Lower extremity range of motion and alignment: A reliability and concurrent validity study of goniometric and three-dimensional motion analysis measurement

Viktor Ore, Salmir Nasic, Jacques Riad, Viktor Ore, Salmir Nasic, Jacques Riad

Abstract

Background: Knowing correlations between passive goniometric and dynamic three-dimensional motion analysis measurements of lower extremity range of motion and alignment would benefit knee injury risk assessment.

Purpose: To investigate reliability and concurrent validity of lower extremity assessment with goniometry and three-dimensional motion analysis.

Methods: Thirty-eight participants (76 limbs) were examined in standardized positions by two physiotherapists with simultaneous goniometric and three-dimensional motion analysis measurements of passive range of motion and alignment. Intra-class correlation coefficient (ICC) and median differences were calculated.

Results: Hip rotation reliability, ICC 0.74-0.89 and validity 0.74-0.94. Tibial rotation reliability, ICC 0.24-0.75 and validity 0.08-0.61. Knee extension reliability, ICC 0.44-0.73 and validity 0.22-0.60. Knee valgus/varus reliability, ICC 0.36-0.68 and validity 0.25-0.62. Tibial torsion reliability, ICC 0.52-0.77 and validity 0.58-0.81. Ankle dorsiflexion reliability, ICC 0.12-0.73 and validity 0.51-0.83. Median differences in reliability and validity ranged from -2.0° to 3.0° and from -6.6° to 7.5° respectively.

Conclusion: Goniometric and three-dimensional motion analysis methods define the lower body segments differently making some degree of discrepancy in the measurements inevitable. Nevertheless, the variables chosen in this study are all strongly associated with anterior cruciate ligament rupture and some may prove useful to identify individuals at risk of knee injury during sport activities.

Study design: Cross-sectional laboratory study.

Keywords: Anatomy; Anterior cruciate ligament rupture; Clinical research; Concurrent validity; Diagnostics; Goniometer; Health promotion; Health technology; Knee injury; Rehabilitation; Reliability; Three-dimensional motion analysis.

© 2020 The Authors.

Figures

Figure 1
Figure 1
A: Assessment with goniometer and marker-based three-dimensional motion analysis of hip external rotation with extended hip in the concurrent validity study. B: Graph from the three-dimensional motion analysis of hip external rotation with extended hip. Motion (degrees) on the y-axis and test duration (percent) on the x-axis. In this case the resting angle is around zero and then at about 55% of the test duration, the hip is moved into external rotation, at around 30°.
Figure 2
Figure 2
A: Assessment with goniometer and marker-based three-dimensional motion analysis of ankle dorsiflexion with extended knee in concurrent validity study. B: Graph from the three-dimensional motion analysis of ankle dorsiflexion with extended knee. Motion in degrees on the y-axis and test duration on the x-axis. In this case the resting angle is around 18° plantar flexion and then at about 45% of the test duration the ankle is moved into dorsiflexion to a maximum of around 12°.
Figure 3
Figure 3
Goniometer and marker-based three-dimensional motion analysis assessment of tibial torsion. The markers on the medial and lateral malleolus are visualized for the acquisition of the bi-malleolar angle, which is calculated in relation to the knee axis.

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