Reliability and Validity of Electro-Goniometric Range of Motion Measurements in Patients with Hand and Wrist Limitations

Siamak Bashardoust Tajali1, 4, *, Joy C. MacDermid1, 2, Ruby Grewal1, 3, Chris Young2
1 Department of Health and Rehabilitation (Physical Therapy), The University of Western Ontario, London, Ontario, Canada
2 Hand and Upper Limb Centre, Clinical Research Laboratory, St Joseph's Health Centre, London, Ontario, Canada
3 Hand and Upper Limb Centre, Department of Surgery, St. Joseph's Health Centre, London, Ontario, Canada
4 Department of Physical Therapy, Tehran University of Medical Sciences, Tehran, Iran

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Creative Commons License
© Bashardoust Tajali et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Hand and Upper Limb Centre, Clinical Research Lab, St. Joseph's Health Centre, 930 Richmond Street, London, Ontario N6A 4V2, Canada; Tel: (519) 646-6100; Ext 61852; Fax: (519) 646-6049; E-mail:


Study Design:

Cross-sectional reliability and validity study.


1. To determine intrarater, interrater and inter instrument reliabilities and validity of two digital electro goniometry to measure active wrist/finger range of motions (ROMs) in patients with limited motion. 2. To determine intrarater and interrater reliabilities of digital goniometry to measure torques of PIP passive flexion of the index finger in patients with limited motion.


The study was designed in a randomized block plan on 44 patients (24 women, 20 men) with limited wrist or hand motions. Two experienced raters measured active wrist ROMs, and active and passive index PIP flexion using two digital goniometers. All measures were repeated by one rater 2-5 days after the initial measurements. The reliability measures were analyzed using Intraclass Correlation Coefficients (ICCs) and the construct validity was determined by correlation coefficients analysis between sub measures of scores; patient rated pain and function (PRWE) and quick Disabilities of the Arm, Shoulder and Hand (quick DASH) scores.


The intrarater, interrater and inter instrument reliabilities were high in most ROM measures (range 0.64-0.97) for both types of electro-goniometers. The 95% limit of agreements and Bland and Altman plots did not show progressive changes. There was a significant difference in force application between the raters when performing passive ROM measures for PIP index, but the same rater produced consistent force. Most of the NK and J-Tech ROM measures were moderately correlated with the patient rated pain and function scores (range 0.32-0.63).

Keywords: Digital goniometry, Hand, Range of Motion, Reliability, Validity, Wrist.