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.

Background: Numerous studies have used smartphone applications to measure the range of motion in different joints. In addition, studies measuring the active range of motion (AROM) of the craniocervical joint have revealed high reliability. However, the subjects in these studies were all healthy subjects. No study has yet been conducted to measure the inter-rater reliability for the AROM of the craniocervical joint in stroke patients. Objects: The purpose of this study was to investigate the inter-rater reliability of the AROM of the craniocervical joint using a smartphone. Methods: The participants included 21 subjects who had strokes (17 males and 4 females). Two raters evaluated six types of craniocervical AROM, including flexion, extension, lateral flexion to the hemiplegic side, lateral flexion to the non-hemiplegic side, rotation to the hemiplegic side, and rotation to the non-hemiplegic side, using a goniometer and a smartphone to investigate inter-rater reliability. The inter-rater reliability was analyzed by intraclass correlation coefficients (ICC). Results: The inter-rater reliability of the smartphone was good for extension, lateral flexion to the hemiplegic side, lateral flexion to the non-hemiplegic side, and rotation to the hemiplegic side [ICC(2,k)=.86∼.88] and excellent for flexion [ICC(2,k)=.95]. The inter-rater reliability for rotation to the non-hemiplegic side was moderate [ICC(2,k)=.72]. Conclusion: These results suggest that the smartphone offers high inter-rater reliability for measurements of the craniocervical AROM in patients with stroke.

The purpose of this study were to determine the intra-rater and inter-rater reliability of shoulder passive range of motion measurement using the “Clinometer + bubble level”, a smartphone application and to compare with the intra-rater and inter-rater reliability of measurement using a goniometer. Twenty six patients with stroke were recruited for this study. Two raters measured the passive range of motion of four types of shoulder movements (forward flexion; FF, abduction; ABD, external rotation at 90° abduction; ER90 and internal rotation at 90° abduction; IR90) using a goniometer and a smartphone to determine within-day inter-rater reliability. A retest session was performed thirty minutes later to determine within-day intra-rater reliability. The reliability was assessed using intraclass correlation coefficients (ICC) and the standard error of measurement (SEM). The ICC (2,1) for the inter-rater reliabilities of the goniometer and smartphone were good in FF and ABD [ICC (2,1)=.75∼.87] and excellent in ER90 [ICC (2,1)=.90∼.95]. The intra-rater reliabilities for the goniometer and smartphone were good or more than good, with an ICC (3,1) value >.75, the exception was IR90 measured by rater 2 on the smartphone. These results suggest that smartphone could be used as an alternative method tool for measurement of passive shoulder range of motion in patients with stroke.