Mechanical Goniometer Research Articles

Reliability of Upper Limb Neurodynamic Tests: Median, Radial, and Ulnar Nerves

Objective Upper limb neurodynamic tests are used to evaluate the mechanical sensitivity of the peripheral nerves. However, very little is known about the reliability of upper limb neurodynamic tests, especially for the radial and ulnar nerves. This study aimed to evaluate the reliability of neurodynamic tests of the upper extremities to test median, radial, and ulnar nerves. Materials & Methods In this observational cross-sectional study, 25 asymptomatic subjects aged 19-45 years participated. They were selected using simple non-random sampling. Then two examiners performed the neurodynamic tests on them on two successive days. The goal was to assess the reliability of median, radial, and ulnar neurodynamic tests. During the neurodynamic tests, the participants reported the initial stretching pain and the moment of submaximal pain (substantially obvious pain) in related areas of the nerve distribution, including the anterior side of the elbow and forearm for the median nerve, posterolateral aspect of the elbow and forearm for radial nerve, and medial side of elbow and forearm for the ulnar nerve. At the starting point of painful stretching and the submaximal pain, the angle of elbow extension (for median and radial nerve tests) and shoulder abduction angle (for ulnar nerve test) were measured using a mechanical goniometer. The range between these two points was used to analyze the reliability. The intraclass correlation coefficient (ICC) and the standard error of measurement (SEM) were calculated to examine the relative and absolute reliability, respectively. Using t-test, the difference in the mean of the measurements was calculated. Results No significant difference was found between the mean measurements of the two testers in intra-session and inter-session reliability. For examiners 1 and 2, was obtained 0.94 (SEM:2ο) and 0.89 (SEM:2.85ο) for the median nerve, 0.56 (SEM:6.36˚ ) and 0.93 (SEM:1.82ο) for radial nerve, and 0.42 (SEM:3.27ο) and 0.79 (SEM:1.42ο) for the ulnar nerve. Inter-tester intra-session reliability was obtained at 0.84 (SEM: 3.44ο), 0.54 (SEM: 6.1ο), and 0.55 (SEM: 2.75ο), respectively, for median, radial, and ulnar nerves. Inter-tester inter-session reliability was obtained at 0.97 (SEM:1.43ο), 0.69 (SEM:5.06ο), and 0.51 (SEM: 2.8˚ο), respectively, for median, radial, and ulnar nerves. Conclusion The upper limb neurodynamic tests and measurement of the range between the onset of stretching pain and the point of submaximal pain have moderate to excellent reliability. Therefore, these clinical tests can be used in diagnostic evaluations and treatment interventions. Also, the median nerve neurodynamic test has higher relative reliability than radial and ulnar nerve neurodynamic tests.

Choice of the method for eliminating postburn shoulder joint contractures

BACKGROUND: In the Russian Federation, over 400,000 patients with thermal injuries are registered yearly, with approximately 30% of them requiring hospitalization. Physicians pay special attention to the rehabilitation of patients with complications of deep burns. According to several authors, deep burns occur in 47% of cases. The most common complications of deep burns are contractures and limb deformities. Shoulder contractures occur in over 50% of patients. The outcomes and terms of a patients return to active social and working life depend on the timeliness and selection of an optimal surgical intervention from a wide range of reconstructive and plastic techniques.
 AIM: This study aimed to improve the functional and esthetic results of surgical treatment in patients with postburn shoulder joint contractures.
 MATERIALS AND METHODS: From 2011 to 2020, 198 patients underwent surgery, including 59% women and 41% men. Right shoulder, left shoulder, and right and left shoulder simultaneous joint contractures occurred in 54.5%, 38.5%, and 7% of cases, respectively. The patients age ranged from 18 to 72 years, and 99% of them were of working age. The scope of preoperative examination included clinical data, photographic documentation, duplex vascular scanning, and determination of the degree of contracture using a mechanical goniometer. Patients with grade I, II, and III shoulder joint lesions accounted for 29%, 60%, and 11% of the total number of cases, respectively. Early surgical rehabilitation prevents the development of secondary myogenic and arthrogenic contractures and accelerates the patients social reintegration. Local tissue plasty using the armpit adipodermal tongue-shaped flap, a nonperforated full-layer or split skin graft, a rotated flap based on perforating vessels, and the expander stretching method were used to eliminate contractures.
 RESULTS: Bacterial infection, total and marginal necrosis, hematomas, and seromas were not observed in the immediate postoperative period. Complete elimination of the shoulder joint contracture was achieved in 63% of cases, whereas joint mobility increased by over 60 in 30% of patients.
 CONCLUSIONS: The algorithm presented for choosing a method of surgical rehabilitation for patients with shoulder joint contractures leads to an increase in the efficiency of reconstructive surgery after burn injuries.

Prevalence of joint hypermobility, postural orthostatic tachycardia syndrome (POTS), and orthostatic hypotension in school-children.

Children with joint hypermobility, postural orthostatic tachycardia syndrome, and orthostatic hypotension report autonomic symptoms such as dizziness, nausea, headaches, and palpitations. It is unclear if there is a pathophysiological link between connective tissue disorders and autonomic symptoms. There is no published data on the prevalence of disorder at the community level. To assess the prevalence of joint hypermobility, orthostatic hypotension, and postural or thostatic tachycardia syndrome in children. To determine the relationship bet ween joint hypermobility, orthostatic hypotension, and postural orthostatic tachycardia syndrome. Participants aged 10 to 18 years were selected from public schools in three Colombian cities. The surveys included historical questions on the incidence of dizziness, nausea, headache, tremor, blurred vision, vertigo, anxiety, near syncope and syncope, sweating, palpitations triggered by standing in the two months prior to the investigation. Each of these signs and symptoms was also assessed during the recumbency (10 minutes) and standing (2, 5 and 10 minutes) phases of the investigation. HR and BP measurements were obtained at the same intervals. Joint mobility was measured with a mechanical goniometer and assessed with the Beighton score. Prevalence of joint hyperlaxity: 87 of 306 (28.4%). Prevalence of orthostatic hypotension: 5 of 306 (1.6%). Prevalen ce of postural orthostatic tachycardia syndrome: 6 of 306 (2.0%). Of 87 children with joint hyperlaxi ty, only 1 child had joint hyperlaxity at the same time as postural hypotension (1.2%) (p = 0.6735), and 1 child had joint hyperlaxity and postural orthostatic tachycardia syndrome simultaneously (1.2%) (p = 0.5188). Children with joint hyperlaxity did not have a higher prevalence of postural orthostatic tachycardia syndrome and orthostatic hypotension. It seems unlikely that con nective tissue disorders are responsible for most cases of postural orthostatic tachycardia syndrome and orthostatic hypotension in the community. Of note, the pathophysiology of postural orthostatic tachycardia syndrome and orthostatic hypotension requires further investigation.

Changes and Associations between Cervical Range of Motion, Pain, Temporomandibular Joint Range of Motion and Quality of Life in Individuals with Migraine Applying Physiotherapy: A Pilot Study.

Background and Objectives: The aim of this study was to assess the effects of physiotherapy with aerobic exercise together with temporomandibular joint range of motion exercises (supervised) and physiotherapy with aerobic exercise only (unsupervised), also to review the correlations between neck movements, pain, temporomandibular joint range of motion movements and quality of life in individuals with migraine. Methods: The flexion, extension and lateral flexion of the cervical spine were measured in degrees with a mechanical goniometer and pressure pain thresholds with algometer. Quality of life was assessed with the SF-36 questionnaire and temporomandibular joint range of motion with a centimeter. Results: The study showed statistically significant cervical flexion results in both groups (p < 0.05), masticatory muscle results and temporomandibular joint range of motion between the groups (p < 0.05). A correlation between left upper trapezius muscle pain and cervical lateral flexion was observed in the intervention group. Physical activity correlated with cervical extension, activity limitation due to physical ailments and general health. A correlation between temporomandibular joint and right-side masticatory muscles pain was found. A correlation between upper trapezius muscle pain and left- as well as right-side temporalis muscles were found in the control group. Strong correlations were found between pain and activity limitation due to physical ailments and emotional state. The temporomandibular joint range of motion strongly correlated with activity limitation due to physical ailments. Conclusions: Physiotherapy based on aerobic exercises together with temporomandibular joint exercises was more effective than physiotherapy based on aerobic exercise for decreasing pain, increasing pressure pain thresholds and cervical range of motion.

Assessing the Validity and Reliability of a New Video Goniometer App for Measuring Joint Angles in Adults and Children

ObjectiveTo assess the convergent validity and reliability of joint angle measurements from a new video goniometer iPhone/iPad application separately in adults, older and young children. DesignCross-sectional. SettingChild care and university environments. ParticipantsFifty-four adults (mean ± SD=22.5±4.5y), 20 older children (mean ± SD=10.9±2.2y), 20 younger children (mean ± SD=1.6±0.8y) (N=94). InterventionsAdults and older children performed both standardized static positions and functional activities. Younger children performed only a functional activity protocol. Main Outcome MeasuresJoint angle measurements using the app were validated against a commercially validated two-dimensional goniometric software program. In addition, validity of the app was compared to a standard mechanical goniometer for the measurement of angles drawn on a white board. Intra- and interrater reliability were assessed through independent rescoring of videos. ResultsCorrelations between joint angle estimates obtained from the app and goniometer software or a mechanical goniometer were positive and very strong (r>.900; P<.0001). The intraclass correlation coefficient (ICC) for repeated scoring from the app indicated excellent intra- and interrater reliability (ICC>.900). ConclusionsHigh correlations for repeated measures and comparison to gold standard angle measurement instruments suggest that the new app is a valid and reliable tool for assessing joint angles during functional activity. This tool may provide clinicians an inexpensive yet accurate method for quantification of movements and immediate feedback on range of motion during tasks in a natural environment.

A Mechanical Sensor Designed for Dynamic Joint Angle Measurement.

Background. The measurement of the functional range of motion (FROM) of lower limb joints is an essential parameter for gait analysis especially in evaluating rehabilitation programs. Aim. To develop a simple, reliable, and affordable mechanical goniometer (MGR) for gait analysis, with six-degree freedom to dynamically assess lower limb joint angles. Design. Randomized control trials, in which a new MGR was developed for the measurements of FROM of lower limb joints. Setting. Reliability of the designed MGR was evaluated and validated by a motion analysis system (MAS). Population. Thirty healthy subjects participated in this study. Methods. Reliability and validity of the new MGR were tested by intraclass correlation coefficient (ICC), Bland-Altman plots, and linear correlation analysis. Results. The MGR has good inter- and intrarater reliability and validity with ICC ≥ 0.93 (for both). Moreover, measurements made by MGR and MAS were comparable and repeatable with each other, as confirmed by Bland-Altman plots. Furthermore, a very high degree of linear correlation (R ≥ 0.92 for all joint angle measurements) was found between the lower limb joint angles measured by MGR and MAS. Conclusion. A simple, reliable, and affordable MGR has been designed and developed to aid clinical assessment and treatment evaluation of gait disorders.

The better way to determine the validity, reliability, objectivity and accuracy ofmeasuring devices.

In relation to statistical analysis, studies to determine the validity, reliability, objectivity and precision of new measuring devices are usually incomplete, due in part to using only correlation coefficient and ignoring the data dispersion. The aim of this study was to demonstrate the best way to determine the validity, reliability, objectivity and accuracy of an electro-inclinometer or other measuring devices. Another purpose of this study is to answer the question of whether reliability and objectivity represent accuracy of measuring devices. The validity of an electro-inclinometer was examined by mechanical and geometric methods. The objectivity and reliability of the device was assessed by calculating Cronbach's alpha for repeated measurements by three raters and by measurements on the same person by mechanical goniometer and the electro-inclinometer. Measurements were performed on "hip flexion with the extended knee" and "shoulder abduction with the extended elbow." The raters measured every angle three times within an interval of two hours. The three-way ANOVA was used to determine accuracy. The results of mechanical and geometric analysis showed that validity of the electro-inclinometer was 1.00 and level of error was less than one degree. Objectivity and reliability of electro-inclinometer was 0.999, while objectivity of mechanical goniometer was in the range of 0.802 to 0.966 and the reliability was 0.760 to 0.961. For hip flexion, the difference between raters in joints angle measurement by electro-inclinometer and mechanical goniometer was 1.74 and 16.33 degree (P<0.05), respectively. The differences for shoulder abduction measurement by electro-inclinometer and goniometer were 0.35 and 4.40 degree (P<0.05). Although both the objectivity and reliability are acceptable, the results showed that measurement error was very high in the mechanical goniometer. Therefore, it can be concluded that objectivity and reliability alone cannot determine the accuracy of a device and it is preferable to use other statistical methods to compare and evaluate the accuracy of these two devices.

Goniometer-apps in hand surgery and their applicability in daily clinical practice

Smartphones have become an integral part of our daily lives, and numerous applications (apps) make use of the goniometer, which is comparable to a medical protractor. The aim of this study was to evaluate the availability, reliability and validity of medical apps using the goniometer function in smartphones. Sixteen goniometer-apps downloaded from Apple’s (twelve apps) and Google’s (four apps) app stores matched initial inclusion criteria (inclusion criteria: *gonio* or *rom*, specifically designed to measure angles) were assessed and compared to a universal mechanical goniometer by measuring an irregular, four-sided pyramid with distinct angles. Twelve iOS (Apple’s operating system) and four Android (Google’s operating system) apps were included. Ten of twelve iOS apps were showing an average deviation from the real angles of a maximum 1.8°; the values for Android apps did not exceed 1.3°. Fourteen out of sixteen apps were reliable and valid for measuring angles. Based on correct handling and adequate user-applicability of the on-board goniometer these apps can make a smartphone applicable for data acquisition in medicine. So far, smartphone apps for measuring angles have not been readily applied in clinical practice in hand surgery.

Range of motion and pain intensity of the first metatarsophalangeal joint in women with hallux valgus deformation after two-month home exercise programme

Hallux Valgus (HV) (also Hallux abducto valgus) is a common deformity of the foot, which causes pain, inflammation and decreased joint mobility in the big toe. There are no universally accepted protocols for treating advanced phase HV, corrective surgery seems to be the most common direction of curing advanced HV deformation. The purpose of this study was to assess the effects of two-month home exercise programme (HEP) on joint mobility and pain of the first metatarsophalangeal joint (MTP-joint) in women with advanced phase HV deformation. Seven women with mean age 55.6±2.9 years with advanced phase HV deformation (first MTP-joint angle more than 20 degrees) participated in the study. Foot pain in different conditions was assessed with modified Foot Function Index's (FFI) pain subscale before and after HEP. Passive range of motion (PROM) of flexion and extension of the first MTP-joint was measured before and after HEP using a standard mechanical goniometer. A significant increase (p&lt;0.001) in the passive extension of the first MTP-joint was noted after HEP compared with the joint mobility before HEP, also passive flexion increased considerably but no significant difference was noted (p&gt;0.05). Foot pain score decreased significantly (p&lt;0.05) after HEP. In conclusion, in advanced phase HV two-month HEP was an effective therapeutic approach for increasing first MTP-joint mobility and reducing foot pain.

Étude comparative de l’évaluation clinique de l’angle poplité en décubitus dorsal versus décubitus latéral asymétrique, chez des sujets infirmes moteurs cérébraux et polyhandicapés (paralysés cérébraux)

Clinical assessment of lengthening possibilities of hamstring muscles is of great importance for cerebral palsied patients because of progressive and early diminution and its functional and orthopaedic consequences. Traditionally, a clinical assessment is carried out by measuring the popliteal angle with the patient in supine position and hip flexed at 90°. Nevertheless, for patients with CP, able to understand orders, popliteal angle data can change from one clinician to the other because of varying resistance of the muscles at lengthening. On the other hand, more patients relax spontaneously when lying in a lateral and asymmetrical position with the lower limb examined flexed, than in a supine position. In the case where the relaxed state is insufficient, we can use a specific maneuver in order to relax him more. The aim of this article is to report the results of a study made to compare popliteal angle in supine position versus lateral and asymmetrical position. Throughout the maneuvers, the degrees of contraction of the muscles were recorded by a surface electromyography. Variations of the angles were measured with electrical goniometers and verified, on obtaining the final popliteal angle by a mechanical goniometer. Data obtained at the end of the study with a group of 12 patients from 8 to 15 years old, showed that for all patients the angle is higher in the lateral and asymmetrical position than in the supine position, that is to say between 20° to 40° more. These results contest the choice of the decubitus dorsal position to assess the popliteal angle allowed by intrinsic lengthening possibilities (visco-elasticity) of the hamstring muscles and not active resistances due to muscular contraction from diverse pathological factors.

A low cost wearable optical-based goniometer for human joint monitoring

Widely used in the fields of physical and occupational therapy, goniometers are indispensible when it comes to angular measurement of the human joint. In both fields, there is a need to measure the range of motion associated with various joints and muscle groups. For example, a goniometer may be used to help determine the current status of the range of motion in bend the arm at the elbow, bending the knee, or bending at the waist. The device can help to establish the range of motion at the beginning of the treatment series, and also allow the therapist to monitor progress during subsequent sessions. Most commonly found are the mechanical goniometers which are inexpensive but bulky. As the parts are mechanically linked, accuracy and resolution are largely limited. On the other hand, electronic and optical fiberbased goniometers promise better performance over its mechanical counterpart but due to higher cost and setup requirements does not make it an attractive proposition as well. In this paper, we present a reliable and non-intrusive design of an optical-based goniometer for human joint measurement. This device will allow continuous and longterm monitoring of human joint motion in everyday setting. The proposed device was benchmarked against mechanical goniometer and optical based motion capture system to validate its performance. From the empirical results, it has been proven that this design can be use as a robust and effective wearable joint monitoring device.

A Simple Method for Orienting Conventional Core Using Microresistivity (FMS) Images and a Mechanical Goniometer to Measure Directional Structures on Cores

Orienting core and gathering downhole orientation data, such as paleocurrents or fractures, has always been a challenge in the petroleum industry and academia. Downhole core orientation while drilling is expensive, time consuming, and not always accurate. Nowadays, microresistivity logs are run in many boreholes and can easily be used for orienting conventional core of all sizes and many shapes (whole, slabbed, or plugged). The only requirement is a facies or lithologic change with a sharp contact visible in both core and microresistivity log. Downhole logging tools can thus provide a quick and inexpensive way to orient conventional core. A simple mechanical goniometer can then be used to measure foresets of cross-stratification for paleocurrent analysis. Mechanical goniometers have the advantage of being more robust than their electronic counterparts, and measurement errors are within a reasonable margin. Using this setup, paleocurrents from core were commonly found to be more precise than those generated digitally from microresistivity logs.

A Simple Method for Orienting Conventional Core Using Microresistivity (Fms) Images and a Mechanical Goniometer to Measure Directional Structures on Cores: RESEARCH METHODS PAPERS

ABSTRACT Orienting core and gathering downhole orientation data, such as paleocurrents or fractures, has always been a challenge in the petroleum industry and academia. Downhole core orientation while drilling is expensive, time consuming, and not always accurate. Nowadays, microresistivity logs are run in many boreholes and can easily be used for orienting conventional core of all sizes and many shapes (whole, slabbed, or plugged). The only requirement is a facies or lithologic change with a sharp contact visible in both core and microresistivity log. Downhole logging tools can thus provide a quick and inexpensive way to orient conventional core. A simple mechanical goniometer can then be used to measure foresets of cross-stratification for paleocurrent analysis. Mechanical goniometers have the advantage of being more robust than their electronic counterparts, and measurement errors are within a reasonable margin. Using this setup, paleocurrents from core were commonly found to be more precise than those generated digitally from microresistivity logs.

Comparison of Visual Estimation and Goniometry in Determination of a Shoulder Joint Angle

<h2>Summary</h2> This study compared the performance of two groups of physiotherapists (practised and non-practised) who used visual estimation and three types of standard goniometer to measure the angle of a shoulder joint of a model whose right arm was fully extended and elevated in flexion to a fixed neutral position (taken to be 100°). Analysis of variance showed that there were no differences in performance either between the criterion groups or among the four measurement methods. There were no significant interactions. The grand mean value recorded was 103.60° (range 101.60° to 105.00°). It was concluded that physiotherapy training in goniometry, which includes the use of both a measuring tool and standard reference system for the human body, provides an organising schema for visual estimation. Coupled with experience and practice, this permits therapists to obtain joint measurements of the shoulder that can be as accurate as those obtained with a mechanical goniometer. The suggestion is advanced that, for highly skilled therapists, visual estimation is the more valid technique and the goniometer may be redundant.

Oriented Core: Its Use, Error, and Uncertainty

Error analysis of oriented-core data indicates that: (1) the error in the coring and surveying procedure is ± 5°; (2) the error inherent to the mechanical goniometer is ± 2 3/4°; (3) the reproducibility error in using the goniometer is ± 2° for one analyst and ± 4° for multiple analysts; and (4) the uncertainty in interpolating and manipulating sets of orientation data may be quite large. Overall error in oriented core procedures should be considered ± 11°. A simple set of guidelines can be used to determine the most accurately oriented zones within the core. The guidelines are based on the physical character of the core, orientation scribes, and patterns displayed by plotting the azimuth of the orientation groove versus depth. Approximately 26% of oriented core analyzed fits the guidelines of most accurately oriented core.

Considerations in the Design of Goniometers for Use in X-Ray Powder Diffractometers

AbstractMost modern X-ray powder diffraction work is carried out using the parafocusing powder diffractometer. The typical instrument employs a mechanical goniometer to control the basic geometric movements required for recording diffraction data. Modern trends toward high speed data acquisition and computerized analytical procedures make the need for a well designed and well maintained goniometer system increasingly critical. This paper reviews the mechanical design parameters of typical goniometer systems in light of their influence on the accuracy and precision obtainable in diffraction data. Data on typical vertical and horizontal goniometer systems are compared, along with bench tests using a state of the art “anti-backlash” gearing system. By examining the nature of the errors typically encountered in today's goniometers it becomes evident why the next major improvement will likely be in software rather than hardware.

Image Frequency Rejection in a Radio Direction Finder

An analysis is given of the bearing error in a radio direction finder due to simultaneous reception of two signals, referred to as target and spurious signals. The carrier frequency of the spurious signal is assumed to be the image of the target-signal frequency around the local-oscillator frequency, so that both signals are passed by the IF amplifier of the direction-finder receiver. The analysis applies to any DF receiver having a carrier-suppressed double-sideband input, such as is obtained using a mechanical or electronic goniometer. The results can serve as a basis for specifying the image rejection requirements on the RF amplifier of the receiver. In particular, it is shown that in order to have less than one degree of error, the spurious signal must be attenuated to at least 35 db below the target signal amplitude at the RF output of the receiver.