School of Physical Therapy, Marshall University, Huntington, West Virginia, USA.
Dept. of Orthopedic Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia, USA.
Musculoskeletal Care. 2021 Jun;19(2):208-216. doi: 10.1002/msc.1525. Epub 2020 Oct 27.
There has been increased usage of virtual telerehabilitation approach during the COVID-19 pandemic. It is crucial to establish reliability of conducting virtual assessments for musculoskeletal conditions.
This research determined the intra- and interrater reliability of measuring knee and wrist range of motion (ROM) assessed virtually and obtained face-to-face (F2F) using a goniometer (UG) for a student and an experienced examiner.
Knee and wrist joint ROM for 54 healthy participants was assessed virtually and F2F by a student examiner and an experienced physical therapist. Intra- (virtual vs. UG assessment) and inter-rater (virtual or UG assessment between examiners) reliabilities were examined for all ROM using Intraclass correlation coefficient (ICC). The ICC values were considered good (>0.75) or excellent (>0.90). Bland and Altman plots determined the limits of agreement (LOA) in assessing joint ROM.
RESULTS/FINDINGS: Student examiner had good reliability in virtually estimating knee extension (ICC = 0.79), wrist flexion (ICC = 0.82) and wrist extension (ICC = 0.78), whereas the experienced examiner had excellent reliability in virtually estimating all knee and wrist ROM (ICC > 0.90). The LOA in assessing knee and wrist ROM for the student examiner were wider indicating higher disagreement between virtual and UG-obtained ROM in some cases.
Virtual estimation of knee and wrist ROM is a reliable technique, however experience level impacts the precision of measurement. It is suggested that the same examiner conducts all the ROM assessments throughout the clinical course of a patient receiving virtual interventions for knee or wrist pathologies.
在 COVID-19 大流行期间，虚拟远程康复的应用有所增加。对于肌肉骨骼疾病，进行虚拟评估的可靠性至关重要。
本研究旨在确定学生和经验丰富的检查者使用量角器（UG）对虚拟和面对面（F2F）评估的膝关节和腕关节活动范围（ROM）进行测量的内部和组内可靠性。
对 54 名健康参与者的膝关节和腕关节 ROM 进行了虚拟和 F2F 评估，由学生检查者和经验丰富的物理治疗师进行。使用组内相关系数（ICC）评估所有 ROM 的组内（虚拟与 UG 评估）和组内（检查者之间的虚拟或 UG 评估）可靠性。ICC 值被认为是良好的（>0.75）或优秀的（>0.90）。Bland 和 Altman 图确定了关节 ROM 评估的一致性界限（LOA）。
结果/发现：学生检查者在虚拟估计膝关节伸展（ICC = 0.79），腕关节屈曲（ICC = 0.82）和腕关节伸展（ICC = 0.78）方面具有良好的可靠性，而经验丰富的检查者在虚拟估计所有膝关节和腕关节 ROM 方面具有卓越的可靠性（ICC > 0.90）。学生检查者评估膝关节和腕关节 ROM 的 LOA 较宽，表明在某些情况下，虚拟和 UG 获得的 ROM 之间存在更高的差异。
虚拟估计膝关节和腕关节 ROM 是一种可靠的技术，但是经验水平会影响测量的精度。建议在接受膝关节或腕关节疾病虚拟干预的患者的整个临床过程中，由同一位检查者进行所有 ROM 评估。
