한국전문물리치료학회지 (Physical Therapy Korea)

  • 제29권3호
  • /
  • Pages.225-234
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  • 2022
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  • 1225-8962(pISSN)
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  • 2287-982X(eISSN)
한국전문물리치료학회 (Korean Research Society of Physical Therapy)
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The Reliability and Validity of the Digital Goniometer and Smart Phone to Determine Trunk Active Range of Motion in Stroke Patients

  • Park, Hee-yong (Department of Physical Therapy, The Graduate School, Yonsei University) ;
  • Hwang, Ui-jae (Department of Physical Therapy, College of Health Science, Yonsei University) ;
  • Kwon, Oh-yun (Department of Physical Therapy, College of Health Science, Yonsei University)
  • 투고 : 2022.05.03
  • 심사 : 2022.06.20
  • 발행 : 2022.08.20
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초록

Background: Trunk movements are an important factor in activities of daily living; however, these movements can be impaired by stroke. It is difficult to quantify and measure the active range of motion (AROM) of the trunk in patients with stroke. Objects: To determine the reliability and validity of measurements using a digital goniometer (DG) and smart phone (SP) applications for trunk rotation and lateral flexion in stroke patients. Methods: This is an observational study, in which twenty participants were clinically diagnosed with stroke. Trunk rotation and lateral flexion AROM were assessed using the DG and SP applications (Compass and Clinometer). Intrarater reliability was determined using intraclass correlation coefficients (ICCs) with 95% confidence intervals. Pearson correlation coefficient was used to determine the validity of the DG and SP in AROM measurement. The level of agreement between the two instruments was shown by Bland-Altman plot and 95% limit of agreement (LoA) was calculated. Results: The intrarater reliability (rotation with DG: 0.96-0.98, SP: 0.98; lateral flexion with DG: 0.97-0.98, SP: 0.96) was excellent. A strong and significant correlation was found between DG and SP (rotation hemiplegic side: r = 0.95; non-hemiplegic side: r = 0.90; lateral flexion hemiplegic side: r = 0.88; non-hemiplegic side: r = 0.78). The level of agreement between the two instruments was rotation (hemiplegic side: 23.02° [LoA 17.41°, -5.61°]; non-hemiplegic side: 31.68° [LoA 23.87°, -7.81°]) and lateral flexion (hemiplegic side: 20.94° [LoA 17.48°, -3.46°]; non-hemiplegic side: 27.12° [LoA 18.44°, -8.68°]). Conclusion: Both DG and SP applications can be used as reliable methods for measuring trunk rotation and lateral flexion in patients with stroke. Although, considering the level of clinical agreement, DG and SP could not be used interchangeably for measurements.

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참고문헌

  1. Meijer R, Ihnenfeldt DS, de Groot IJ, van Limbeek J, Vermeulen M, de Haan RJ. Prognostic factors for ambulation and activities of daily living in the subacute phase after stroke. A systematic review of the literature. Clin Rehabil 2003;17(2):119-29. https://doi.org/10.1191/0269215503cr585oa
  2. Karthikbabu S, Chakrapani M, Ganeshan S, Rakshith KC, Nafeez S, Prem V. A review on assessment and treatment of the trunk in stroke: a need or luxury. Neural Regen Res 2012;7(25):1974-7. https://doi.org/10.3969/j.issn.1673-5374.2012.25.008
  3. Duarte E, Marco E, Muniesa JM, Belmonte R, Diaz P, Tejero M, et al. Trunk control test as a functional predictor in stroke patients. J Rehabil Med 2002;34(6):267-72. https://doi.org/10.1080/165019702760390356
  4. Hsieh CL, Sheu CF, Hsueh IP, Wang CH. Trunk control as an early predictor of comprehensive activities of daily living function in stroke patients. Stroke 2002;33(11):2626-30. https://doi.org/10.1161/01.str.0000033930.05931.93
  5. Verheyden G, Nieuwboer A, De Wit L, Feys H, Schuback B, Baert I, et al. Trunk performance after stroke: an eye catching predictor of functional outcome. J Neurol Neurosurg Psychiatry 2007;78(7):694-8.
  6. Verheyden G, Nieuwboer A, Feys H, Thijs V, Vaes K, De Weerdt W. Discriminant ability of the Trunk Impairment Scale: a comparison between stroke patients and healthy individuals. Disabil Rehabil 2005;27(17):1023-8. https://doi.org/10.1080/09638280500052872
  7. Sunderland A, Tinson D, Bradley L, Hewer RL. Arm function after stroke. An evaluation of grip strength as a measure of recovery and a prognostic indicator. J Neurol Neurosurg Psychiatry 1989;52(11):1267-72. https://doi.org/10.1136/jnnp.52.11.1267
  8. Ryerson S, Byl NN, Brown DA, Wong RA, Hidler JM. Altered trunk position sense and its relation to balance functions in people post-stroke. J Neurol Phys Ther 2008;32(1):14-20. https://doi.org/10.1097/NPT.0b013e3181660f0c
  9. Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurol 2009;8(8):741-54. https://doi.org/10.1016/S1474-4422(09)70150-4
  10. Buckler J, Stanish W, Kozey C. Passive rotation range of motion and shoulder subluxation: a comparative study. N Am J Sports Phys Ther 2009;4(4):182-9.
  11. Mullaney MJ, McHugh MP, Johnson CP, Tyler TF. Reliability of shoulder range of motion comparing a goniometer to a digital level. Physiother Theory Pract 2010;26(5):327-33. https://doi.org/10.3109/09593980903094230
  12. Aldridge R, Stephen Guffey J, Whitehead MT, Head P. The effects of a daily stretching protocol on passive glenohumeral internal rotation in overhead throwing collegiate athletes. Int J Sports Phys Ther 2012;7(4):365-71.
  13. Wellmon RH, Gulick DT, Paterson ML, Gulick CN. Validity and reliability of 2 goniometric mobile apps: device, application, and examiner factors. J Sport Rehabil 2016;25(4):371-9. https://doi.org/10.1123/jsr.2015-0041
  14. Jayavel A, Misra P, Sivakumar VPR. Reliability and validity of I Handy android application on measurement of lumbar spine movement in patients with low back pain. IJOCS 2017;11(3):84-8.
  15. Malmstrom EM, Karlberg M, Melander A, Magnusson M. Zebris versus Myrin: a comparative study between a three-dimensional ultrasound movement analysis and an inclinometer/compass method: intradevice reliability, concurrent validity, intertester comparison, intratester reliability, and intraindividual variability. Spine (Phila Pa 1976) 2003;28(21):E433-40. https://doi.org/10.1097/01.BRS.0000090840.45802.D4
  16. Youdas JW, Carey JR, Garrett TR. Reliability of measurements of cervical spine range of motion--comparison of three methods. Phys Ther 1991;71(2):98-104; discussion 105-6. https://doi.org/10.1093/ptj/71.2.98
  17. Klein AB, Snyder-Mackler L, Roy SH, DeLuca CJ. Comparison of spinal mobility and isometric trunk extensor forces with electromyographic spectral analysis in identifying low back pain. Phys Ther 1991;71(6):445-54. https://doi.org/10.1093/ptj/71.6.445
  18. Olson KA, Goehring MT. Intra and inter-rater reliability of a goniometric lower trunk rotation measurement. J Back Musculoskelet Rehabil 2009;22(3):157-64. https://doi.org/10.3233/bmr-2009-0229
  19. Furness J, Schram B, Cox AJ, Anderson SL, Keogh J. Reliability and concurrent validity of the iPhone® Compass application to measure thoracic rotation range of motion (ROM) in healthy participants. PeerJ 2018;6:e4431. https://doi.org/10.7717/peerj.4431
  20. Burdett RG, Brown KE, Fall MP. Reliability and validity of four instruments for measuring lumbar spine and pelvic positions. Phys Ther 1986;66(5):677-84. https://doi.org/10.1093/ptj/66.5.677
  21. Gajdosik RL, Bohannon RW. Clinical measurement of range of motion. Review of goniometry emphasizing reliability and validity. Phys Ther 1987;67(12):1867-72. https://doi.org/10.1093/ptj/67.12.1867
  22. Nitschke JE, Nattrass CL, Disler PB, Chou MJ, Ooi KT. Reliability of the American Medical Association guides' model for measuring spinal range of motion. Its implication for wholeperson impairment rating. Spine (Phila Pa 1976) 1999;24(3):262-8. https://doi.org/10.1097/00007632-199902010-00013
  23. Otter SJ, Agalliu B, Baer N, Hales G, Harvey K, James K, et al. The reliability of a smartphone goniometer application compared with a traditional goniometer for measuring first metatarsophalangeal joint dorsiflexion. J Foot Ankle Res 2015;8:30. https://doi.org/10.1186/s13047-015-0088-3
  24. Mourcou Q, Fleury A, Franco C, Klopcic F, Vuillerme N. Performance evaluation of smartphone inertial sensors measurement for range of motion. Sensors (Basel) 2015;15(9):23168-87. https://doi.org/10.3390/s150923168
  25. Tousignant-Laflamme Y, Boutin N, Dion AM, Vallee CA. Reliability and criterion validity of two applications of the iPhoneTM to measure cervical range of motion in healthy participants. J Neuroeng Rehabil 2013;10(1):69. https://doi.org/10.1186/1743-0003-10-69
  26. Kolber MJ, Pizzini M, Robinson A, Yanez D, Hanney WJ. The reliability and concurrent validity of measurements used to quantify lumbar spine mobility: an analysis of an iphone® application and gravity based inclinometry. Int J Sports Phys Ther 2013;8(2):129-37.
  27. Salamh PA, Kolber M. The reliability, minimal detectable change and concurrent validity of a gravity-based bubble inclinometer and iphone application for measuring standing lumbar lordosis. Physiother Theory Pract 2014;30(1):62-7. https://doi.org/10.3109/09593985.2013.800174
  28. Iveson BD, McLaughlin SL, Todd RH, Gerber JP. Reliability and exploration of the side-lying thoraco-lumbar rotation measurement (STRM). N Am J Sports Phys Ther 2010;5(4):201-7.
  29. Pourahmadi MR, Taghipour M, Jannati E, Mohseni-Bandpei MA, Ebrahimi Takamjani I, Rajabzadeh F. Reliability and validity of an iPhone® application for the measurement of lumbar spine flexion and extension range of motion. PeerJ 2016;4:e2355. https://doi.org/10.7717/peerj.2355
  30. Lexell JE, Downham DY. How to assess the reliability of measurements in rehabilitation. Am J Phys Med Rehabil 2005;84(9):719-23. https://doi.org/10.1097/01.phm.0000176452.17771.20
  31. Alhwoaimel N, Warner M, Hughes AM, Ferrari F, Burridge J, Wee SK, et al. Concurrent validity of a novel wireless inertial measurement system for assessing trunk impairment in people with stroke. Sensors (Basel) 2020;20(6):1699. https://doi.org/10.3390/s20061699
  32. Svensson M, Lind V, Lofgren Harringe M. Measurement of knee joint range of motion with a digital goniometer: a reliability study. Physiother Res Int 2019;24(2):e1765. https://doi.org/10.1002/pri.1765
  33. Johnson KD, Grindstaff TL. Thoracic rotation measurement techniques: clinical commentary. N Am J Sports Phys Ther 2010;5(4):252-6.
  34. Lewis JS, Valentine RE. Clinical measurement of the thoracic kyphosis. A study of the intra-rater reliability in subjects with and without shoulder pain. BMC Musculoskelet Disord 2010;11:39. https://doi.org/10.1186/1471-2474-11-39
  35. Portney LG, Watkins MP. Foundations of clinical research: applications to practice. 3rd ed. Upper Saddle River (NJ): Prentice Hall; 2009;594-5.
  36. Wallwork TL, Hides JA, Stanton WR. Intrarater and interrater reliability of assessment of lumbar multifidus muscle thickness using rehabilitative ultrasound imaging. J Orthop Sports Phys Ther 2007;37(10):608-12. https://doi.org/10.2519/jospt.2007.2418
  37. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Int J Nurs Stud 2010;47(8):931-6. https://doi.org/10.1016/j.ijnurstu.2009.10.001
  38. Neumann DA. Kinesiology of the musculoskeletal system: foundations for rehabilitation. 2nd ed. St. Louis (MO): Mosby; 2010;346-7.
  39. Ukita A, Abe M, Kishigami H, Hatta T. Influence of back support shape in wheelchairs offering pelvic support on asymmetrical sitting posture and pressure points during reaching tasks in stroke patients. PLoS One 2020;15(4):e0231860. https://doi.org/10.1371/journal.pone.0231860
  40. Jeong YJ, Kim GS, Jeong YG, Moon HI. Can pulmonary function testing predict the functional outcomes of poststroke patients?: an observational study. Am J Phys Med Rehabil 2020;99(12):1145-9. https://doi.org/10.1097/PHM.0000000000001507
  41. Muscolino JE. The muscular system manual: the skeletal muscles of the human body. 4th ed. St. Louis (MO): Mosby; 2016;300.
  42. Atkinson G, Nevill AM. Statistical methods for assessing measurement error (reliability) in variables relevant to sports medicine. Sports Med 1998;26(4):217-38. https://doi.org/10.2165/00007256-199826040-00002
  43. Park I, Park K, Yi C, Moon I. The inter-rater reliability of measurements of active craniocervical range of motion with smartphone in patients with stroke. Phys Ther Korea 2019;26(1):8-18. https://doi.org/10.12674/ptk.2019.26.1.008
  44. Lee B, Choi H, An S. The relative.absolute reliability and validity of step test in patients with chronic stroke. J Korean Soc Integr Med 2017;5(1):43-53. https://doi.org/10.15268/KSIM.2017.5.1.043
  45. Lu WS, Wang CH, Lin JH, Sheu CF, Hsieh CL. The minimal detectable change of the simplified stroke rehabilitation assessment of movement measure. J Rehabil Med 2008;40(8):615-9. https://doi.org/10.2340/16501977-0230
  46. Morvan G, Mathieu P, Vuillemin V, Guerini H, Bossard P, Zeitoun F, et al. Standardized way for imaging of the sagittal spinal balance. Eur Spine J 2011;20(Suppl 5):602. https://doi.org/10.1007/s00586-011-1927-y
  47. Legaye J, Saunier P, Dumas R, Vallee C. Correction for patient sway in radiographic biplanar imaging for three-dimensional reconstruction of the spine: in vitro study of a new method. Acta Radiol 2009;50(7):781-90. https://doi.org/10.1080/02841850903036272