Psychometric properties of measurement tools for quantifying knee joint position and movement: a systematic review

This systematic review critically evaluates literature on the reliability and validity of measurement tools for quantifying knee joint angles and knee movement. A search was conducted of seven medical databases and one biomedical engineering database, yielding 43 articles that reported reliability or validity. Tools for quantifying knee joint angles included standard handheld goniometers, fluid-based goniometers, gravity-based goniometers, photographs and two dimensional (2-D) motion analysis. Knee movement was measured with electrogoniometers, 2-D and three dimensional (3-D) motion analysis. Intraclass correlation coefficients for testing knee angles ranged from 0.51-1.00 for intratester reliability and 0.43-0.99 for intertester reliability. For quantifying knee position, sequential MRI and 2-D had the least error of measurement, followed by hand held goniometers and photographs. For dynamic measurements, electrogoniometers and 3-D motion analysis were most reliable and had low error of measurement. Strong concurrent validity was found between hand held goniometers and radiographs, as well as between hand held goniometers and 3-D motion analysis.