Reliability of range-of-motion measurement in the elbow and forearm

The purpose of this study was to examine intratester, intertester, and inte rdevice reliability of range of motion measurements of the elbow and forear m. Elbow flexion and extension and Forearm pronation and supination were me asured on 38 subjects with elbow, forearm, or wrist disease by 5 testers. S tandardized test methods and a randomized order of testing were used to tes t groups of patients with universal standard goniometers, a computerized go niometer, and a mechanical rotation measuring device. Intratester reliabili ty was high for all 3 measuring devices. Meaningful changes in intratester range of motion measurements taken with a universal goniometer occur with 9 5% confidence if they are greater than 6 degrees for flexion, 7 degrees for extension, 8 degrees for pronation, and 8 degrees for supination. Intertes ter reliability was high for flexion and extension measurements with the co mputerized goniometer and moderate for flexion and extension measurements w ith the universal goniometer. Meaningful change in interobserver range of m otion measurements was expected if the change was greater than 4 degrees fo r flexion and 6 degrees For extension with the computerized goniometer comp ared with 10 degrees and 10 degrees respectively, if the universal goniomet er was used. Intertester reliability was high For pronation and supination with all 3 devices. Meaningful change in forearm rotation is characterized by a minimum of 10 degrees for pronation and 11 degrees for supination with the universal goniometer Reliable measurements of elbow and Forearm arm mo vement are obtainable regardless of the level of experience when standardiz ed methods are used. Measurement error was least For repeated measurements taken by the same tester with the same instrument and most when different i nstruments were used.