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 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

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 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.

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