A technical support tool for joint range of motion determination in functional diagnostics—An inter-rater study
Open accessAbstract
BACKGROUND: The examination of joint range of motion (RoM) is part of musculo-skeletal functional diagnostics, used, for example, in occupational examinations. Various examination methodologies exist that have been optimized for occupational medical practice, which means they were reduced to the most necessary and feasible measures and examinations for efficiency and usability reasons. Because of time constraints in medical examinations in occupational settings, visual inspection is commonly used to quantify joint RoM. To support medical examiners, an inertial sensor-based measurement system (CUELA) was adapted for joint RoM examination in these settings. The objective of the present study was to evaluate the measurement tool in functional diagnostics under conditions close to clinical practice. METHODS: The joint RoM of twenty healthy subjects were examined by three physicians, who were simultaneously using the measurement tool. Physicians were blinded to the measurement results and the other physicians. Active RoM was examined on the cervical, thoracic and lumbar spine while passive RoM was examined on the shoulder, elbow, wrist, hip, and knee, resulting in a total of 40 joint examination angles. The means, standard deviations, intraclass correlation coefficients (I C C 3,k ), and Bland-Altman-Plots were calculated using MatLab for statistical analysis. RESULTS: Most measurement results were in accordance with expected joint RoMs. All examinations showed an acceptable repeatability. In active RoM examinations, the ICC of inter-rater reliability varied between 0.79 and 0.95. In passive RoM examination the ICC varied between 0.71 and 0.96, except examination angles at the elbow and knee extension (ICC: 0.0-0.77). CONCLUSION: The reliability and objectivity of active RoM examinations were improved by the measurement tool compared with examiners. In passive RoM examinations of upper and lower extremities, the increase of objectivity by the measurements was limited for some examination angles by external factors such as the individual examiner impact on motion execution or the given joint examination conditions. Especially the elbow joint examination requires further development to achieve acceptable reliability. A modification in the examination method to reduce the examiner impact on measurement and the implementation of a more complex calibration procedure could improve the objectivity and reliability of the measurement tool in passive joint RoM examination to be applicable on nearly the whole body.
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Shoulder SEM and ICC for inter-rater reliability ranged from 4.2 to 7.8° and 0.71 to 0.99.
“SEM and ICC for inter-raterreliability ranged respectively from 4.2 to 7.8° and 0.71 to 0.99 [28,66].”
From Validity and Reliability of Wearable Sensors for Joint Angle Estimation: A Systematic Review (2019) · cites this paper as [66]
Neck SEM and ICC for inter-rater reliability ranged from 1.2 to 9.4° and 0.64 to 0.99.
“Standard error of the mean (SEM) and ICC for inter-rater reliability ranged respectively from 1.2 to 9.4° and from 0.64 to 0.99 [64,65,66].”
From Validity and Reliability of Wearable Sensors for Joint Angle Estimation: A Systematic Review (2019) · cites this paper as [66]
Both wrist reliability studies presented good to excellent intra-rater reliability for all joint movements (CMC and ICC 0.79 to 0.96).
“Both studies presented good to excellent intra-rater reliability for all joint movements (CMC and ICC between 0.79 to 0.96) [28,66].”
From Validity and Reliability of Wearable Sensors for Joint Angle Estimation: A Systematic Review (2019) · cites this paper as [66]
Trunk reliability results are consistent and demonstrate good to excellent intra-rater reliability (ICC ≥0.8 except coronal plane fair to excellent 0.67 to 0.93).
“Results from these three studies are consistent and demonstrate good to excellent intra-rater reliability (ICC ≥ 0.8 except for coronal plane which is fair to excellent (0.67 to 0.93)) [46,66,68].”
From Validity and Reliability of Wearable Sensors for Joint Angle Estimation: A Systematic Review (2019) · cites this paper as [66]
For elbow reliability, one study showed excellent reliability in every movement direction (CMC ≥0.9) and the other presented poor to good reliability (ICC = 0.2 to 0.77).
“One study showed excellent reliability in every movement direction (CMC ≥ 0.9) and the other presented poor to good reliability (ICC = 0.2 to 0.77) [28,66].”
From Validity and Reliability of Wearable Sensors for Joint Angle Estimation: A Systematic Review (2019) · cites this paper as [66]
Hip intra-rater reliability is fair to excellent and inter-rater reliability varied across movements (good for walking ICC 0.4 to 0.74 and poor for jumping ICC ≤0.39).
“Intra-rater reliability is fair to excellent and inter-rater reliability varied across movements performed (good for walking [ICC of 0.4 to 0.74] and poor for jumping [ICC ≤ 0.39] [46,53,66]).”
From Validity and Reliability of Wearable Sensors for Joint Angle Estimation: A Systematic Review (2019) · cites this paper as [66]
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Self-citation
- Authors
- Schiefer, C., Kraus, T., Ellegast, R. P., & Ochsmann, E.
- Affiliations
- Institut für Arbeitsschutz der Deutschen Gesetzlichen Unfallversicherung (DE)
- RWTH Aachen University (DE)
- Westsächsische Hochschule Zwickau (DE)
- Corresponding author
- Schiefer, Christoph
- Venue
- Journal of Occupational Medicine and Toxicology
- Published
- 2015-04-29
- Volume
- 10
- Issue
- 1
- Pages
- 16-16
- ISSN
- 1745-6673 (ISSN-L)
- PMC
- PMC4433057
- OpenAlex
- W2141111879
- Cited by
- 31
- References
- 31
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 1 · 2022: 3 · 2021: 3 · 2020: 4 · 2019: 7 · 2018: 1 · 2017: 3 · 2016: 2
- FWCI
- 2.02
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Journal of Occupational Medicine and Toxicology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RWTH Publications (RWTH Aachen) (submittedVersion, cc-by)
- RWTH Publications (RWTH Aachen)
- Funders
- Deutsche Gesetzliche Unfallversicherung
- RWTH Aachen University
- Topics
- Health Sciences › Medicine › Rehabilitation › Musculoskeletal Disorders and Rehabilitation
- Social Sciences › Psychology › Social Psychology › Ergonomics and Musculoskeletal Disorders
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- range of motion, inertial sensors, inter-rater reliability, functional diagnosis, occupational medical examination, passive range of motion, active range of motion, upper and lower extremities
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