Validity and Reliability of Smartphones in Assessing Spinal Kinematics: A Systematic Review and Meta-analysis

Abstract

Objective: Advances in mobile technology have led to the development of smartphones, whose applications present numerous utilities, such as the analysis of human movement based on inertial sensors. The purpose of this review was to investigate validity and reliability of smartphones in assessing the kinematics of the human spine. Methods: A systematic search was performed on MEDLINE, Embase, Scopus, and LILACS databases, as well as manual searches. The included studies evaluated psychometric properties of smartphones in assessing kinematic variables of the spine (range of motion [ROM], speed, and acceleration). Two independent reviewers performed the selection, reading, data extraction, and risk of bias assessment of the studies. Results: Of the 2651 articles initially found, 9 were included and had their results for ROM analyzed. The metaanalyses for validity showed very high correlation coefficients in the evaluation of cervical flexion, extension, and lateral flexion; high ones in the evaluation of cervical rotation; and also high ones for intrarater and interrater reproducibility of all cervical movements. The meta-analyses for interrater reproducibility showed high correlation coefficients in the evaluation of lumbar flexion and very high ones for intrarater reproducibility. Conclusion:The use of smartphones for assessing the ROM of cervical flexion, extension, and lateral flexion and lumbar flexion is feasible. Their use for assessing thoracic rotation is potentially viable, but further validation studies are still needed to ensure a safe use. There is a lack of validation studies that evaluate the applicability of this device in assessing other kinematic characteristics, such as speed and acceleration.

Measurement properties of smartphone applications for the measurement of neck range of motion: a systematic review and meta analyses

“…The evidence from this review suggests that smartphone apps are a reliable and valid method of measuring neck ROM in symptomatic and asymptomatic people. This indication is in line with other research on this topic [ 15 , 36 ] that shows relatively strong evidence to support the intra-rater reliability, inter-rater reliability, and validity of smartphone apps for measuring ROM in a variety of joints including the trunk. However, due to the low quality of evidence identified in this review, one specific app cannot be recommended over another for use.…”

“…Magnetometers are more sensitive to signal distortion from environmental magnetic fields, therefore potentially making the measurement of rotation in these circumstances less accurate [ 26 ]. This concurs with a recent systematic review that evaluated measurement properties of apps to assess the range of spinal movement [ 15 ].…”

“…Previous systematic reviews have synthesised available evidence to determine the measurement properties of PBOM to evaluate ROM in general joint angles [ 14 ] or more specifically, for the measurement of spinal movements [ 15 ]. The main conclusions of these reviews are that there is low quality evidence supporting the measurement properties of apps to assess joint angles due to their heterogeneous nature [ 14 ] and no research has explored the responsiveness of different mobile apps.…”

“…The main conclusions of these reviews are that there is low quality evidence supporting the measurement properties of apps to assess joint angles due to their heterogeneous nature [ 14 ] and no research has explored the responsiveness of different mobile apps. Specifically for spinal movements, available apps showed good levels of reliability and validity for neck ROM in the sagittal and frontal plane but highlighted the lack of evidence to support measurements in the horizontal plane [ 15 ].…”

Interexaminer Reliability and Validity of Quantity of Cervical Mobility during Online Dynamic Inspection

“…According to Magee et al [ 7 ], tests of active range of movement (AROM) are used to identify or determinate limitation on motion, patient’s willingness to move, and to identify the ROM in which the patient reports symptoms. Many non-radiological instruments have been developed in recent years, including goniometry, inclinometry [ 8 ], electrogoniometry, electromagnetic, ultrasonic and optoelectronic systems [ 9 ] and smartphone apps [ 10 , 11 , 12 ], those being a cheaper and more accessible option for physiotherapists.…”