Remote self-measurement of wrist range of motion performed on normal wrists by a minimally trained individual using the iPhone level application only demonstrated good reliability in measuring wrist flexion and extension

Abstract

Study DesignThis is a reliability study using the intraclass correlation coefficient. PurposeThe purpose of this study was to determine whether an individual with minimal training could use the iPhone Level application to self-measure the range of motion of the forearm and wrist from a remote location. MethodsForty healthy participants (80 wrists) were measured twice by two examiners using a universal goniometer and the iPhone Level application. After measurement, each participant received a training session in the self-measurement method. They were then asked to perform remote self-measurements two to three days later and report their findings to the examiners using Skype or FaceTime. ResultsSPSS, version 26, was used to run intraclass correlation coefficients using a two-way random analysis at a 95% confidence interval with absolute agreement. Comparisons of single measurements were used to determine reliability. Good inter-rater reliability was found between wrist flexion and extension in all testing conditions. Measurement of active motion in supination, pronation, radial, and ulnar deviation demonstrated moderate reliability compared with the universal goniometer where the measurements were performed by the investigators. Self-measurement of the participant resulted in moderate reliability for supination and poor reliability in pronation, radial, and ulnar deviation. DiscussionSome participants found the procedures technologically and perceptually challenging. Anatomical variances, positional requirements, and substitution patterns complicated the process. ConclusionsThe iPhone Level application may be used to perform reliable self-measurements of wrist flexion and extension from a remote location. Further research exploring methods for remote selfmeasurement is indicated.