Reliability and validity of clinically accessible smartphone applications to measure joint range of motion: A systematic review

Abstract

Measuring joint range of motion is an important skill for many allied health professionals. While the Universal Goniometer is the most commonly utilised clinical tool for measuring joint range of motion, the evolution of smartphone technology and applications (apps) provides the clinician with more measurement options. However, the reliability and validity of these smartphones and apps is still somewhat uncertain. The aim of this study was to systematically review the literature regarding the intra- and inter-rater reliability and validity of smartphones and apps to measure joint range of motion. Eligible studies were published in English peer-reviewed journals with full text available, involving the assessment of reliability and/or validity of a non-videographic smartphone app to measure joint range of motion in participants >18 years old. An electronic search using PubMed, Medline via Ovid, EMBASE, CINAHL, and SPORTSDiscus was performed. The risk of bias was assessed using a standardised appraisal tool. Twenty-three of the eligible 25 studies exceeded the minimum 60% score to be classified as a low risk of bias, although 3 of the 13 criteria were not achieved in >50% of the studies. Most of the studies demonstrated adequate intra-rater or inter-rater reliability and/or validity for >50% of the range of motion tests across all joints assessed. However, this level of evidence appeared weaker for absolute (e.g. mean difference ± limit of agreement, minimal detectable change) than relative (e.g. intraclass correlation, correlation) measures; and for spinal rotation than spinal extension, flexion and lateral flexion. Our results provide clinicians with sufficient evidence to support the use of smartphones and apps in place of goniometers to measure joint motion. Future research should address some methodological limitations of the literature, especially including the inclusion of absolute and not just relative reliability and validity statistics.

Reliability of the Polar Vantage M Sports Watch when Measuring Heart Rate at Different Treadmill Exercise Intensities

“…Standard error of measurement was calculated to provide an "absolute index of reliability" associated with a measurement [20]. The following criteria were used for absolute measures: good SEM = <10 bps and poor SEM = ≥10 bps [24,25]. To determine any clinically important changes, the smallest real difference (SRD) was used and calculated using the equation SRD = 1.96 × SEM × √ 2 [26].…”

Mobile applications addressing violence against women: a systematic review

“…Given the large population as well as the high density of smartphone use, especially in the densely populated areas of Central and East Asia, the low numbers of apps with location of initiation in these regions are presumably not an accurate reflection of the actual app distribution but rather are to be interpreted in the context of country-specific online search bias, as well as the language restrictions in this systematic review. However, this depicts a common limitation in systematic app reviews that are most commonly restricted to even only one language 29–34. The restriction of year of release from 2010 up to and including 2018 as eligibility criterion can potentially lead to another selection bias.…”

“…The restriction of year of release from 2010 up to and including 2018 as eligibility criterion can potentially lead to another selection bias. Nevertheless, the systematic review at hand aims to assess the recent developments in app development, for which reviewing the past 8 years is sufficient and in line with previous systematic reviews on other mHealth applications 29–34. Additionally, it must be mentioned that each app was assigned to the sector(s) (private/public/both) of institutions by which it was merchandised; whether other institutions were involved in actually implementing the app was not incorporated into this review.…”

Feasibility of Smartphone-Based Badminton Footwork Performance Assessment System

“…Although IMUs are considerably more affordable than motion analysis systems, their convenience and availability remain a concern for coaches and players [17]. As the popularity of smartphones surges, more and more researchers have utilized the high-quality built-in inertial sensors of smartphones to measure postural sway, joint range of motion, or gait spatiotemporal parameters [19][20][21]. Numerous studies have confirmed that smartphones' built-in sensors are valid and reliable, and can be applied for measuring human motions [20,22].…”

“…As the popularity of smartphones surges, more and more researchers have utilized the high-quality built-in inertial sensors of smartphones to measure postural sway, joint range of motion, or gait spatiotemporal parameters [19][20][21]. Numerous studies have confirmed that smartphones' built-in sensors are valid and reliable, and can be applied for measuring human motions [20,22]. Because of their convenience, smartphones might represent an innovative measurement tool for badminton footwork performance on the court.…”