Goniometry and linear assessments to monitor movement outcomes: Are they reliable tools in burn survivors?

BackgroundDespite common use and theoretical construct validity, goniometry is not reported to be reliable for the measurement of burn-affected joint range of motion. Similarly, a number of simple objective measures commonly used to document hand mobility have eluded this rigour.This study aimed to examine the within sessions of intra-rater and inter-rater reliability of active joint range of motion measurement in patients with burns.MethodsIntra-rater reliability: One physical therapist (PT) recorded duplicate measurements on each burn-affected joint after a 5-min interval in a subset of patients (n = 21). Inter-rater reliability: Four qualified PTs took part in repeated measures testing of 45 patients on the same day.ResultsIntra-rater reliability was excellent with intraclass correlation coefficients (ICCs > .99) and 95% confidence intervals (CIs) = .99–1.0. Inter-rater reliability was also excellent with ICCs > .94 (95% CIs = .90–.99). The minimum detectable change using goniometry at the ankle was ≥5° and for all other joints tested was ≥9°. For linear hand measures a change of >1 cm and thumb opposition ≥1/2 of one scale point indicated measurable difference.ConclusionThis study demonstrated excellent intra-rater and inter-rater reliability and measurement of clinically relevant change for all measurements when applied with a standardised protocol. Therefore, assessing joint range of motion (ROM) with a goniometer or hand movement with linear or scale measurements can provide accurate, objective measures in the burns population.