Accuracy and inter-observer reliability of visual estimation compared to clinical goniometry of the elbow

Blonna, Davide; Zarkadas, Peter C.; Fitzsimmons, James S.; O’Driscoll, Shawn W.

doi:10.1007/s00167-011-1720-9

Cited by 42 publications

(34 citation statements)

References 23 publications

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“…However, Blonna et al (2012) evaluated ICC of visual estimation compared to clinical goniometry in 50 elbows. ICC for visually-based goniometry was 0.97 for both extension and flexion estimations of elbow ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

Smartphone and Universal Goniometer for Measurement of Elbow Joint Motions: A Comparative Study

et al. 2016

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BackgroundUniversal goniometer (UG) is commonly used as a standard method to evaluate range of motion (ROM) as part of joint motions. It has some restrictions, such as involvement of both hands of the physician, leads to instability of hands and error. Nowadays smartphones usage has been increasing due to its easy application.ObjectivesThe study was designed to compare the smartphone inclinometer-based app and UG in evaluation of ROM of elbow.Materials and MethodsThe maximum ROM of elbow in position of flexion and pronation and supination of forearm were examined in 60 healthy volunteers with UG and smartphone. Data were analyzed using SPSS (ver. 16) software and appropriate statistical tests were applied, such as paired t-test, ICC and Bland Altman curves.ResultsThe results of this study showed high reliability and validity of smartphone in regarding UG with ICC > 0.95. The highest reliability for both methods was in elbow supination and the lowest was in the elbow flexion (0.84).ConclusionsSmartphones due to ease of access and usage for the physician and the patient, may be good alternatives for UG.

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Section: Discussionmentioning

confidence: 99%

Smartphone and Universal Goniometer for Measurement of Elbow Joint Motions: A Comparative Study

et al. 2016

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“…ROM measurements via traditional clinical goniometry may be limited for reasons such as incorrect goniometer placement. 4,5 Alternative goniometry techniques have been studied to achieve improved accuracy, precision, and/or Fig. 2 Digital photographs that were deemed inadequate for measurement of (A) active flexion and (B) active extension.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 Sources of error for measurements made by clinical goniometry include incorrect goniometer placement, incorrect anatomic landmark identification, and variable force applied for passive ROM measurements. 4,5 Alternative goniometry techniques have been studied to achieve improved accuracy, precision, and/ or convenience, including radiograph-based measurements, visual estimation, three-dimensional (3D) motion analysis, smartphone-assisted measurements, and photography-based measurements. 4,[6][7][8][9] Additionally, traditional assessment of WROM necessitates an office visit; longterm interval visits after the acute postoperative period may be difficult or impossible secondary to insurance issues, travel distances, patient relocation, inconvenience, and cost.…”

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confidence: 99%

At Home Photography-Based Method for Measuring Wrist Range of Motion

et al. 2017

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To determine the reliability of wrist range of motion (WROM) measurements based on digital photographs taken by patients at home compared with traditional measurements done in the office with a goniometer. Sixty-nine postoperative patients were enrolled in this study at least 3 months postoperatively. Active and passive wrist flexion/extension and radial/ulnar deviation were recorded by one of the two attending surgeons with a 1-degree resolution goniometer at the last postoperative office visit. Patients were provided an illustrated instruction sheet detailing how to take digital photographic images at home in six wrist positions (active and passive flexion/extension, and radial/ulnar deviation). Wrist position was measured from digital images by both the attending surgeons in a randomized, blinded fashion on two separate occasions greater than 2 weeks apart using the same goniometer. Reliability analysis was performed using the intraclass correlation coefficient to assess agreement between clinical and photography-based goniometry, as well as intra- and interobserver agreement. Out of 69 enrolled patients, 30 (43%) patients sent digital images. Of the 180 digital photographs, only 9 (5%) were missing or deemed inadequate for WROM measurements. Agreement between clinical and photography-based measurements was "almost perfect" for passive wrist flexion/extension and "substantial" for active wrist flexion/extension and radial/ulnar deviation. Inter- and intraobserver agreement for the attending surgeons was "almost perfect" for all measurements. This study validates a photography-based goniometry protocol allowing accurate and reliable WROM measurements without direct physician contact. Passive WROM was more accurately measured from photographs than active WROM. This study builds on previous photography-based goniometry literature by validating a protocol in which patients or their families take and submit their own photographs. Patient-performed photography-based goniometry represents an alternative to traditional clinical goniometry that could enable longer-term follow-up, overcome travel-related impediments to office visits, improve convenience, and reduce costs for patients.

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“…Twenty-two patients (61%) experienced a loss of extension averaging 13° (range 0°–30°) measured using a goniometer in office. The goniometer measurement technique was performed similarly to Blonna et al [ 8 ] with an ICC of 0.97 and negligible systematic error of 1°. All patients suffered loss of function (20 limited sports activity, 9 limited other activities, 7 affected activities of daily living).…”

Section: Methodsmentioning

confidence: 99%

Arthroscopic treatment successfully treats posterior elbow impingement in an athletic population

Koh

Zwahlen²,

Altchek

et al. 2017

Knee Surg Sports Traumatol Arthrosc

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PurposePosterior elbow impingement can cause disabling pain and limited motion during activities involving elbow extension. Less understood is whether arthroscopic treatment, compared to open surgery, can result in effective management of pain, loss of range of motion, and return athletes to previous levels of activity. This study determined whether arthroscopic debridement is a safe and effective treatment for posterior elbow impingement and whether it enables athletes to return to a previous level of function.MethodsA retrospective review of 36 consecutive patients that underwent arthroscopic debridement of the posterior elbow was performed. There were 34 male and 2 female patients, with a median age of 32 years (17–54 years). There were 7 professional athletes, 6 college athletes, and 23 high school or recreational athletes. All patients had a positive posterior impingement test for posterior pain with extension and limitations of activity. Arthroscopic debridement and additional surgical procedures were performed, and patients underwent follow-up visits at a median 51 months (range 14–81).ResultsSignificant improvements were seen in pain, motion, and function. No neurovascular complications were seen related to the arthroscopic debridement. The mean Andrews and Timmerman elbow score improved from 159 ± 27 to 193 ± 11 (p < 0.01). Thirty-five of thirty-six (97%) patients returned to their previous level of activity, including all professional athletes.ConclusionsArthroscopic management of posterior elbow impingement is safe and effective and can return patients, including professional athletes, to high-level athletic activity. Athletes with symptomatic posterior elbow impingement can be successfully and safely treated with arthroscopic debridement and typically will return to preinjury levels of activity.Level of evidenceIV.Electronic supplementary materialThe online version of this article (doi:10.1007/s00167-017-4563-1) contains supplementary material, which is available to authorized users.

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Accuracy and inter-observer reliability of visual estimation compared to clinical goniometry of the elbow

Abstract: Diagnostic study, Level II.

Cited by 42 publications

References 23 publications

Smartphone and Universal Goniometer for Measurement of Elbow Joint Motions: A Comparative Study

Smartphone and Universal Goniometer for Measurement of Elbow Joint Motions: A Comparative Study

At Home Photography-Based Method for Measuring Wrist Range of Motion

Arthroscopic treatment successfully treats posterior elbow impingement in an athletic population

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