Reliability and validity varies among smartphone apps for range of motion measurements of the lower extremity: a systematic review

Abstract

The aim of this review was to determine whether smartphone applications are reliable and valid to measure range of motion (RoM) in lower extremity joints. A literature search was performed up to October 2020 in the databases PubMed and Cochrane Library. Studies that reported reliability or validity of smartphone applications for RoM measurements were included. The study quality was assessed with the QUADAS-2 tool and baseline information, validity and reliability were extracted. Twenty-five studies were included in the review. Eighteen studies examined knee RoM, whereof two apps were analysed as having good to excellent reliability and validity for knee flexion ("DrGoniometer", "Angle") and one app showed good results for knee extension ("DrGoniometer"). Eight studies analysed ankle RoM. One of these apps showed good intra-rater reliability and excellent validity for dorsiflexion RoM ("iHandy level"), another app showed excellent reliability and moderate validity for plantarflexion RoM ("Coach's Eye"). All other apps concerning lower extremity RoM had either insufficient results, lacked study quality or were no longer available. Some apps are reliable and valid to measure RoM in the knee and ankle joint. No app can be recommended for hip RoM measurement without restrictions.

Keywords: lower limb; mobile application; range of motion; reliability; smartphone; validity.