TITLE:
What Is the Accuracy of Shoulder Range of Motion Measurements on Physical Exam?
AUTHORS:
Yousef Shishani, Janice Flocken, Reuben Gobezie
KEYWORDS:
Shoulder, Range of Motion, Digital Assessment, Goniometry, Smartphone Application
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.5 No.9,
September
1,
2015
ABSTRACT: The purpose of this
study is to investigate a new method for measuring shoulder range of motion (ROM) in an orthopedic practice utilizing a smartphone
application to improve accuracy from physical exam typically used in research.
Our aim is to evaluate the application, Physio2Go (P2G), which uses a virtual goniometer,
assessing validity by comparing its measurements to those taken by a universal goniometer
(UG). Two observers of varying clinical experience, a research assistant and research fellow, compared measurements. Statistically,
we used the intra-class correlation coefficient
(ICC), standard error of measurement (SEM), and the Pearson correlation coefficient (PCC). Following validation we tested P2G in symptomatic postoperative shoulder
patients measuring forward flexion (FF) and external rotation (ER). We compared
P2G measurements to visual estimation (VE) done by a fellowship trained orthopedic
surgeon. Statistically we used ICC, Bland- Altman plots with 95% limits of agreement
(LOA), and scatter plots. We examined the impact of the application using Welch’s
t-test comparing pre-to-postoperative ROM improvements using the values obtained
by P2G and VE. We found high intra-rater reliability of P2G for both observers,
substantial correlation between UG and P2G measurements, highly correlated inter-observer
reliability for UG and P2G, and statistically significant PCC values (p