Reliability of range-of-motion measurement in the elbow and forearm

Armstrong, April; MacDermid, Joy C.; Chinchalkar, Shrikant J.; Stevens, Rob S.; King, Graham J.W.

doi:10.1016/s1058-2746(98)90003-9

Cited by 205 publications

(185 citation statements)

References 7 publications

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“…Furthermore, several studies suggest using a standard goniometer to measure ROM in joints, including the wrist, shows excellent intraobserver reliability [4,17,43]. In another study specifically examining the intertester and intratester reliability of ROM measurements using a standard goniometer; the intraobserver results showed the minimum detectable change in forearm rotation using a goniometer was 8° [4]. Thus, our study may not be able to resolve small differences in ROM between patient subgroups.…”

Section: Discussionmentioning

confidence: 81%

“…However, we do not believe this jeopardizes the general results of our study because our conclusions are based largely on the relative, and not absolute, differences between groups. Furthermore, several studies suggest using a standard goniometer to measure ROM in joints, including the wrist, shows excellent intraobserver reliability [4,17,43]. In another study specifically examining the intertester and intratester reliability of ROM measurements using a standard goniometer; the intraobserver results showed the minimum detectable change in forearm rotation using a goniometer was 8° [4].…”

Section: Discussionmentioning

confidence: 99%

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Distal Radius Fractures in Older Patients: Is Anatomic Reduction Necessary?

Synn

Makhni

et al. 2008

Clin Orthop Relat Res

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The relationship between radiographic and functional outcomes in older patients with distal radius fractures is controversial. We explored this relationship by assessing the influence of radiographic displacement and fracture comminution on the functional outcomes of these fractures. We also asked whether operative intervention and demographic factors (age, gender, duration of followup) influenced outcome. We examined 53 patients older than 55 years with distal radius fractures with various functional assessments: range of motion (ROM) and strength measurements, three subjective surveys (Disabilities of the Arm, Shoulder, and Hand; Patient-rated Wrist Evaluation; Modernized Activity Subjective Survey of 2007), a Gartland and Werley score, and an objective, standardized hand performance test (Jebsen-Taylor). We measured angulation, articular gap/stepoff, and radial shortening on final radiographs and fracture comminution of preoperative radiographs. We observed no effect of radiographic displacement on subjective or objective outcome assessments, including standardized hand performance timed testing. Surgically treated fractures were less likely to display residual dorsal angulation and radial shortening, but surgical intervention did not independently predict functional outcome. Fracture comminution, patient gender, and months of followup similarly had no effect on outcome. We found no relationship between anatomic reduction as evidenced by radiographic outcomes and subjective or objective functional outcomes in this older patient cohort.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Distal Radius Fractures in Older Patients: Is Anatomic Reduction Necessary?

Synn

Makhni

et al. 2008

Clin Orthop Relat Res

View full text Add to dashboard Cite

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“…When different observers independently assess a joint range that does not change over time, interobserver reliability generally will be good provided that standardized protocols 17 are used and the observers are trained. 29 In addition to common sources of measurement variation, the development of contractures, hypertonia, and shoulder pain may complicate and negatively influence the reliability of PROM measure-Assessed for eligibility (n=260) Flow of participants through each stage of the trial from initial screening by physician to follow-up measurement.…”

Section: Discussionmentioning

confidence: 99%

“…The reliability of arm range-ofmotion measurements is good in people who are healthy 14,15 and in patients with orthopedic conditions, 16,17 but these findings cannot be generalized to patients with stroke because stroke-specific impairments may influence reliability. Over time, many patients develop contractures 10, 18 and hypertonia, 19,20 especially in shoulder internal rotators and wrist flexors.…”

mentioning

confidence: 99%

Repeated Measurements of Arm Joint Passive Range of Motion After Stroke: Interobserver Reliability and Sources of Variation

Jong¹,

Dijkstra²,

Stewart

et al. 2012

Physical Therapy

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Background Goniometric measurements of hemiplegic arm joints must be reliable to draw proper clinical and scientific conclusions. Previous reliability studies were cross-sectional and based on small samples. Knowledge about the contributions of sources of variation to these measurement results is lacking. Objective The aims of this study were to determine the interobserver reliability of measurements of passive range of motion (PROM) over time, explore sources of variation associated with these measurement results, and generate smallest detectable differences for clinical decision making. Design This investigation was a measurement-focused study with a longitudinal design, nested within a 2-arm randomized controlled trial. Methods Two trained physical therapists assessed 7 arm movements at baseline and after 4, 8, and 20 weeks in 48 people with subacute stroke using a standardized protocol. One physical therapist performed the passive movement, and the other read the hydrogoniometer. The therapists then switched roles. The relative contributions of several sources of variation to error variance were explored with analysis of variance. Results Interobserver reliability coefficients ranged from .89 to .97. The PROM measurements were influenced by error variance ranging from 31% to 50%. The participant × time interaction made the largest contribution to error variance, ranging from 59% to 81%. Smallest detectable differences were 6 to 22 degrees and were largest for shoulder movements. Limitations Verification of shoulder pain and hypertonia as sources of error variance led to a substantial number of unstable variance components, necessitating a simpler analysis. Conclusions The assessment of PROM with a standardized protocol, a hydrogoniometer, and 2 trained physical therapists yielded high interobserver reliability indexes for all arm movements. Error variance made a large contribution to the variation in measurement results. The resulting smallest detectable differences can be used to interpret future hemiplegic arm PROM measurements with more confidence.

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“…It was also shown that both standard manual and computerized goniometers have high intra-and inter-tester reliability (Armstrong et al, 1998).…”

Section: Wrist Positions and Movementsmentioning

confidence: 99%

Concordance between VDU-users’ ratings of comfort and perceived exertion with experts’ observations of workplace layout and working postures

Lindegård

Karlberg

Tornqvist³

et al. 2005

Applied Ergonomics

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All previously published papers have been reproduced with permission from the publisher.Published and printed by Intellecta DocuSys AB, Göteborg, Sweden, 2007 © Agneta Lindegård Andersson, 2007 ISBN 978-91-628-7098-0 Working technique during computer work Associations with biomechanical and psychological strain, neck and upper extremity musculoskeletal symptoms Agneta Lindegård AnderssonThe Sahlgrenska Academy at Göteborg University, Institute of Medicine Department of Public Health and Community Medicine Occupational and Environmental Medicine AbstractAbout 35 % of the working population in Sweden report that computer use accounts for 50% or more of their total working hours. Among this population approximately 40% of the women and 25% of the men experienced symptoms in the neck and/or upper extremities at least once a week during the preceding 3 month. The overall aim of the studies underlying this thesis was to explore possible associations between working technique and perceived exertion, comfort, biomechanical and psychosocial strain as well as neck and upper extremity symptoms among computer users. Specific research questions addressed were a) Whether working technique was associated with muscle activity, wrist positions and forces applied to the computer mouse, respectively? b) Whether working technique was associated with psychological demands, emotional stress and perceived muscle tension, respectively? c) Whether there were associations between self-rated perceived comfort and observations of workplace layout and between self-rated perceived exertion and working postures. d) Whether working technique perceived exertion and comfort was associated with neck and upper extremity symptoms.The results showed that subjects classified as having a good working technique worked with less muscular load in the forearm (p=0.03) and in the trapezius muscle on the mouse operating side (p=0.02) compared to subjects classified as having a poor working technique. Subjects who reported high psychological demands and perceived muscular tension, respectively, used poorer working technique than subjects who did not perceive this conditions (demands, p=0.03, muscular tension, p=0.02). Moreover, the concordance between ratings of comfort and observations of workplace layout was reasonably good concerning the working chair and the keyboard and good regarding the computer screen and the input device. The concordance between ratings of perceived exertion and observations of working postures indicated good agreement for all measured body locations. This applies to the group that rated poor comfort and high exertion. Regarding the group that rated good comfort and low exertion ratings must be supplemented with observations. Furthermore, the results revealed that high perceived exertion and low comfort were related to an increased incidence of neck, and upper extremity symptoms, while poor working technique was not associated with such a risk. It is concluded that working technique is associated with both biomechanical and p...

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Reliability of range-of-motion measurement in the elbow and forearm

Cited by 205 publications

References 7 publications

Distal Radius Fractures in Older Patients: Is Anatomic Reduction Necessary?

Distal Radius Fractures in Older Patients: Is Anatomic Reduction Necessary?

Repeated Measurements of Arm Joint Passive Range of Motion After Stroke: Interobserver Reliability and Sources of Variation

Concordance between VDU-users’ ratings of comfort and perceived exertion with experts’ observations of workplace layout and working postures

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