The study, from researchers at the University of Virginia Health Systems, tested the Clinometer app as a replacement for the goniometer tool. A goniometer tool is the clinical and research “gold standard” in evaluating the range of motion for patients’ joints. Similar to a protractor, the two arms of the goniometer are placed in the same orientation to the two axis of the tested joint to determine range of motion through flexion and extension or adduction and abduction.
Accurate measurements are important for proper patient evaluation and for monitoring improvement after treatment. Similar to the reflex hammer, the goniometer is one of the oldest tools used in the history of medicine. It has been essentially unchanged for hundreds of years. That is, until the development of a mobile app goniometer.
Werner et al., studied 24 healthy undergraduate students and 15 symptomatic post-operative patients’ shoulder range of motion. Five examiners compared the range of motion using visual inspection, a clinical goniometer, and the Clinometer app. They found that the Clinometer app had excellent interobserver agreement for healthy and symptomatic patients.
There are several additional advantages of an app in this case. First, it’s an incredibly low cost tool at only $0.99 and the app is easily accessible and easy to use in clinic. Physicians may not always have a traditional goniometer with them in clinic, but they are likely to have their mobile phone with them in the exam room.
The goniometer can be a bulky and awkward tool to carry around in a white coat. I own several goniometers, however when I need one in a clinical setting they are usually not available or hard to find. With this app, I no longer need to worry about carrying a goniometer with me to see patients. Interestingly, the article also found visual inspection (which is the most common method used in clinic) had the lowest mean interobserver reliability.
This app, and the associated research study, validate the role that simple yet elegant mobile apps can play in improving patient care. The research team identified an important and common aspect of patient care that could be improved with mobile technology. We look forward to similar apps in the near future.