Goniometric reliability in a clinical setting. Shoulder measurements.

Area of Science:

• Orthopedics
• Physical Therapy
• Biomechanics

Background:

• Clinical assessment of shoulder passive range of motion (PROM) is crucial for diagnosis and treatment.
• Goniometric measurement is a standard technique, but its reliability can be influenced by various factors.
• Understanding the reliability of goniometric measurements is essential for consistent clinical practice.

Purpose of the Study:

• To evaluate the intratester and intertester reliability of clinical goniometric measurements for shoulder PROM.
• To compare the reliability using two different sizes of universal goniometers.
• To assess reliability across multiple shoulder movements: flexion, extension, abduction, horizontal abduction, horizontal adduction, lateral rotation, and medial rotation.

Main Methods:

• Two groups of 50 subjects each underwent repeated shoulder PROM measurements.
• Measurements were taken using two different sizes of universal goniometers.
• Therapist goniometric placement and patient positioning were not controlled during measurements.

Main Results:

• Intratester reliability (intraclass correlation coefficients [ICCs]) was high for all motions, ranging from .87 to .99.
• Intertester reliability varied by motion: ICCs ranged from .26 to .55 for horizontal abduction, horizontal adduction, extension, and medial rotation.
• Intertester reliability was high for flexion, abduction, and lateral rotation, with ICCs ranging from .84 to .90.

Conclusions:

• Goniometric PROM measurements of the shoulder demonstrate high reliability when performed by the same physical therapist, regardless of goniometer size.
• Intertester reliability for shoulder PROM measurements is specific to the range of motion being assessed.
• Standardization of measurement techniques is recommended to improve intertester reliability in clinical settings.