Inter-rater,intra-rater and inter-instrument reliability of an electrogoniometer to measure wrist range of motion

Abstract

Introduction

Assessment of the wrist is essential in hand rehabilitation. The flexible electrogoniometer has been used to measure joint range of motion in the wrist, although it has lack of reliability. The objectives of the study were to examine intra- and inter-examiner reliability, as well as inter-device reliability, of wrist range of motion obtained by a flexible electrogoniometer.

Methods

Twenty-four right-handed individuals (12 men and 12 women) took part in the study. Participants were actively and randomly subjected to radial and ulnar deviation, flexion and extension of the right wrist. The motions were measured by both the universal goniometer (CARCI®) and the electrogoniometer (MIOTEC®). Two examiners carried out three series of measurements. One of the examiners performed repeated measurement after seven days. The Intraclass Correlation Coefficient, standard error of measurement and the Bland-Altman limits of agreement were used for data analysis.

Results

Data showed excellent intra- and inter-examiner reliability for all movements with the electrogoniometer (Intraclass Correlation Coefficient > 0.90), except for the inter-examiner analysis of wrist flexion, with an Intraclass Correlation Coefficient of 0.89. The correlation between the devices was deemed to be satisfactory. Even though the excellent reliability and low standard error of measurement results were presented, Bland-Altman graphs showed some discrepant data.

Conclusion

Based on this sample, we suggest that this electrogoniometer is a reliable device regarding intra- and inter-examiner for clinical application when compared with a universal goniometry for wrist motion.

Keywords

Goniometry electrogoniometry reliability wrist

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References

Seftchick

Detullio

Fedorczyk

Clinical examination of the hand. In: Skirven

Osterman

Fedorczyk

(eds). Rehabilitation of the hand and upper extremity, 6th ed. New York: Elsevier, 2011, pp. 55–71.

Norkin

White

. Measurement of joint motion: a guide to goniometry, 4th ed. Philadelphia: F.A. Davis, 2011, pp. 39–47.

Cleffken

Breukelen

Mameren

. Test–retest reproducibility of elbow goniometric measurements in a rigid double-blinded protocol: Intervals for distinguishing between measurement error and clinical change. J Shoulder Elbow Surg 2007; 16: 788–794.

Chapleau

Canet

Petit

. Validity of goniometric elbow measurements: comparative study with a radiographic method. Clin Orthop Relat Res 2011; 469: 3134–3140.

Santos

Ferreira

Malacco

. Confiabilidade intra e interexaminadores e erro da medição no uso do goniômetro e inclinômetro digital. Rev Bras Med Esporte 2012; 18: 38–41.

Barbosa

Filgueira

VLS

Santana

. Estudo comparativo entre o goniômetro universal e o flexímetro na mensuração da flexão passiva da articulação do cotovelo. Fisioter Bras 2009; 10: 171–175.

Armstrong

Macdermit

Chinchalka

. Reliability of range-of-motion measurement in the elbow and forearm. J Shoulder Elbow Surg 1998; 7: 573–580.

Marques

. Manual de goniometria, 2nd ed. São Paulo: Manole, 2003, pp. 1–5.

Ladin Z. Three-dimensional instrumentation. In: Allard P, Stokes IAF, Blanchi J (eds), Three-dimensional analysis of human movement. Champaign: Human Kinetics, 1995, pp.3–17.

10.

Campbell-Kyureghyan

Jorgensen

Burr

. The prediction of lumbar spine geometry: method development and validation. Clin Biomech 2005; 20: 455–464.

11.

Rowe

. Validation of flexible electrogoniometry as a measure of joint kinematics. Physiother Lond 2001; 87: 479–488.

12.

Hansson

Balogh

Ohlsson

. Physical workload in various types of work, Part I: wrist and forearm. Int J Ind Ergon 2009; 39: 221–233.

13.

Shiratsu

Coury

HJCG

. Reliability and accuracy of different sensors of a flexible electrogoniometer. Clin Biomech 2003; 18: 682–684.

14.

Singh

Dias

Slijper

. Assessment of velocity, range, and smoothness of wrist circumduction using flexible electrogoniometry. J Hand Surg 2012; 37: 2331–2339.

15.

Norkin

White

. Measurement of joint motion: a guide to goniometry, 4th ed. Philadelphia: F.A. Davis, 2011, pp. 118–124.

16.

De Vet

HCW

Terwee

Mokking

. Measurement in medicine: a practical guide, 4th ed. New York: Cambridge. Chap. 5, 2011, pp. 96–149.

17.

Bland

Altman

. Measuring agreement in method comparison studies. Stat Methods Med Res 1999; 8: 135–160.

18.

Moriguchi

Carnaz

Silva

. Reliability of intra and inter-rater palpation discrepancy and estimation of its effects on joint angle measurements. Man Ther 2009; 14: 299–305.

19.

Bruton

Conway

Holgate

. Reliability: What is it and how is it measured? Physiotherapy 2000; 86: 94–99.

20.

Johnson

Jonsson

Hagberg

. Comparison of measurement accuracy between two wrist goniometer system during pronation and supination. J Electromyogr Kinesiol 2002; 23: 413–420.

21.

Cimatti

Marcolino

Barbosa

. A study to compare two goniometric methods for measuring active pronation and supination range of motion. Hand Therapy 2013; 18: 57–63.

22.

Hansson

Balogh

Ohlsson

. Measurement of wrist and forearm positions and movements: effect of compensation form goniometer crosstalk. J Electromyogr Kinesiol 2004; 14(3): 355–367.

23.

Foltran

Silva

LCCB

Sato

. Wrist electrogoniometry: are current mathematical correction procedures effective in reducing crosstalk in functional assessment? Braz J Phys Ther 2013; 17: 32–40.

24.

Balogh

Ohlsson

Nordander

. Precision of measurements of physical workload during standardized manual handling part III: goniometry of the wrists. J Eletromyogr Kinesiol 2009; 19: 1005–1012.

25.

Pratt

Burr

. Review of goniometry use within current hand therapy practice. Br J Hand Ther 2001; 6: 45–49.

26.

Chourasia

Buhr

Rabago

. Relationships between biomechanics, tendon pathology, and function in individuals with lateral epicondylosis. J Orthop Sports Phys Ther 2013; 43: 368–378.