ABSTRACT
Keywords: Remote practice;Range of movement;Validity Purpose: Assessing joint mobility is a vital element of MSK care, as findings can be used to identify pathology or dysfunction, guide treatment plans or evaluate the effect of a treatment. For over 50 years, the Universal Goniometer (UG) has been the most widely used tool in measuring range of movement (ROM). Studies have found the simplistic protractor devise to be both reliable and valid, however recently apps (used via a smartphone or tablet) for measuring ROM have been introduced as an alternative. One such app is ‘DrGoniometer’, designed to measure ROM through the use of a virtual goniometer on top of a photographic image. However, literature regarding its validity remains sparse. Therefore, the purpose of this study was to investigate the validity of the DrGoniometer in measuring ROM in peripheral joints Methods: A correlation study was conducted utilising 20 healthy Cardiff University students (aged 18–29). Participants had their hip, knee, ankle, shoulder, elbow and wrist joint randomly positioned in a range of flexion, this angle was measured by the blinded researcher, using the DrGoniometer app and a UG. The continuity of the joint position was maintained by the use of foam blocks in order to ensure that the angle remained stable for the UG measurement and the DrGoniometer measurement. In order to assess concurrent validity, comparisons were made between the DrGoniometer smartphone app measurements and the UG measurements. Results: Spearman's Rank Correlation Coefficient was used for analysis and the r values were as follows: hip, 0.993;knee, 0.985;ankle, 0.949;shoulder, 0.988;elbow, 0.973;wrist, 0.985. All results were statistically significant. Conclusion(s): This study found the DrGoniometer app demonstrated an excellent level of concurrent validity. However, this study was carried out on 20 healthy individuals within a ‘healthy weight’ range BMI, and only on one physiological movement per joint. Therefore, further research is warranted on a larger number of participants with joint pathology, a range of BMI values, and a wider age range. It is also suggested that a wider variety of physiological movements are measured. Studies could also be conducted to determine intra-rater, reliability, and inter-rater reliability of DrGoniometer measurements. Impact: ROM measurement is a key aspect of physiotherapy management with clinician's needing to use reliable and valid measurement tools, that are also time-efficient and can be used remotely. Apps for measuring ROM (on a tablet or a smartphone) therefore offer a quick and efficient ROM measurement, with the increased benefit of being able to store measurements on the app, for reference. With increasing strains placed on the NHS due to Covid 19, apps for ROM measurement may offer a potential solution. Clinicians can photograph a joint during a video consultation, or patients can photograph their own joint and send images to the clinician. The clinician can consequently mark-up ROM using the app and guide further treatment through telephone or video consultations. Furthermore, if the patient were to purchase this low-cost app, with the aid of some simple instructions, they could be guided on how to monitor their own progress. Funding acknowledgements: This work was not funded.