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Reliability of the dial test using a handheld inclinometer.

David A Krause1, Bruce A Levy, Jay P Shah

  • 1The Departments of Orthopedic Surgery and Physical Medicine and Rehabilitation, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.

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This study validates the dial test with a digital inclinometer for measuring knee external rotation, finding it reliable for clinical use. A 10° change indicates meaningful progression, while a 15° side-to-side difference suggests clinical significance.

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Area of Science:

  • Orthopedics
  • Biomechanics
  • Kinesiology

Background:

  • Assessing knee external rotation is crucial for diagnosing and managing knee joint conditions.
  • The traditional dial test has limitations in objective measurement.
  • Instrumented methods offer potential for improved accuracy and reliability.

Purpose of the Study:

  • To evaluate the intra-tester and inter-tester reliability of the dial test using a handheld digital inclinometer.
  • To assess the responsiveness and side-to-side differences of this instrumented dial test.

Main Methods:

  • Twenty-four healthy subjects underwent the dial test on both knees at 30° and 90° flexion.
  • A handheld digital inclinometer measured tibial external rotation with the ankle in neutral.
  • Two blinded examiners performed the test, and minimal detectable change (MDC) was calculated.

Main Results:

  • High intra-tester reliability was observed (0.83-0.89).
  • Inter-tester reliability ranged from 0.74 to 0.83.
  • MDC values indicated sensitivity to change, with side-to-side differences suggesting clinical significance.

Conclusions:

  • The instrumented dial test with a digital inclinometer demonstrates acceptable reliability for clinical application.
  • A 10° change in a single knee measurement suggests a meaningful change.
  • Differences exceeding 15° between knees indicate clinical significance for side-to-side comparisons.