Goniometric Measurement of Wrist and Forearm Active Joint Position Sense: Test–Retest Reliability and Measurement Error

Abstract

Objective: This study aimed to examine the test-retest reliability and measurement error of goniometric assessment of wrist and forearm active joint position sense in healthy young adults.

Method: Twenty-eight healthy young adults participated. Wrist flexion, extension, radial deviation, and ulnar deviation were assessed bilaterally with a universal goniometer; forearm pronation and supination with a plumb-line goniometer. Participants reproduced each target angle three times without visual feedback; mean absolute angle errors were analyzed. The same assessor repeated measurements after one week. Relative reliability was evaluated with intraclass correlation coefficients; absolute error with standard errors of measurement, minimal detectable changes at the 95% confidence level, mean bias, and Bland–Altman 95% limits of agreement.

Results: Intraclass correlation coefficients ranged from 0.690 to 0.913. Point estimates indicated moderate-to-excellent reliability, but lower 95% confidence limits fell within the poor range for dominant radial deviation, nondominant pronation, and nondominant ulnar deviation. Standard errors of measurement ranged from 0.33° to 0.96°, and minimal detectable changes from 0.93° to 2.66°. Mean biases ranged from −0.02° to 0.06°; all 95% confidence intervals included zero. Limits of agreement differed in width by movement and side.

Conclusion: Goniometric assessment appears generally reliable for repeated wrist and forearm active joint position sense measurement in healthy young adults. Variation across movements and sides, however, indicates measurements should not be interpreted using a single common threshold. Movement-specific minimal detectable change values should guide determination of true change during individual follow-up.

 

Keywords

• Proprioception
• wrist joint
• forearm
• arthrometry
• reproducibility of results.

Supporting Institution

This research was conducted within the scope of the TÜBİTAK 2209-A project.

Ethical Statement

Approval was obtained from an independent ethics committee before the study [İzmir Katip Çelebi University Health Research Institutional Review Board, date: 16.01.2025, decision no.: 0009]

Thanks

We thank all participants who took part in this study and the İzmir Katip Çelebi University, Department of Health, Culture, and Sports for supporting the study by providing access to its facilities and appropriate conditions for conducting the research. We thank TÜBİTAK for its support.

El Bileği ve Önkol Aktif Eklem Pozisyon Hissinin Gonyometrik Ölçümü: Test–Tekrar Test Güvenirliği ve Ölçüm Hatası

Abstract

Amaç: Bu çalışmanın amacı sağlıklı genç yetişkinlerde el bileği ve önkol aktif eklem pozisyon hissinin gonyometrik değerlendirilmesine ilişkin test–tekrar test güvenirliği ve ölçüm hatasını incelemektir.

Yöntem: Çalışmaya 28 sağlıklı genç yetişkin katıldı. El bileği fleksiyonu, ekstansiyonu, radyal deviasyonu ve ulnar deviasyonu evrensel gonyometreyle; önkol pronasyonu ve supinasyonu ise çekül hatlı gonyometreyle her iki tarafta değerlendirildi. Katılımcılar her hedef açıyı görsel geri bildirim olmadan üç kez yeniden oluşturdu; ortalama mutlak açı hataları analiz edildi. Ölçümler bir hafta sonra aynı değerlendirici tarafından tekrarlandı. Göreli güvenirlik sınıf içi korelasyon katsayılarıyla; mutlak hata ise standart ölçüm hataları, %95 güven düzeyindeki minimal saptanabilir değişimler, ortalama yanlılık ve Bland–Altman %95 uyum sınırlarıyla değerlendirildi.

Bulgular: Sınıf içi korelasyon katsayıları 0,690–0,913 arasında değişti. Nokta tahminlerine göre güvenirlik üç ölçümde orta, sekiz ölçümde iyi ve bir ölçümde mükemmeldi; ancak dominant radyal deviasyon, nondominant pronasyon ve nondominant ulnar deviasyon için %95 güven aralıklarının alt sınırları zayıf güvenirlik düzeyindeydi. Standart ölçüm hataları 0,33°–0,96°, minimal saptanabilir değişimler ise 0,93°–2,66° arasında değişti. Ortalama yanlılıklar −0,02° ile 0,06° arasında değişti; %95 güven aralıklarının tümü sıfırı içerdi. Uyum sınırlarının genişliği hareket ve tarafa göre farklılık gösterdi.

Sonuç: Gonyometrik değerlendirme, sağlıklı genç yetişkinlerde el bileği ve önkol aktif eklem pozisyon hissinin tekrarlı ölçümünde genel olarak güvenilir görünmektedir. Bununla birlikte, güvenirliğin hareket ve tarafa göre değişmesi, ölçümlerin tek bir ortak eşik kullanılarak yorumlanmaması gerektiğini göstermektedir. Bireysel izlem sırasında gerçek değişimin belirlenmesinde harekete özgü minimal saptanabilir değişim değerleri dikkate alınmalıdır.

Keywords

• Propriyosepsiyon
• el bileği eklemi
• önkol
• artrometri
• sonuçların tekrarlanabilirliği

Supporting Institution

Bu araştırma, TÜBİTAK 2209-A projesi kapsamında gerçekleştirilmiştir.

Ethical Statement

Çalışma öncesinde bağımsız bir etik kuruldan onay alınmıştır [İzmir Katip Çelebi Üniversitesi Sağlık Araştırmaları Kurumsal Etik Kurulu, tarih: 16.01.2025, karar no.: 0009]

Thanks

Bu çalışmaya katılan tüm katılımcılara ve araştırmanın yürütülmesi için tesislerine erişim imkânı ve uygun koşullar sağlayarak çalışmaya destek olan İzmir Katip Çelebi Üniversitesi Sağlık, Kültür ve Spor Bölümü’ne teşekkür ederiz. TÜBİTAK’a da desteği için teşekkür ederiz.

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