Reliability and Validity of Measurement Using Smartphone - Based Goniometer of Tibial External Rotation Angle in Standing Knee Flexion

The purpose of this study was to assess the intra-rater test-retest reliability of tibial external rotation angle measurement using a smartphone-based photographic goniometer, DrGoniometer (DrG) compared to a three-dimensional motion analysis system (Vicon). The current study showed an interchangeable method using DrG to measure the tibial external rotation angle in standing knee flexion at 9°. Twelve healthy subjects participated in this study. A rest session was conducted 30 minutes later for within-day reliability and five days later for between-day intra-rater test-retest reliability. To assess the validity of the measurement using DrG, we used a three dimensional motion analysis system as a gold standard to measure the angle of tibial external rotation. Intra-class correlation coefficient (ICC) and the standard error of measurement (SEM) values were used to determine the within-and between-day intra-rater test-retest reliability of using DrG and a three dimensional motion analysis system. To assess validity, Pearson correlation coefficients were used for two measurement techniques. The measurement for tibial external rotation had high intra-rater test-retest reliability of within-day (ICC=.88) and between-day (ICC=.83) reliability using DrG and of within-day (ICC=.93) and between-day (ICC=.77) reliability using a three-dimentional motion analysis system. Tibial external rotation angle measurement using DrG was highly correlated with those of the three-dimensional motion analysis system (r=.86). These results represented that the tibial external rotation angle measurement using DrG showed acceptable reliability and validity compared with the use of three-dimensional motion analysis system.