Smartphone Applications as a Suitable Alternative to CROM Device and Inclinometers in Assessing the Cervical Range of Motion in Patients With Nonspecific Neck Pain

Abstract

Objective: The purpose of this study was to compare the reliabilities of the cervical range-of-motion (CROM) device and a dual digital inclinometer (as accepted clinical tools) and iPhone or Android smartphone applications (clinometer and compass; as new technologies) in measuring cervical range of motion in patients with neck pain.

Methods: Twenty participants (13 women, 7 men; age 19-33 years) with neck pain persisting for at least 4 weeks were enrolled. Neck movements were measured in each participant using 4 noninvasive devices in random order.

Results: The CROM device showed excellent intra- and interrater reliabilities in assessing cervical range of motion except in right rotation for which it showed moderate intrarater reliability. The dual digital inclinometer demonstrated moderate to excellent intra- and interrater reliabilities. Cervical range of motion measurements using iPhone applications showed good to excellent intra- and interrater reliabilities, whereas Android applications had poor to excellent intra- and interrater reliabilities. Based on the validity results, all assessment tools differed from the CROM device depending on the direction of movement, although the iPhone applications showed fewer differences than the other 2 devices.

Conclusion: Generally, the CROM device showed the highest reproducibility, and iPhone applications showed more acceptable intra- and interrater reliabilities than the digital inclinometer and Android applications. The clinometer application of smartphones could be reliable in measuring frontal and sagittal cervical range of motion in patients with neck pain and in a sitting position. However, the compass application of the iPhone showed acceptable results, whereas that of the Android device could not be recommended for clinical use.

Keywords: Articular; Health Care; Neck Pain; Outcome and Process Assessment; Range of Motion; Reproducibility of Results; Smartphone.

© 2020 by National University of Health Sciences.

Figures

Fig 1

Cervical range of motions measurement in sagittal plane using dual digital inclinometer. Two sensors were used to assess flexion and extension range of motion in 3 trials as the subject was sitting on the chair.

Fig 2

Assessing cervical range of motions in frontal plane by Android clinometer application. The examiner placed the smartphone and asked the subject to lateral flex to right and left.

Fig 3

Measurement of cervical rotation with CROM device while the rotation arm of CROM device was added to the devic, and the magnetic yoke was placed on subject's shoulder for calibration. CROM, cervical range-of-motion.

Fig 4

Measurement of cervical rotation to right and left were performed as the subject was supine according to inclinometer's catalogue and using just the primary sensor.

Fig 5

Assessing horizontal plane of cervical range of motion by smartphone compass application.