title: The reliability and measurement error of protractor-based goniometry of the fingers: A systematic review.
abstract: METHODS
  Systematic review PURPOSE OF THE STUDY: The purpose was to review the available literature for evidence on the reliability and measurement error of protractor-based goniometry assessment of the finger joints.
  
  
  METHODS
  Databases were searched for articles with key words "hand," "goniometry," "reliability," and derivatives of these terms. Assessment of the methodological quality was carried out using the Consensus-Based Standards for the Selection of Health Measurement Instruments checklist. Two independent reviewers performed a best evidence synthesis based on criteria proposed by Terwee et al (2007).
  
  
  RESULTS
  Fifteen articles were included. One article was of fair methodological quality, and 14 articles were of poor methodological quality. An acceptable level for reliability (intraclass correlation coefficient > 0.70 or Pearson's correlation > 0.80) was reported in 1 study of fair methodological quality and in 8 articles of low methodological quality. Because the minimal important change was not calculated in the articles, there was an unknown level of evidence for the measurement error.
  
  
  CONCLUSIONS
  Further research with adequate sample sizes should focus on reference outcomes for different patient groups. For valid therapy evaluation, it is important to know if the change in range of motion reflects a real change of the patient or if this is due to the measurement error of the goniometer. Until now, there is insufficient evidence to establish this cut-off point (the smallest detectable change).
  
  
  CONCLUSIONS
  Following the Consensus-Based Standards for the Selection of Health Measurement Instruments criteria, there was limited level of evidence for an acceptable reliability in the dorsal measurement method and unknown level of evidence for the measurement error.
  
  
  METHODS
  2a.
authors.affiliation: Handtherapie Nederland, Utrecht, The Netherlands. Electronic address: y.vankooij@handencentrum.nl.
authors.forename: Yara E
authors.initials: YE
authors.lastname: van Kooij
authors.affiliation: Handtherapie Nederland, Utrecht, The Netherlands.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Fink
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands.
authors.forename: Maria W
authors.initials: MW
authors.lastname: Nijhuis-van der Sanden
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands; Physical Therapy Science, University Medical Center Utrecht, Program in Clinical Health Sciences, Utrecht, The Netherlands; Department of Oral-Maxillofacial Surgery, University Medical Center Utrecht, Prosthodontics and Special Dental Care, Utrecht, The Netherlands.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Speksnijder
mesh_terms: D053587:Arthrometry, Articular / Q000379:methods*; D005260:Female; D005384:Finger Joint / Q000503:physiopathology*; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis* / Q000534:rehabilitation*; D008297:Male; D016059:Range of Motion, Articular / Q000502:physiology; D015203:Reproducibility of Results; D012720:Severity of Illness Index
keywords: Finger; Goniometry; Measurement error; Range of motion; Reliability