Intra- and inter-rater reliability of goniometric finger range of motion using a written protocol.
Takuya Nakai, Satoru Amano, Chikako Murao and 2 others
PMID 39386320WHAT IT FOUND
Using a written protocol, a single therapist measuring the same patient twice got consistent finger range of motion results.
But different therapists measuring the same patient got much less consistent results. Stick to one examiner for tracking changes.
Key findings
01Intra-rater reliability (same therapist, two sessions) was acceptable, but inter-rater reliability (different therapists) was generally lower.
02The minimal detectable change for inter-rater measurements often fell between 10 and 15 degrees, meaning small differences between examiners are likely just measurement error.
03To reliably track finger range of motion changes over time, the same rater should perform the assessment.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample size was small (20 participants), which may affect the stability of the reliability estimates. All participants were healthy adults, so the results may not apply to patients with hand pathologies, pain, or stiffness. The measurement process took 30-40 minutes per participant, which may not reflect typical clinical time pressures. It was a single-center study, so results may not generalize to other settings.
Declared interests
The authors declared no conflicts of interest. The study was supported by a grant from AMED (Japan Agency for Medical Research and Development).
The easy way to misread this
Do not assume that a 5-degree difference in finger ROM between two therapists represents a real change in the patient's condition. The study showed that inter-rater measurement error often exceeds 10 degrees, so small differences are likely just noise.