title: Comparative analysis of photograph-based clinical goniometry to standard techniques.
abstract: BACKGROUND
  Assessment of joint range of motion (ROM) is an accepted evaluation of disability as well as an indicator of recovery from musculoskeletal injuries. Many goniometric techniques have been described to measure ROM, with variable validity due to inter-rater reliability. In this report, we assessed the validity of photograph-based goniometry in measurement of ROM and its inter-rater reliability and compared it to two other commonly used techniques.
  
  
  METHODS
  We examined three methods for measuring ROM in the upper extremity: manual goniometry (MG), visual estimations (VE), and photograph-based goniometry (PBG). Eight motions of the upper extremity were measured in 69 participants at an academic medical center.
  
  
  RESULTS
  We found visual estimations and photograph-based goniometry to be clinically valid when tested against manual goniometry (r avg. 0.58, range 0.28 to 0.87). Photograph-based measurements afforded a satisfactory degree of inter-rater reliability (ICC avg. 0.77, range 0.28 to 0.96).
  
  
  CONCLUSIONS
  Our study supports photograph-based goniometry as the new standard goniometric technique, as it has been clinically validated, is performed with greater consistency and better inter-rater reliability when compared with manual goniometry. It also allows for better documentation of measurements and potential incorporation into medical records in direct contrast to visual estimation.
authors.affiliation: College of Medicine, The Ohio State University, Columbus, OH 43210 USA.
authors.forename: Jared A
authors.initials: JA
authors.lastname: Crasto
authors.affiliation: Department of Orthopedics, Division of Hand and Upper Extremity Surgery, University of Miami Miller School of Medicine, Miami, FL 33136 USA.
authors.forename: Arash J
authors.initials: AJ
authors.lastname: Sayari
authors.affiliation: Department of Orthopedics, Division of Hand and Upper Extremity Surgery, University of Miami Miller School of Medicine, Miami, FL 33136 USA.
authors.forename: Robert R-L
authors.initials: RR
authors.lastname: Gray
authors.affiliation: Department of Orthopedics, Division of Hand and Upper Extremity Surgery, University of Miami Miller School of Medicine, Miami, FL 33136 USA ; Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Miami Miller School of Medicine, 1120 NW 14th St., Clinical Research Building, Rm 410F, Miami, FL 33136 USA.
authors.forename: Morad
authors.initials: M
authors.lastname: Askari
keywords: Goniometry; Photograph; Range of motion; Visual estimation