anterior tibialis muscles.Results:Intrarater reliability values (ICC3,1) ranged from .68 to .89. Interrater reliability (ICC2,1) ranged from .55 to .82. ICCs were the greatest with the modified lunge. The minimal detectable change (MDC95) ranged from 6° to 8° among the different techniques. A significant difference in DF ROM was found between all methods. Measurements taken with active DF were greater than the same measures taken passively. The lunge position resulted in greater DF ROM than both active and passive techniques. EMG activity of the soleus was greater with active DF and the lunge than with passive DF.Conclusions:The modified lunge, which demonstrated excellent intrarater and interrater reliability, may best represent maximal DF. Active end-range DF was significantly greater than passive end-range DF when measured at either 0° or 90° knee flexion. Greater active DF was not explained by inhibition of the soleus. Finally, using the modified lunge, a difference between 2 measurements over time of 6° or more suggests that a meaningful change has occurred.

scholarly journals Reliability and validity of an iPhone®application for the measurement of lumbar spine flexion and extension range of motion

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2355 ◽  
Author(s):  
Mohammad Reza Pourahmadi ◽  
Morteza Taghipour ◽  
Elham Jannati ◽  
Mohammad Ali Mohseni-Bandpei ◽  
Ismail Ebrahimi Takamjani ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Range Of Motion ◽  
Concurrent Validity ◽  
Pearson Correlation ◽  
Medical Science ◽  
Reliability And Validity ◽  
Convenience Sample ◽  
Rater Reliability ◽  
Flexion Extension ◽  
Flexion And Extension

BackgroundMeasurement of lumbar spine range of motion (ROM) is often considered to be an essential component of lumbar spine physiotherapy and orthopedic assessment. The measurement can be carried out through various instruments such as inclinometers, goniometers, and etc. Recent smartphones have been equipped with accelerometers and magnetometers, which, through specific software applications (apps) can be used for inclinometric functions.PurposeThe main purpose was to investigate the reliability and validity of an iPhone®app (TiltMeter©-advanced level and inclinometer) for measuring standing lumbar spine flexion–extension ROM in asymptomatic subjects.DesignA cross-sectional study was carried out.SettingThis study was conducted in a physiotherapy clinic located at School of Rehabilitation Sciences, Iran University of Medical Science and Health Services, Tehran, Iran.SubjectsA convenience sample of 30 asymptomatic adults (15 males; 15 females; age range = 18–55 years) was recruited between August 2015 and December 2015.MethodsFollowing a 2–minute warm-up, the subjects were asked to stand in a relaxed position and their skin was marked at the T12–L1and S1–S2spinal levels. From this position, they were asked to perform maximum lumbar flexion followed by maximum lumbar extension with their knees straight. Two blinded raters each used an inclinometer and the iPhone®app to measure lumbar spine flexion–extension ROM. A third rater read the measured angles. To calculate total lumbar spine flexion–extension ROM, the measurement from S1–S2was subtracted from T12–L1. The second (2 hours later) and third (48 hours later) sessions were carried out in the same manner as the first session. All of the measurements were conducted 3 times and the mean value of 3 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. Furthermore, minimum detectable change at the 95% confidence level (MDC95) was computed as 1.96 × standard error of measurement × $\sqrt{2}$.ResultsGood to excellent intra-rater and inter-rater reliability were demonstrated for both the gravity-based inclinometer with ICC values of ≥0.84 and ≥0.77 and the iPhone®app with ICC values of ≥0.85 and ≥0.85, respectively. The MDC95ranged from 5.82°to 8.18°for the intra-rater analysis and from 7.38°to 8.66° for the inter-rater analysis. The concurrent validity for flexion and extension between the 2 instruments was 0.85 and 0.91, respectively.ConclusionsThe iPhone®app possesses good to excellent intra-rater and inter-rater reliability and concurrent validity. It seems that the iPhone®app can be used for the measurement of lumbar spine flexion–extension ROM.Level of evidenceIIb.

scholarly journals Smartphone Application with Virtual Reality Goggles for the Reliable and Valid Measurement of Active Craniocervical Range of Motion

Diagnostics ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 71 ◽  
Author(s):  
Ke-Vin Chang ◽  
Wei-Ting Wu ◽  
Mei-Chu Chen ◽  
Yi-Chi Chiu ◽  
Der-Sheng Han ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Range Of Motion ◽  
Correlation Coefficient ◽  
Pearson Correlation ◽  
Random Effect Model ◽  
Altman Plot ◽  
Rater Reliability ◽  
Hybrid Device ◽  
Flexion Extension ◽  
The Right

Objective: This study aimed to determine the intra-rater and inter-rater reliability and validity of a hybrid device, combining virtual reality goggles, a magnetometer and an inclinometer application for smartphones, to measure craniocervical range. Summary of Background Data: Accurate evaluation of craniocervical range of motion is important for early detection of certain diseased conditions and monitoring the progress of interventions. The universal goniometer is widely used for the measurement but it requires experienced practitioners. Whether a combination of virtual reality goggles and smartphone applications can provide the same or better performance compared with the goniometer is still unknown. Methods: Forty-one healthy adults from the department of physical medicine and rehabilitation were recruited for craniocervical range examination (flexion, extension, side-bending to the right or left and rotating to the right or left) by using the hybrid device and universal goniometer. Using the hybrid device, repeated measurements were performed twice by a primary rater and once by a second rater. The primary rater also conducted a measurement using the universal goniometer in the same cohort. The intra-rater and inter-rater reliability (intra-class correlation coefficient (ICC)) were calculated using the two-way random effect model, whereas the validity was examined by the Pearson correlation coefficient and Bland-and-Altman plot. The interval between the first and second sessions of the measurement for intra-rater reliability was set at 30 min. Results: Excellent intra-rater (ICC ≥ 0.925) and inter-rater (ICC ≥ 0.880) reliability was noted for the hybrid device. The minimal detectable changes from intra-observer and inter-observer comparisons ranged between 4.12° and 7.42° in all six directions. The Bland-and-Altman plot revealed small mean differences (≤1.68°) between the hybrid device and universal goniometer. Both instruments had highly correlated measurements of craniocervical motion (r values ≥ 0.918). Conclusion: For healthy participants, excellent intra-rater and inter-rater reliability was noted for the hybrid device, and the measurements were consistent with the universal goniometer measurements. Future studies are needed to examine whether the device can perform similarly for patients with neck disorders.

scholarly journals Comparison of the efficacy of three cervical collars in restricting cervical range of motion: A randomized study

2018 ◽  
Vol 27 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Jae Guk Kim ◽  
Sung Hwan Bang ◽  
Gu Hyun Kang ◽  
Yong Soo Jang ◽  
Wonhee Kim ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Range Of Motion ◽  
Cervical Spine Injury ◽  
Axial Rotation ◽  
The Other ◽  
Spine Injury ◽  
Cervical Range Of Motion ◽  
Flexion Extension ◽  
Cervical Immobilization ◽  
The Difference

Background: The cervical collar has been used as a common device for the initial stabilization of the cervical spine. Although many cervical collars are commercially available, there is no consensus on which offers the greatest protection, with studies showing considerable variations in their ability to restrict cervical range of motion. The use of the XCollar (Emegear, Carpinteria, CA) has been known to decrease the risk of spinal cord injury by minimizing potential cervical spinal distraction. We compared XCollar with two other cervical collars commonly used for adult patients with cervical spine injury to evaluate the difference in effectiveness between the three cervical collars to restrict cervical range of motion. Objectives: This study aimed to evaluate the difference between the three cervical collars in their ability to restrict cervical range of motion. Method: A total of 30 healthy university students aged 21–25 years participated in this study. Participants with any cervical disease and symptoms were excluded. Three cervical collars were tested: Philadelphia® Collar, Stifneck® Select™ Collar, and XCollar. A digital camera and an image-analysis technique were used to evaluate cervical range of motion during flexion, extension, bilateral bending and bilateral axial rotation. Cervical range of motion was evaluated in both the unbraced and braced condition. Results: XCollar permitted less than a mean of 10° of movement during flexion, extension, bilateral bending and bilateral axial rotation. This was less than the movement permitted by the other two cervical collars. Conclusion: XCollar presented superior cervical immobilization compared to the other two commonly used cervical collars in this study. Thus, when cervical collar is considered for an adult patient with cervical spine injury, XCollar might be one of the considerate options as a cervical immobilization device.

scholarly journals Responsiveness of a Balance Assessment Using a Mobile Application

2020 ◽  
Vol 12 (4) ◽  
pp. 401-404
Author(s):  
David A. Krause ◽  
Sarah E. Anderson ◽  
Graeme R. Campbell ◽  
Samson J. Davis ◽  
Samuel W. Tindall ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Intraclass Correlation ◽  
Algorithm Analysis ◽  
Minimal Detectable Change ◽  
Balance Assessment ◽  
Level Of Evidence ◽  
Convenience Sample ◽  
Warm Up ◽  
Testing Procedures ◽  
A Value

Background: Balance assessment is used by clinicians as part of athlete concussion screening. The King-Devick (K-D) Balance app is designed to provide an objective balance assessment value. The purpose of this study was to investigate the responsiveness of a balance assessment using the K-D Balance app. Hypothesis: The K-D Balance app will demonstrate acceptable responsiveness for balance assessment. Study Design: Repeated-measures study. Level of Evidence: Level 5. Methods: A convenience sample of 25 participants between the ages of 20 and 25 years completed testing procedures. A battery of balance tests using the K-D Balance app on an iPhone were conducted 1 week apart. After a 5-minute warm-up, 3 stances were assessed: double leg, tandem right, and tandem left. The K-D Balance app guided the test positions and test times. A value representing movement was generated by the app algorithm. Analysis included descriptive statistics along with intraclass correlation coefficient and minimal detectable change (MDC). Results: The median score of the K-D test was 0.5 for session 1 and 0.4 for session 2. The ICC was 0.42 (95% CI, 0.04-0.70), and the MDC was 1.58. Conclusion: The MDC value of 1.58 represents the threshold of meaningful change in balance, as measured with the K-D Balance app. Clinical Relevance: Clinicians can use the results of this study to objectively assess changes in balance over time using the K-D Balance app.

Trueness and Minimal Detectable Change of Smartphone Inclinometer Measurements of Shoulder Range of Motion

2017 ◽  
Vol 23 (6) ◽  
pp. 503-506 ◽  
Author(s):  
Patrick Boissy ◽  
Serigne Diop-Fallou ◽  
Karina Lebel ◽  
Mikael Bernier ◽  
Frederic Balg ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Shoulder Range Of Motion ◽  
Shoulder Range

scholarly journals KNEE ISOKINETIC TORQUE IMBALANCE IN FEMALE FUTSAL PLAYERS

2017 ◽  
Vol 23 (5) ◽  
pp. 352-356
Author(s):  
Ana Carolina de Mello Alves Rodrigues ◽  
Nathália Arnosti Vieira ◽  
Ana Lorena Marche ◽  
Juliana Exel Santana ◽  
Marco Aurélio Vaz ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Repeated Measures ◽  
Knee Flexion ◽  
Peak Torque ◽  
Joint Angles ◽  
Muscle Imbalance ◽  
Flexion Extension ◽  
Isokinetic Torque ◽  
Extensor Torque ◽  
Joint Range

ABSTRACT Introduction: The specificity of sports training can lead to muscle specialization with a possible change in the natural hamstring/quadriceps torque ratio (HQ ratio), constituting a risk factor for muscle injury at the joint angles in which muscle imbalance may impair dynamic stability. Objective: The aim was to evaluate the torque distribution of the hamstrings and quadriceps and the HQ ratio throughout the range of motion in order to identify possible muscle imbalances at the knee of female futsal athletes. Methods: Nineteen amateur female futsal athletes had their dominant limb HQ ratio evaluated in a series of five maximum repetitions of flexion/extension of the knee at 180°/second in the total joint range of motion (30° to 80°). The peak flexor and extensor torque and the HQ ratio (%) were compared each 5° of knee motion using one-way repeated measures ANOVA and Tukey’s post hoc test (p<0.05) to determine the joint angles that present muscular imbalance. Results: Quadriceps torque was higher than 50° to 60° of knee flexion, while hamstrings torque was higher than 55° to 65°. The HQ ratio presented lower values than 30° to 45° of knee flexion and four athletes presented values lower than 60%, which may represent a risk of injury. However, the HQ ratio calculated by the peak torque showed only one athlete with less than 60%. Conclusion: The HQ ratio analyzed throughout the knee range of motion allowed identifying muscle imbalance at specific joint angles in female futsal players.

scholarly journals Reliability and concurrent validity of an alternative method of lateral lumbar range of motion in athletes

2016 ◽  
Vol 28 (1) ◽  
pp. 23-26 ◽  
Author(s):  
M Hecimovich
Keyword(s):  
Lumbar Spine ◽  
Range Of Motion ◽  
Concurrent Validity ◽  
Pearson Correlation ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Index Test ◽  
Low Back ◽  
Detectable Change ◽  
Rater Reliability

Background: Cricket bowling involves combined spinalmovements of side bending and rotation and, consequently, injuryto the low back is a common problem. Therefore the assessmentof lumbar spine kinematics has become a routine component inpreseason screening. This includes static measurement of lateralspinal flexion as asymmetrical range of motion may predispose anathlete to low back injury.Objectives: This study examined intra-rater reliability andconcurrent validity of the fingertip-to-floor distance test (FFD)when compared to a criterion range of motion measure.Methods: Thirty-four junior-level cricket players aged 13‑16years were recruited. Lumbar spine lateral flexion was measuredsimultaneously with the fingertip-to-floor distance test and digitalinclinometry methods. Relative and absolute intra-rater reliabilitywere investigated with intraclass correlation coefficients (ICC3,1)of agreement, standard error of measurement (SEM) estimates,Bland and Altman bias estimates and 95% limits of agreement,respectively. The concurrent validity of the fingertip-to-floordistance test, compared to digital inclinometry measures, wasexamined with Pearson correlation coefficients.Results: Intra-rater reliability demonstrated substantial agreementfor both measures (ICC3,1 > 0.84). The fingertip-to-floor distancetest SEM values ranged from 1.71‑2.01 cm with an estimatedminimum detectable change (MDC) threshold of 4.73‑5.55 cm.The inclinometry SEM values ranged from 1.00‑1.09° withminimal detectable change estimates of 2.77‑3.01°. There werestrong correlations between the index test and criterion measureoutcomes (r > 0.84, p < 0.001).Conclusions: This study’s results support the intra-rater reliabilityand concurrent validity of the finger-to-floor distance test,suggesting it to be a suitable surrogate measure for lumbar lateralflexion testing

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