Validity and Reliability of Teleconference-Based Goniometry for Measuring Ankle and Great Toe Joint Range of Motion

Introduction Many studies focused on the positive impact of virtual visits during the COVID-19 pandemic. In the post-pandemic era, research exploring telemedicine's impact on the orthopedic physical examination, particularly for the lower extremities, continues to expand. This research evaluates the validity and reliability of telemedicine measuring ankle and great toe range of motion (ROM). Methods In this prospective study, 59 ankles and 59 great toes were measured by a researcher trained by a licensed occupational therapist for goniometer use both in-person and through telemedicine. Telemedicine measurements were also made by a second researcher. Mean differences and intraclass correlation coefficients (ICCs) were used to assess validity by comparing the ROM between in-person and telemedicine ROM measures. ICCs were used to evaluate reliability by assessing agreement in telemedicine ROM measures between the two different researchers. Results In the evaluation of validity, in-person and telemedicine measurements for both ankle dorsiflexion and plantarflexion revealed ICCs of 0.81, with mean differences equal to -0.64 and -0.93 degrees, respectively. In-person and still-shot photography for ankle dorsiflexion had an ICC of 0.83 and plantarflexion had an ICC of 0.82, with respective mean differences of -1.39 and -0.24 degrees. Hallux extension measurements between in-person and telemedical visits had an ICC of 0.87 (mean difference: 2.34 degrees), whereas still-shot showed an ICC of 0.86 (mean difference: 2.58 degrees). Hallux flexion had an ICC of 0.93 (mean difference: -0.98 degrees) for in-person and telemedical visits and an ICC of 0.95 (mean difference: -1.51 degrees) for in-person and still-shot measures. Conclusion Ankle and great toe joint ROM can be measured effectively during an orthopedic telemedicine visit equivalent to that of an in-person measurement.​ This supports the idea that a virtual physical ROM exam can increase efficiency for both patients and providers.