File
Lind V.1,2, Harringe L. M.2,3
1GIH - The Swedish School of Sport and Health Science, Stockholm, Sweden, 2Hela Kroppen Physiotherapy, Stockholm, Sweden, 3Karolinska Institutet, Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Stockholm, Sweden
Background: At present there is a lack of reliable, easy to handle evaluation instruments for measuring joint angles. The most widespread method for measuring range of motion (ROM) is to use the traditional goniometer (TG). Meloq© has developed a digital goniometer (DGA: EasyAngle) which aims to improve and simplify evaluation of joint mobility and to increase efficiency. An easy to handle, evaluation instrument for measuring joint angles, could help the physical therapist in managing faster and more accurate outcome measures in the clinical work.
Purpose: The present study aimed to evaluate the reliability and validity of DGA measuring active and passive flexion and extension of the knee joint.
Methods: In total 36 knee joints were evaluated with the TG and the DGA by measuring knee joint ROM in sagittal plane. 18 individuals, equally women and men between 19-73 years were recruited. The study was conducted at a private physiotherapy practice in Stockholm, Sweden by a licensed physiotherapist with experience in the test method. Reliability was measured with a test-retest procedure while validity was tested through measurements during one occasion with the TG and the DGA, considering TG as Golden Standard. The measurements were performed on both knees, first right, then left in standardized order: active flexion, passive flexion, active extension, passive extension. Each direction of movement was measured four times: first with DGA, second with both TG + DGA, and last with DGA. All measurements were standardized and the test leader was blinded for the measurements with the DGA.
Results: Knee joint ROM for active and passive flexion as well as for passive extension measured with DGA was reliable with high Intraclass correlation coefficient (ICC) values ranging from 0.887 to 0.911. In contrast, active extension was found to be of moderate reliability with an ICC of 0.599. Flexion proved to be more reliable than extension and active was more accurate than passive. Measuring the knee joint ROM with DGA and TG was shown to have a very high correlation at active and passive flexion (r 0.969 respective r 0.97), and moderate to high at active and passive extension (r 0.751 respective r 0.892). All data analysis was performed with STATISTICA version 9.1.
Conclusion(s): The digital goniometer measuring active and passive flexion of the knee joint showed good reliability and validity. Measuring extension was less accurate which may partly be due to detected technical problems and partly to the difficulties of standardizing. Further research is needed to ensure DGAs reliability and validity as well as the inter- and intra-rater reliability when measuring the ROM of the bodies various joints and movement directions
Implications: To evaluate joint range of motion with a measurement instrument, which is reliable and valid as well as time efficient and easy to handle would improve the physical therapists daily work, both for status recording and as assessment tool of the treatment effect.
Funding acknowledgements: None
Topic: Outcome measurement
Ethics approval: The study was conducted within a masterprogram and followed the WMA Declaration of Helsinki. Informed consent was collected from participants.
All authors, affiliations and abstracts have been published as submitted.
