Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA.
Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA.
J Shoulder Elbow Surg. 2014 Nov;23(11):e275-82. doi: 10.1016/j.jse.2014.02.030. Epub 2014 Jun 9.
An accurate and reliable measurement of shoulder range of motion (ROM) is important in the evaluation of the shoulder. A smartphone digital clinometer application is a potentially simpler method for measuring shoulder ROM. The goal of this study was to establish the reliability and validity of shoulder ROM measurements among varying health care providers using a smartphone clinometer application in healthy and symptomatic adults.
An attending surgeon, fellow, resident, physician assistant, and student served as examiners. Bilateral shoulders of 24 healthy subjects were included. Fifteen postoperative patients served as the symptomatic cohort. Examiners measured ROM of each shoulder, first using visual estimation and then using a goniometer and smartphone clinometer in a randomized fashion.
The interobserver reliability among examiners showed significant correlation, with average intraclass correlation coefficient [ICC(2,1)] values of 0.61 (estimation), 0.69 (goniometer), and 0.80 (smartphone). All 5 examiners had substantial agreement with the gold standard in healthy subjects, with average ICC(2,1) values ranging from 0.62 to 0.79. The interobserver reliability in symptomatic patients showed significant correlation, with average ICC(2,1) values of 0.72 (estimation), 0.79 (goniometer), and 0.89 (smartphone). Examiners had excellent agreement with the gold standard in symptomatic patients, with an average ICC(2,1) value of 0.98.
The smartphone clinometer has excellent agreement with a goniometer-based gold standard for measurement of shoulder ROM in both healthy and symptomatic subjects. There is good correlation among different skill levels of providers for measurements obtained using the smartphone. A smartphone-based clinometer is a good resource for shoulder ROM measurement in both healthy subjects and symptomatic patients.
准确可靠的肩部活动范围（ROM）测量在肩部评估中非常重要。智能手机数字测角器应用程序是一种更简单的测量肩部 ROM 的方法。本研究的目的是在健康和有症状的成年人中，使用智能手机测角器应用程序，确定不同医疗保健提供者在测量肩部 ROM 时的可靠性和有效性。
一名主治外科医生、研究员、住院医师、医师助理和学生担任检查者。纳入了 24 名健康受试者的双侧肩部。15 名术后患者作为症状组。检查者首先使用目测，然后以随机的方式使用量角器和智能手机测角器测量每个肩部的 ROM。
检查者之间的观察者间可靠性显示出显著相关性，平均组内相关系数 [ICC（2,1）] 值为 0.61（估计）、0.69（量角器）和 0.80（智能手机）。在健康受试者中，所有 5 名检查者与金标准均具有高度一致性，平均 ICC（2,1）值范围为 0.62 至 0.79。在有症状的患者中，观察者间可靠性显示出显著相关性，平均 ICC（2,1）值为 0.72（估计）、0.79（量角器）和 0.89（智能手机）。在有症状的患者中，检查者与金标准具有极好的一致性，平均 ICC（2,1）值为 0.98。
智能手机测角器与基于量角器的金标准在健康和有症状的受试者中测量肩部 ROM 具有极好的一致性。不同技能水平的提供者使用智能手机获得的测量值之间具有良好的相关性。基于智能手机的测角器是健康受试者和有症状患者测量肩部 ROM 的良好资源。
