Graduate School of Life and Health Sciences, Chubu University, Kasugai, Japan.
Department of Rehabilitation, Asahi Hospital, Kasugai, Japan.
Nagoya J Med Sci. 2022 Feb;84(1):7-18. doi: 10.18999/nagjms.84.1.7.
This study aimed to examine the reliability and validity of using a smartphone to measure the multi-joint range of motion of the lower limbs. We measured the straight leg raise angle, ankle dorsiflexion angle, and hip internal rotation angle in each of the 40 lower extremities of 20 healthy adults. Measurements were compared between a conventional method using a goniometer and a smartphone application method. The intraclass correlation coefficient (ICC) was used to evaluate the reliability of each smartphone measurement, and Bland-Altman analysis was used to examine measurement errors. The criterion-related validity of the two methods was also examined. Intra-rater reliability (ICC 0.668-0.939) was substantial to almost perfect, with no systematic errors found for all items, and the standard errors of measurement were acceptable. Inter-rater reliability (ICC 0.701-0.936) was also substantial to almost perfect, but the straight leg raise angle and hip internal rotation angle showed fixation errors. For these two measurements, with more than one examiner, the limit of agreement of error needs to be considered. No systematic errors were found in the ankle dorsiflexion angle, and the standard error of measurement was within the acceptable range. A moderate to strong correlation (r = 0.626-0.915) was found between the conventional and smartphone methods, demonstrating good criterion-related validity. However, in the ankle dorsiflexion angle measurements, the reliability and validity were shown to be lower than the other two items. This suggested the necessity of changing the measurement conditions in order to use the ankle dorsiflexion angle in clinical practice.
本研究旨在检验使用智能手机测量下肢多关节活动度的可靠性和有效性。我们测量了 20 名健康成年人的 40 条下肢的直腿抬高角度、踝关节背屈角度和髋关节内旋角度。将常规的量角器测量法与智能手机应用程序测量法进行了比较。使用组内相关系数（ICC）评估了每个智能手机测量的可靠性，并使用 Bland-Altman 分析检查了测量误差。还检查了两种方法的标准相关效度。内部一致性（ICC 0.668-0.939）为中等至高，所有项目均无系统误差，测量标准误差可接受。内部一致性（ICC 0.701-0.936）也为中等至高，但直腿抬高角度和髋关节内旋角度显示固定误差。对于这两个测量，若有一个以上的评估者，需要考虑误差的一致性界限。踝关节背屈角度无系统误差，测量标准误差在可接受范围内。常规方法和智能手机方法之间存在中度至高度相关性（r = 0.626-0.915），表明具有良好的标准相关效度。然而，在踝关节背屈角度测量中，可靠性和有效性低于其他两个项目。这表明在临床实践中使用踝关节背屈角度时需要改变测量条件。
