Accuracy of a Smartphone Software Application Compared With a Handheld Goniometer for Measuring Shoulder Range of Motion in Asymptomatic Adults.

Background: 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. Purpose: 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. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: 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. Results: 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. Conclusion: 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.

Effect of stretch positions on hamstring muscle length, lumbar flexion range of motion, and lumbar curvature in healthy adults.

Hamstring stretching is a common practice in physical therapy to change not only hamstring muscle length (HML), but also lumbar flexion range of motion (LROM) or lumbar curvature (LC). Yet limited published research compares the effectiveness of two commonly used hamstring stretch positions, sitting and standing. The purposes of this study were to determine the effect of (1) stretch position on HML; and 2) HML on LROM and LC. Thirty-six participants (M=44.8 years, SD=17.1) with short HML (i.e., with shortness for men ≥45° and for women ≥ 24° of active knee flexion with 90° hip flexion) were measured for HML, LROM, and LC; randomly allocated to one of three groups: (1) hamstring stretching in sitting (SI); (2) standing (ST); or (3) no stretching (control); and remeasured after 4 weeks. Participants in the stretching groups performed two 30-second static stretches 4 days per week for 4 weeks. Multivariate analysis of covariance (MANCOVA) showed significance between the stretching groups and nonstretching group for HML only. Nonsignificance was shown for HML between the stretch positions (i.e., SI-active knee extension (AKE) and ST-AKE), indicating that both were equally effective for increasing HML. However, there was no change in LROM or in LC even though HML increased.

Lumbar spine flexion and extension extremes of motion in women of different age and racial groups: the WIN Study.

STUDY DESIGN: Observational. OBJECTIVE: To provide normative values of lumbar flexion and extension for women of different age and racial groups. SUMMARY OF BACKGROUND DATA: Spinal range of motion (ROM) is one of the AMA Guides criteria used to estimate level of impairment and subsequent compensation entitlement. Studies show that spinal ROM varies with age, gender, and possibly race/ethnicity, but adequate normative values for different age and racial/ethnic groups do not exist. METHODS: A cohort of free-living women was recruited for the Women's Injury Study at The Cooper Institute in Dallas. Originally, 917 women between the ages of 20 and 83 (M = 52 +/- 13) underwent an orthopedic examination including lumbar spine flexion and extension measurement using an electronic inclinometer. Measurements were taken in the fully extended and flexed positions, respectively. This removes the influence of initial resting posture and is termed "extreme of motion" (EOM) as opposed to ROM. Age and racial groups were compared using a 2-way multivariate analysis of variance (MANOVA) followed with post hoc tests. RESULTS: Means (+/-SD) were calculated for racial (white, N = 619, African-American, N = 147) and age groups (young, 20-39 years, n = 126; middle, 40-59 years, n = 412; older, > or = 60 years, n = 228). Lumbar extension for African-American women (60.1 degrees) was significantly greater (P < 0.05) than for white women (52.6 degrees), but flexion was not different (15.2 degrees and 17.0 degrees), respectively. Extension EOM for the young group (61.6 degrees) was greater (P < 0.05) than the middle (56.6 degrees) and older (50.8 degrees) groups. Extension difference between the middle and older groups was significant. Flexion EOM for the young group (20.1 degrees) was greater (P < 0.05) than the middle (15.2 degrees) and older (12.8 degrees) groups. The difference in flexion between the middle and older groups was not significant. CONCLUSION: Normative values of lumbar extension are different for white and African-American women. Values for lumbar flexion and extension are different between age groups. Different criteria should be used to estimate impairment level in women of different racial and age groups.