Reliability and clinical utility of telehealth-based goniometry to measure digit range of motion

Emiliana Guerra, Lisa Licciardi, Penny van Veenendaal, Luke Robinson

Research output: Contribution to journalMeeting Abstractpeer-review


Introduction: Telehealth usage surged as consumers and clinicians sought to safely access and deliver hand therapy services during the COVID-19 pandemic. To date, there is no reliable method to measure digit range of motion during a teleconsultation.
Objective: This study aimed to investigate manual goniometry’s reliability and clinical utility for measuring digit range of motion during a teleconsultation.
Method: Following a test–retest protocol, 12 independent raters (who currently provide hand therapy services) each obtained 12 screen-based goniometric range of motion measurements of the fifth digit. Four pre-recorded videos of an unaffected fifth digit were distributed at two-time points via a web-based survey. Raters evaluated the clinical utility of the method using a Likert-scale and freetext format. Analysis of test–retest and inter-rater reliability involved measures of relative and absolute reliability. Free-text responses were analysed using content analysis.
Results: Inter-rater reliability was excellent for flexion and extension measures (ICC ≥ 0.888) but poor for arc of motion (ICC ≤ 0.667). Test–retest reliability was poor (ICC ≤ 0.433). No statistically significant differences between test and retest measurements were observed (p ≥ 0.24). The overall coefficient of variation indicated good precision (14.69%). Measurement error (≤ 6.07) and limits of agreement (≤ 6.33) had acceptable levels to support clinical use. Content analysis revealed several practical considerations.
Conclusion: This study suggests that manual goniometry is unreliable for measuring digit range of motion during a teleconsultation. Patient-reported and functional outcomes should be used with range of motion assessment in virtual hand therapy practice for a true indication of client outcomes.
Original languageEnglish
Pages (from-to)158
Number of pages1
JournalAustralian Occupational Therapy Journal
Issue numberS1
Publication statusPublished - Jun 2023
EventOccupational Therapy Australia National Conference and Exhibition 2023 - Cairns, Australia
Duration: 21 Jun 202323 Jun 2023
Conference number: 30th

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