Keywords: Goniometry;Remote consultation/telemedicine;Hand therapy Purpose: Measurement of finger and hand joint range of motion is a core part of hand therapy assessment with protocols for reliable assessment, and well-established intra- and inter-rater reliability to guide appropriate interpretation. The rapid shift to adoption of video consultations in March 2020, due to COVID restrictions, necessitated a shift in assessment and treatment approaches across many branches of healthcare and brought the challenge of how to effectively deliver assessment and interventions remotely. While goniometry over video had been shown to be reliable for assessment of other joints, there was no literature testing the reliability of measurement of finger range using goniometry performed over video. We sought to evaluate the reliability of using on-screen goniometry for the measurement of finger range to determine the value of using this as an outcome measure and inform clinical practice. Methods: One hundred and thirty-three pairs of measurements (in-person, and over video) were collected, including measures of extension and flexion at each finger joint. Pairs of measurements were compared and Pearson's correlation coefficients (r) and Coefficient of Reproducibility (CR) were calculated on the difference between each pair. Results: Across all pairs of measurements r = 0.98 showing a very high degree of agreement between measurements taken face to face or over video. The reproducibility coefficient (CR), indicating a smallest accurately detectable change, was 11.8ʹ. Conclusion(s): These findings suggest that while measuring finger range over video introduces an additional element of variability compared to measuring face to face (likely due to additional difficulty of standardising orientation of the hand relative to the screen) it appears only marginally less consistent than the accepted inter-rater reliability for standard finger goniometry (7–9ʹ). We find that this data supports the use of goniometry as a standard part of hand therapy assessment in video consultations, but recommend that care is taken to reduce variability as far as possible (by maintaining therapist continuity, standardising position and measurement protocol), and interpret findings appropriately for the reliability of this measurement. Impact: Improved understanding of the reliability of goniometry during remote consultations allows effective assessment and interpretation of findings – strengthening reliability of assessment measures and improving remote assessment and treatment. Funding acknowledgements: None.
Evaluating the reliability of goniometry for assessment of finger range of motion during video consultations