Reliability of goniometric measurements and visual estimates of knee range of motion obtained in a clinical setting

The purpose of this study was to examine the intratester and intertester reliability for goniometric measurements of knee flexion and extension passive range of motion (PROM). In addition, parallel-forms reliability for PROM measurements of the knee obtained by use of a goniometer and by visual estimation was examined. The intertester reliability for visual estimates of the PROM of the knee was also examined. Repeated measurements were obtained on 43 patients in a clinical setting. The intraclass correlation coefficients (ICCs) for intratester reliability of measurements obtained with a goniometer were .99 for flexion and .98 for extension. Intertester reliability for measurements obtained with a goniometer was .90 for flexion and .86 for extension. The ICCs for parallel-forms reliability for measurements obtained with a goniometer and by visual estimation ranged from .82 to .94. The intertester reliability for measurements obtained by visual estimation was .83 for flexion and .82 for extension. Results suggest clinicians should use a goniometer to take repeated PROM measurements of a patient's knee to minimize the error associated with these measurements.