Smartphone “Selfies”—A reliable and accurate tool for measuring elbow range of motion

Abstract

Background To determine if self-taken photographs (“selfies”), performed independently after instruction by video or illustrated handout, would be an accurate and reliable tool for capturing elbow range of motion in patients with elbow contractures. Methods Fifty patients presenting with elbow contractures participated in the study. After completion of the selfie, the senior author clinically measured flexion and extension with a goniometer. The angles from the photographs were measured and analyzed. Results The agreement between goniometer and “selfie” measurements correlated closely (R2 = 0.98) and agreement was excellent in both extension and in flexion with intra-class correlation coefficients of 0.95 (95% CI 0.92 to 0.97) in extension with a mean difference of 2° (95% CI −3° to 7°), and 0.93 (95% CI 0.89 to 0.96) in flexion with a mean difference of 4° (95% CI 0° to 8°). Systematic errors were low in extension, 0° (95% CI, ±11°) and in flexion −3° (95% CI, ±10°). Six patients demonstrated ≥10° difference between clinical and selfie measurements. Ability to take a usable selfie was inversely correlated with age (R2 = 0.97). Discussion Self-taken flexion–extension photographs are a reliable and accurate tool for measuring elbow range of motion. Errors in the selfie technique are well tolerated and appear to have a negligible effect upon measurements of motion. This important parameter of elbow function can therefore be obtained outside a normal clinic visit, thereby improving frequency of follow-up assessments (and minimizing loss to follow-up) necessary for quality control and research.

Long-Term Patient-Reported Outcomes After Arthroscopic Debridement of Grade 3 or 4 Capitellar Osteochondritis Dissecans Lesions

“…This method for assessing elbow ROM has been validated and proved to be accurate and reliable. 6,18 ROM measurements during physical examination and photographs were rounded to the nearest 5° interval and then recorded. Additionally, patients who underwent revision surgery were included in the survival analysis, but their PROs were not included in the final analysis of clinical outcomes.…”

The Telemedicine-Based Pediatric Examination of the Neck and Upper Limbs: A Narrative Review

“…Interestingly, smartphone mirror "selfies" were also shown to have excellent validity and intra-rater reliability when compared to manual goniometry, but patients' ability to take a usable selfie was inversely correlated with age. 65 Several studies have shown that smartphone applications possess moderate-to-excellent inter-rater reliability, intra-rater reliability and validity when compared to visual estimation, manual goniometry and digital inclinometers for elbow flexion, extension, pronation and supination. 22,[66][67][68][69][70][71][72][73] Among the apps currently available for download are Angle Meter (Smart Tool Factory; Google Play), 22 Dr. Goniometer, 70 Goniometer Pro, 69,71 GetMyROM, 66 and Measure (Apple; AppStore).…”