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American Association for Hand Surgery
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Theme: Inclusion and Collaboration Theme: Inclusion and Collaboration

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New Smartphone Applications Provide Accurate and Reliable Measures of Finger Range of Motion
Hannah H. Lee, MD, PhD; Kwesi St. Louis, MD; John R. Fowler, MD
University of Pittsburgh Medical Center, Pittsburgh, PA

Background: Measurement of finger ROM is critical in clinical settings. Goniometer measurement and visual inspections are the two most widespread tools. We compared three smartphone applications and visual inspection measurements of the finger joints to the goniometer measurement standard.

Materials & Methods: An independent observer measured each joint flexion angle using a universal hand-held goniometer and was used as the reference standard (Figure 1). Three different smartphone applications were used to measure the flexion angles of the finger: Goniometer (Jinfra), iPhone Compass (Apple), and PT-Tools (PT Tools suite). In addition, visual inspection was used to estimate the flexion angles. Agreement examination of the each measurement tools against the standard measurement were evaluated using Bland-Altman method. Comparisons of the each measurement tools against the standard measurement were performed via two-tailed Pearson correlation. Inter-rater reliability was quantified using interclass correlation coefficient (ICC).

Results: The results of our study suggest that all three smartphone measurement tools, as well as visual inspection, agree and correlate well with the reference standard XR measurement. Figure 2 documents all measured readings of finger joints for all observers. Overall agreement of the smartphone applications as well as visual inspection measurements of the finger joints to the goniometer measurement standard, as assessed by Bland-Altman method, is illustrated in Figure 3. The mean correlation coefficients for each smartphone applications exceeded 0.7 (Table 1). Overall inter-rater reliability was similar, with ICC greater than 0.9 for all the measurement tools (Table 2).

Conclusions: Our data suggest that new smartphone applications are promising means to provide accurate and reliable measures of ROM.

Figure 1:

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Figure 2:

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Figure 3:

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Table 1: Overall Pearson r2 coefficients


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