Shin Seung Han, Ro Du Hyun, Lee O-Sung, Oh Joo Han, Kim Sae Hoon
Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea.
Man Ther. 2012 Aug;17(4):298-304. doi: 10.1016/j.math.2012.02.010. Epub 2012 Mar 13.
Measuring range of motion (ROM) is the first step of a physical examination and functional evaluation of the shoulder joint. Digital inclinometers are available on the market; however, they are expensive, and hence will not come into wide use. In this study, we present a new method for the shoulder ROM measurement using the inclinometer application on a smartphone. We hypothesized that the method would demonstrate acceptable reliability and reproducibility. Three observers performed goniometric and smartphone inclinometric measurements of various shoulder movements, including both active and passive ROM for forward flexion, abduction, external rotation while the arms are at the sides, external rotation at 90° abduction, and internal rotation at 90° abduction. Measurements were performed in the affected shoulders of 41 patients. All measurements were taken twice to assess the intra-observer reliability. Inter- and intra-observer reliabilities were evaluated using the intraclass correlation coefficient (ICC). Reliability between two measurements was also assessed in terms of the ICC. Both the goniometric and inclinometric measurements showed satisfactory inter-observer reliability except for internal rotation at 90° abduction for which the ICC value was <0.7 (range, 0.63-0.68). Intra-observer reliability was excellent with an ICC value>0.9, except for some movements. Within-day inclinometric measurements with a smartphone showed acceptable reliability compared to the classical goniometric measurements of movements and the correlation between the two measurements was fairly high. Considering convenience and cost-effectiveness, this new method could be widely used for measuring the shoulder ROM, although the between-day reliability needs to be established first.
测量关节活动范围（ROM）是肩关节体格检查和功能评估的第一步。市面上有数字倾角仪；然而，它们价格昂贵，因此不会被广泛使用。在本研究中，我们提出了一种使用智能手机上的倾角仪应用程序测量肩部ROM的新方法。我们假设该方法将显示出可接受的可靠性和可重复性。三名观察者对各种肩部运动进行了角度测量和智能手机倾角测量，包括前屈、外展、手臂位于身体两侧时的外旋、90°外展时的外旋以及90°外展时的内旋的主动和被动ROM。对41例患者的患侧肩部进行了测量。所有测量均进行两次以评估观察者内可靠性。使用组内相关系数（ICC）评估观察者间和观察者内的可靠性。还根据ICC评估了两次测量之间的可靠性。除了90°外展时的内旋（ICC值<0.7，范围为0.63 - 0.68）外，角度测量和倾角测量均显示出令人满意的观察者间可靠性。除了一些运动外，观察者内可靠性极佳，ICC值>0.9。与传统的运动角度测量相比，使用智能手机进行的日内倾角测量显示出可接受的可靠性，并且两次测量之间的相关性相当高。考虑到便利性和成本效益，尽管需要首先确定日间可靠性，但这种新方法可广泛用于测量肩部ROM。
