Reliability of range-of-motion measurement in the elbow and forearm

April Armstrong, Joy C. MacDermid, Shrikant Chinchalkar, Rob S. Stevens, Graham J.W. King

Research output: Contribution to journalArticlepeer-review

173 Scopus citations


The purpose of this study was to examine intratester, intertester, and interdevice reliability of range of motion measurements of the elbow and forearm. Elbow flexion and extension and forearm pronation and supination were measured on 38 subjects with elbow, forearm, or wrist disease by 5 testers. Standardized test methods and a randomized order of testing were used to test groups of patients with universal standard goniometers, a computerized goniometer, and a mechanical rotation measuring device. Intratester reliability was high for all 3 measuring devices. Meaningful changes in intratester range of motion measurements taken with a universal goniometer occur with 95% confidence if they are greater than 6° for flexion, 7° for extension, 8° for pronation, and 8° for supination. Intertester reliability was high for flexion and extension measurements with the computerized goniometer and moderate for flexion and extension measurements with the universal goniometer. Meaningful change in interobserver range of motion measurements was expected if the change was greater than 4° for flexion and 6° for extension with the computerized goniometer compared with 10° and 10°, respectively, if the universal goniometer was used. Intertester reliability was high for pronation and supination with all 3 devices. Meaningful change in forearm rotation is characterized by a minimum of 70° for pronation and 11° for supination with the universal goniometer. Reliable measurements of elbow and forearm arm movement are obtainable regardless of the level of experience when standardized methods are used. Measurement error was least for repeated measurements taken by the same tester with the same instrument and most when different instruments were used.

Original languageEnglish (US)
Pages (from-to)573-580
Number of pages8
JournalJournal of Shoulder and Elbow Surgery
Issue number6
StatePublished - 1998

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine


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