School of Physical Therapy, Marshall University, 2847 5th Ave, Huntington, WV, USA; Dept. of Orthopedic Surgery, Joan C. Edwards School of Medicine, Marshall University, 1600 Medical Center Dr, Huntington, WV, USA.
School of Physical Therapy, Marshall University, 2847 5th Ave, Huntington, WV, USA; Dignitiy Health, St Rose Dominican Hospital, 3001 St. Rose Pkwy, Henderson, NV, USA.
J Bodyw Mov Ther. 2021 Jan;25:67-74. doi: 10.1016/j.jbmt.2020.11.021. Epub 2020 Nov 16.
Smartphone app-based goniometer (SG) are emerging as an alternative to Universal Goniometers (UG) in assessing joint range of motion (ROM). This study examined whether the experience level of examiner affected the reliability of assessing knee flexion (KF) and knee extension (KE) ROM using UG and SG.
Participants with osteoarthritis of the knee or following total knee replacement were recruited. KF and KE ROM using UG and SG were assessed twice by an experienced physical therapist (PT) and a student PT (SPT). Intraclass correlation coefficients (ICC) examined the interrater (experienced PT vs SPT) and intrarater reliabilities (for experienced PT and SPT) in assessing KF and KE ROM for UG and SG. Concurrent relationships were examined between the knee ROM with pain and physical function using Pearson Correlation Coefficient (r).
The interrater reliability in assessing KF and KE ROM was excellent (ICC>0.90) between novice and experienced examiners. The standard error of measurement (SEM) for novice examiner in assessing KF was 1° and 2° while using UG and SG respectively; whereas the SEM for experienced examiner in assessing KF was 1° irrespective of which device was used. The concurrent relationships between KF and KE ROM with measures of pain and function were divergent (moderate to low correlations; r <0.7; p > 0.05).
Both UG and SG have smaller measurement error in assessing KF and KE ROM irrespective of experience level of examiner and therefore no one tool is superior than the other for assessing knee ROM in clinical practice.
基于智能手机应用的量角器（SG）正逐渐成为评估关节活动范围（ROM）的通用量角器（UG）的替代方法。本研究旨在探讨评估者的经验水平是否会影响使用 UG 和 SG 评估膝关节屈曲（KF）和膝关节伸展（KE）ROM 的可靠性。
招募膝关节骨关节炎或全膝关节置换术后的患者。由一位经验丰富的物理治疗师（PT）和一位学生 PT（SPT）分别使用 UG 和 SG 两次评估 KF 和 KE ROM。组内相关系数（ICC）评估了 UG 和 SG 评估 KF 和 KE ROM 时的组间（经验丰富的 PT 与 SPT）和组内（经验丰富的 PT 和 SPT）可靠性。Pearson 相关系数（r）用于评估膝关节 ROM 与疼痛和身体功能之间的相关性。
在评估 KF 和 KE ROM 时，新手和有经验的评估者之间的组间可靠性很高（ICC>0.90）。在评估 KF 时，新手评估者的测量误差（SEM）使用 UG 和 SG 分别为 1°和 2°；而在评估 KF 时，经验丰富的评估者的 SEM 为 1°，而与使用的设备无关。KF 和 KE ROM 与疼痛和功能测量之间的相关性不同（中度至低度相关性；r <0.7；p > 0.05）。
无论评估者的经验水平如何，UG 和 SG 在评估 KF 和 KE ROM 时的测量误差都较小，因此在临床实践中，没有一种工具比另一种更适合评估膝关节 ROM。
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