Major drawbacks of goniometry are that the starting position, the center of rotation, the long axis of the limb and the true vertical and horizontal positions can only be visually estimated moreover, conventional goniometers must be held with two hands, leaving neither hand free for stabilization of the body or the proximal part of the joint. The two-arm goniometer is still the most commonly used, economical and portable device for the evaluation of ROM, despite acknowledged limitations. The advantages of goniometry are the simplicity in assessing ROM, the direct measurement of joint angles without any data reduction process and the low cost of the instrument. Hip joint ROM is widely assessed using low-technology tools such as manual goniometers or inclinometers. Smaller error of measurement values for the smartphone goniometric application might indicate superiority for assessment where clinical situations demand greater precision of knee range of motion.Hip joint range of motion (ROM) is a basic clinical parameter for diagnosing hip diseases, such as osteoarthritis or femoroacetabular impingement (FAI), and for monitoring the efficacy of a treatment.
The universal goniometer and the smartphone goniometric application were reliable in repeated measures of knee flexion angles. The Standard Error of Measurement ranged between 1.56° (0.52e2.66) for the UG and 0.62° (0.29e1.27) for the KGA. Agreement between the universal goniometer and smartphone goniometric application measurements was also high for all examiners with average CCCs all above 0.96. There were no significant differences in reliability between the experienced and the novice practitioners for either device.
The universal goniometer and the smartphone goniometric application were reliable in repeated measures of knee flexion angles (average Concordance Correlation Coefficient (CCC) > 0.98) with both experienced clinicians and final year physiotherapy students (average CCCs > 0.96). Three clinicians, each with over seven years' experience as musculoskeletal physiotherapists and three final year physiotherapy students, measured 18 different knee joint angles three times, using both the universal goniometer and the smartphone goniometric application. This study examined the intra- and inter-measurer reliability of novice and experienced clinicians and the concurrent validity of assessing knee range of motion using a smartphone application (the Knee Goniometer App (Ockendon©)) (KGA) and a standard universal goniometer (UG). Recently smartphone goniometry applications have become available to clinicians. The use of goniometers to measure joint angles is a key part of musculoskeletal practice.
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