Smartphone-based abdominal inclination angles for assessing abdominal obesity: Convergent validity and reliability...

Abdominal obesity is associated with increased cardiometabolic risk, highlighting the need for regular monitoring. However, tape-based waist circumference measurements may be inconvenient for repeated self-monitoring and do not readily support digital recording. Given the widespread availability of smartphones, measuring abdominal inclination angles using a smartphone inclinometer (SI) may be a practical option for assessing abdominal obesity.

This study aimed to investigate the convergent validity and reliability of SI-derived abdominal inclination angles obtained through examiner- and self-measurements among participants with obesity types ranging from normal weight to type II obesity.

Forty adults underwent abdominal inclination angle measurements using SI. Examiner- and self-measured upper abdomen (UA), lower abdomen (LA), and total abdomen (TA) angles were obtained. Convergent validity was evaluated using Spearman correlations with anthropometric indices. Intra- and inter-rater reliability were assessed using intraclass correlation coefficients, standard error of measurement, Bland-Altman analysis, and regression analysis for proportional bias and heteroscedasticity.

Self-measured UA and TA angles showed stronger validity with anthropometric indices than examiner measurements. UA and TA angles demonstrated good-to-excellent intra-rater reliability, while inter-rater reliability was moderate. Bland-Altman analyses showed no proportional bias, although heteroscedasticity was observed in self-LA for intra-rater comparisons and in self-UA and self-LA for inter-rater comparisons.

SI measurements of abdominal inclination angles demonstrated acceptable validity and reliability, with consistent performance for UA and TA angles, whereas LA measurements showed greater variability and should be interpreted with caution. This method may provide a practical approach for monitoring abdominal obesity in daily life.