Research Group Musculoskeletal Rehabilitation, HAN University of Applied Sciences, Nijmegen, The Netherlands; Department of Physiotherapy, Sports Medical Centre Papendal, Arnhem, the Netherlands.
Department of Orthopaedics, Rijnstate Hospital, Arnhem, the Netherlands.
Physiotherapy. 2023 Sep;120:95-102. doi: 10.1016/j.physio.2023.06.005. Epub 2023 Jun 22.
Shoulder pain commonly has a detrimental impact on patient's work and social activities. Although pain is the most common reason for seeking care, a reduction in shoulder range of motion (ROM) is another common impairment. ROM assessment is used as an evaluation tool and multiple methods are available to measure shoulder ROM. Virtual reality (VR) has been introduced into shoulder rehabilitation, mostly when exercise and ROM measurement is indicated. This study evaluated the concurrent validity and system reliability of active ROM measurements of VR for people with and without shoulder pain.
Forty volunteers participated in this study. Virtual goniometry was used to assess active shoulder ROM. Participants performed flexion and scaption to six predetermined angles. Measurements from the VR goniometer and smartphone inclinometers were recorded simultaneously. To assess reliability, two identical test sequences were performed.
The concurrent validity ICCs were 0.93 for shoulder flexion and 0.94 for shoulder scaption. The VR goniometer application on average systematically overestimated the ROM compared to the smartphone inclinometer. The mean difference between goniometer values was -11.3 degrees for flexion and -10.9 for scaption. The system reliability was excellent with an overall ICC of 0.99 for the flexion movements and 0.99 for the scaption movements.
Although the VR system demonstrated excellent reliability, and high ICC's for concurrent validity, the large range between the lower and upper 95% CI limits suggests it lacks measurement precision. This suggests VR, as used in this study, should not be used interchangeably with other measurement tools. CONTRIBUTION OF THE PAPER.
肩部疼痛通常会对患者的工作和社会活动产生不利影响。尽管疼痛是寻求治疗的最常见原因，但肩部活动范围（ROM）的减小也是另一种常见的障碍。ROM 评估被用作评估工具，有多种方法可用于测量肩部 ROM。虚拟现实（VR）已被引入肩部康复中，主要是在需要运动和 ROM 测量时。本研究评估了有和没有肩部疼痛的人群的 VR 主动 ROM 测量的同时效度和系统可靠性。
40 名志愿者参加了这项研究。虚拟量角器用于评估主动肩部 ROM。参与者将肩部进行六个预定角度的前屈和外展。VR 量角器和智能手机测斜仪同时记录测量值。为了评估可靠性，进行了两次完全相同的测试序列。
肩部前屈的同期效度 ICC 为 0.93，肩部外展的 ICC 为 0.94。与智能手机测斜仪相比，VR 量角器应用程序平均系统地高估了 ROM。量角器值的平均差值为前屈时为 11.3 度，外展时为 10.9 度。系统可靠性极佳，总体 ICC 为 0.99，前屈运动为 0.99，外展运动为 0.99。
尽管 VR 系统具有出色的可靠性和高的同期效度 ICC，但下限和上限 95%CI 之间的范围较大表明其缺乏测量精度。这表明，如本研究中使用的 VR 系统，不应与其他测量工具互换使用。
