Reliability Analysis of In-person and Virtual Goniometric Measurements of the Upper Extremity

# Background Virtual healthcare has forced clinicians to modify or eliminate parts of the musculoskeletal evaluation such as motion assessment. Although acceptable to excellent levels of in-person goniometric reliability is achievable, reliability of virtual assessments is unknown. # Purpose To d...

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Main Authors: Tracy Spigelman, Leah Simpkins, Casey Humphrey, Yehor Vitel, Aaron Sciascia
Format: Article
Language:English
Published: North American Sports Medicine Institute 2023-08-01
Series:International Journal of Sports Physical Therapy
Online Access:https://doi.org/10.26603/001c.81065
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author Tracy Spigelman
Leah Simpkins
Casey Humphrey
Yehor Vitel
Aaron Sciascia
author_facet Tracy Spigelman
Leah Simpkins
Casey Humphrey
Yehor Vitel
Aaron Sciascia
author_sort Tracy Spigelman
collection DOAJ
description # Background Virtual healthcare has forced clinicians to modify or eliminate parts of the musculoskeletal evaluation such as motion assessment. Although acceptable to excellent levels of in-person goniometric reliability is achievable, reliability of virtual assessments is unknown. # Purpose To determine if similar upper extremity goniometric measurements could be obtained in-person and virtually. # Study Design Reliability study; classroom setting # Methods Publicly recruited sample over 18 years of age with no upper extremity injuries. Each subject was tested in a standing position with dominant arm facing the clinicians to visualize the landmarks for goniometer placement. Flexion and extension of the shoulder, elbow and wrist were measured. Prior to performing in-person goniometric measurements for each joint, an image was captured of each pre-determined joint position using a mobile device with a camera. This image represented the screenshot on a virtual platform. Four clinicians performed in-person measurements twice during the same session on each subject. The following week clinicians measured virtual images using the same techniques. Inter-rater and intra-rater reliability were determined via intraclass correlation coefficients (ICC). # Results Inter-rater reliability for five of the six in-person (ICC≥0.81) and virtual measurements (ICC≥0.78 ) were classified as excellent. In-person wrist extension (ICC=0.60) and virtual wrist flexion (ICC=0.65) were classified as good. Intra-rater reliability for individual clinicians were between good and excellent for the in-person measurements (ICC:0.61-0.96) and virtual measurements (ICC:0.72-0.97). There were a greater number of excellent ICC values for the virtual measurements (90%) compared to in-person measurements (70%). There were statistically significant differences between in-person and virtual sessions for five of six measurements (p≤0.006). Only elbow extension did not differ between sessions (p=0.966). # Conclusion Virtual assessment compared to goniometric measurements showed good to excellent inter- and intra-rater reliabilities (ICC \> 0.60), which suggests clinicians can utilize goniometry either in person or on a virtual platform. # Level of Evidence 3b
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spelling doaj-art-d8c3b5d83a09443d9dd92401f7db26e02025-02-11T20:29:55ZengNorth American Sports Medicine InstituteInternational Journal of Sports Physical Therapy2159-28962023-08-01184Reliability Analysis of In-person and Virtual Goniometric Measurements of the Upper ExtremityTracy SpigelmanLeah SimpkinsCasey HumphreyYehor VitelAaron Sciascia# Background Virtual healthcare has forced clinicians to modify or eliminate parts of the musculoskeletal evaluation such as motion assessment. Although acceptable to excellent levels of in-person goniometric reliability is achievable, reliability of virtual assessments is unknown. # Purpose To determine if similar upper extremity goniometric measurements could be obtained in-person and virtually. # Study Design Reliability study; classroom setting # Methods Publicly recruited sample over 18 years of age with no upper extremity injuries. Each subject was tested in a standing position with dominant arm facing the clinicians to visualize the landmarks for goniometer placement. Flexion and extension of the shoulder, elbow and wrist were measured. Prior to performing in-person goniometric measurements for each joint, an image was captured of each pre-determined joint position using a mobile device with a camera. This image represented the screenshot on a virtual platform. Four clinicians performed in-person measurements twice during the same session on each subject. The following week clinicians measured virtual images using the same techniques. Inter-rater and intra-rater reliability were determined via intraclass correlation coefficients (ICC). # Results Inter-rater reliability for five of the six in-person (ICC≥0.81) and virtual measurements (ICC≥0.78 ) were classified as excellent. In-person wrist extension (ICC=0.60) and virtual wrist flexion (ICC=0.65) were classified as good. Intra-rater reliability for individual clinicians were between good and excellent for the in-person measurements (ICC:0.61-0.96) and virtual measurements (ICC:0.72-0.97). There were a greater number of excellent ICC values for the virtual measurements (90%) compared to in-person measurements (70%). There were statistically significant differences between in-person and virtual sessions for five of six measurements (p≤0.006). Only elbow extension did not differ between sessions (p=0.966). # Conclusion Virtual assessment compared to goniometric measurements showed good to excellent inter- and intra-rater reliabilities (ICC \> 0.60), which suggests clinicians can utilize goniometry either in person or on a virtual platform. # Level of Evidence 3bhttps://doi.org/10.26603/001c.81065
spellingShingle Tracy Spigelman
Leah Simpkins
Casey Humphrey
Yehor Vitel
Aaron Sciascia
Reliability Analysis of In-person and Virtual Goniometric Measurements of the Upper Extremity
International Journal of Sports Physical Therapy
title Reliability Analysis of In-person and Virtual Goniometric Measurements of the Upper Extremity
title_full Reliability Analysis of In-person and Virtual Goniometric Measurements of the Upper Extremity
title_fullStr Reliability Analysis of In-person and Virtual Goniometric Measurements of the Upper Extremity
title_full_unstemmed Reliability Analysis of In-person and Virtual Goniometric Measurements of the Upper Extremity
title_short Reliability Analysis of In-person and Virtual Goniometric Measurements of the Upper Extremity
title_sort reliability analysis of in person and virtual goniometric measurements of the upper extremity
url https://doi.org/10.26603/001c.81065
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