Soeters Rupali, Damodar Dhanur, Borman Nicole, Jacobson Kendal, Shi Jing, Pillai Raji, Mehran Nima
University of St Augustine, Austin, Texas, USA.
Rush University/Midwest Orthopedics at Rush, Chicago, Illinois, USA.
Orthop J Sports Med. 2023 Jul 31;11(7):23259671231187297. doi: 10.1177/23259671231187297. eCollection 2023 Jul.
Typically, shoulder range of motion (ROM) measurements are performed in a clinic setting, where physicians, physical therapists (PTs), and occupational therapists make use of a goniometer.
To determine the accuracy of a smartphone-based ROM software application (app) in assessing active shoulder ROM and compare the measurements with traditional goniometry as measured by a PT.
Cohort study (diagnosis); Level of evidence, 2.
This prospective, nonblinded study was conducted at a single institution with adult asymptomatic participants with full active ROM of both shoulders. Participants were enrolled between June 1 and 15, 2021. Each participant self-assessed their active shoulder ROM using the PeerWell smartphone app. A single PT concurrently measured each participant's active shoulder ROM using a handheld universal goniometer. Bilateral shoulder ROM (forward flexion, abduction [AB], external rotation, internal rotation [IR], and extension) was measured 2 times for each participant. Interrater reliability between the smartphone app and PT measurements as well as intrarater reliability for each method of measurement were assessed using the intraclass correlation coefficient (ICC), and limits of agreement were analyzed for the difference in measurement methods.
Data were analyzed for 60 shoulders (30 right, 30 left) from 30 participants (mean age, 31.4 ± 11.7 years; 73% female). The interrater reliability between the 2 methods was excellent for all movements (ICCs, 0.90-0.96). For all movements except shoulder AB, the mean difference in the measurements between the 2 methods was <1.3°; the mean difference in AB ROM was 2.08°. For all movements except IR, both PTs and the app showed excellent intrarater reliability (ICCs >0.90); for IR, good intrarater reliability (ICC ≥0.75) was observed.
The PeerWell smartphone app provided measurements comparable with manual measurements taken by a PT using a goniometer. These data provide evidence that the smartphone app is a reliable and valid tool for measuring shoulder ROM and show promise for measuring and monitoring patient ROM remotely.
通常，肩部活动范围（ROM）测量是在临床环境中进行的，医生、物理治疗师（PT）和职业治疗师会使用角度计。
确定一款基于智能手机的ROM软件应用程序（应用）在评估肩部主动ROM方面的准确性，并将测量结果与PT使用传统角度测量法测得的结果进行比较。
队列研究（诊断）；证据等级，2级。
这项前瞻性、非盲法研究在单一机构对双肩具有完全主动ROM的成年无症状参与者进行。参与者于2021年6月1日至15日入组。每位参与者使用PeerWell智能手机应用自行评估其肩部主动ROM。一名PT同时使用手持式通用角度计测量每位参与者的肩部主动ROM。对每位参与者的双侧肩部ROM（前屈、外展[AB]、外旋、内旋[IR]和后伸）进行了2次测量。使用组内相关系数（ICC）评估智能手机应用与PT测量之间的评分者间信度以及每种测量方法的评分者内信度，并分析测量方法差异的一致性界限。
对30名参与者（平均年龄31.4±11.7岁；73%为女性）的60个肩部（30个右侧，30个左侧）的数据进行了分析。两种方法之间的评分者间信度在所有动作中均极佳（ICC为0.90 - 0.96）。除肩部AB外，两种方法测量结果的平均差异在所有动作中均<1.3°；AB ROM的平均差异为2.08°。除IR外，PT和应用在所有动作中均显示出极佳的评分者内信度（ICC>0.90）；对于IR，观察到良好的评分者内信度（ICC≥0.75）。
PeerWell智能手机应用提供的测量结果与PT使用角度计进行的手动测量结果相当。这些数据证明智能手机应用是测量肩部ROM的可靠且有效的工具，并显示出远程测量和监测患者ROM的前景。
