Test-retest reproducibility of elbow goniometric measurements in a rigid double-blinded protocol: intervals for distinguishing between measurement error and clinical change.

B. Cleffken*, G. van Breukelen, H. van Mameren, P. Brink, S. Olde Damink

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Increasingly, goniometry of elbow motion is used for qualification of research results. Expression of reliability is in parameters not suitable for comparison of results. We modified Bland and Altman's method, resulting in the smallest detectable differences (SDDs). Two raters measured elbow excursions in 42 individuals (144 ratings per test person) with an electronic digital inclinometer in a classical test-retest crossover study design. The SDDs were 0 +/- 4.2 degrees for active extension; 0 +/- 8.2 degrees for active flexion, both without upper arm fixation; 0 +/- 6.3 degrees for active extension; 0 +/- 5.7 degrees for active flexion; 0 +/- 7.4 degrees for passive flexion with upper arm fixation; 0 +/- 10.1 degrees for active flexion with upper arm retroflexion; and 0 +/- 8.5 degrees and 0 +/- 10.8 degrees for active and passive range of motion. Differences smaller than these SDDs found in clinical or research settings are attributable to measurement error and do not indicate improvement.

Original languageEnglish
Pages (from-to)788-794
JournalJournal of Shoulder and Elbow Surgery
Issue number6
Publication statusPublished - 1 Jan 2007

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