Document Type : Research Paper
Authors
1 MSc student, Department of Corrective Exercise & Sports Injury, Allameh Tabataba'i University, Tehran, Iran
2 Department of sport injuries and corrective exercises, Faculty of Physical Education and Sports Sciences, Allameh Tabataba’i University, Tehran, Iran
3 BSc student, Department of Corrective Exercise & Sports Injury, Allameh Tabataba'i University, Tehran, Iran
4 Assistant Professor of Sport Injuries and Corrective Exercises, Faculty of Physical Education and Sport Sciences, Allameh Tabataba'i University, Tehran, Iran
Abstract
Purpose: Muscle flexibility is a component of physical fitness. Using traditional tools in muscle length evaluation tests creates challenges. Therefore, the use of smartphones and health-related software as an alternative method has become widespread. This study aimed to investigate smartphones' intra- and inter-rater reliability and validity for measuring hamstring muscle length. Method: In a blinded study design, two researchers measured hamstring flexibility through four types of tests on each of the 22 asymptomatic participants with a total of 44 lower limbs. The measurements were compared between the traditional goniometer method and the practical smartphone application method. The intraclass correlation coefficient (ICC) was used to evaluate the reliability of each smartphone measurement, and Bland-Altman analysis was used to check the measurement errors. The validity of the two methods was also investigated. Results: Intra- and inter-rater reliability (ICC≥0.8) were good to almost perfect. In intra-rater reliability, PSLR angle showed consistent imprecision; other tests were free of systematic error and measurement error. The inter-rater reliability revealed a constant error in the right leg's PKE angle. A good to excellent correlation (r = 0.817–0.699) was observed in all the measured values, indicating the two methods' validity. Conclusion: These findings support from intra- and inter-rater reliability and validity of both instruments when measuring hamstring muscle length.
Keywords
Aalto, T. J., Airaksinen, O., Härkönen, T. M., & Arokoski, J. P. (2005). Effect of passive stretch on reproducibility of hip range of motion measurements. Archives of physical medicine and rehabilitation, 86(3), 549-557. https://doi.org/https://doi.org/10.1016/j.apmr.2004.04.041
Albeshri, Z. S., & Youssef, E. F. (2023). The immediate effect of Kinesio tape on hamstring muscle length and strength in female university students: A pre–post experimental study. Saudi Journal of Medicine &
Medical Sciences, 11(1), 73. https://doi.org/https://doi.org/10.4103/sjmms.sjmms_585_22
Allam, N. M., Ebrahim, H. A., Ibrahim, A. M., Elneblawi, N. H., ElSherbiny, M., & Fouda, K. Z. (2023). The association of hamstring tightness with lumbar lordosis and trunk flexibility in healthy individuals: gender analysis. Frontiers in Bioengineering and Biotechnology, 11.
https://doi.org/https://doi.org/10.3389/fbioe.2023.1225973
Ayala, F., de Baranda, P. S., Croix, M. D. S., & Santonja, F. (2012). Reproducibility and concurrent validity of hip joint angle test for estimating hamstring flexibility in recreationally active young men. The Journal of Strength & Conditioning Research, 26(9), 2372-2382. https://doi.org/https://doi.org/10.1519/jsc.0b013e31823db1e2
Chenani, K. T., & Madadizadeh, F. (2021). Guideline for selecting types of reliability and suitable intra-class correlation coefficients in clinical research. Journal of Biostatistics and Epidemiology, 7(3), 305-309. https://doi.org/https://doi.org/10.18502/jbe.v7i3.7301
Cox, R. W., Martinez, R. E., Baker, R. T., & Warren, L. (2018). Validity of a smartphone application for measuring ankle plantar flexion. Journal of sport rehabilitation, 27(3).
https://doi.org/https://doi.org/10.1123/jsr.2017-0143
Dos Santos, R. A., Derhon, V., Brandalize, M., Brandalize, D., & Rossi, L. P. (2017). Evaluation of knee range of motion: Correlation between measurements using a universal goniometer and a smartphone goniometric application. Journal of bodywork and movement therapies,
21(3), 699-703.
https://doi.org/https://doi.org/10.1016/j.jbmt.2016.11.008
Furness, J., Schram, B., Cox, A. J., Anderson, S. L., & Keogh, J. (2018). Reliability and concurrent validity of the iPhone® Compass application to measure thoracic rotation range of motion (ROM) in healthy participants. PeerJ, 6, e4431.
https://doi.org/https://doi.org/10.7717/peerj.4431
Ganokroj, P., Sompornpanich, N., Kerdsomnuek, P., Vanadurongwan, B., & Lertwanich, P. (2021). Validity and reliability of smartphone applications for measurement of hip rotation, compared with threedimensional motion analysis. BMC Musculoskeletal Disorders, 22(1), 1-9. https://doi.org/https://doi.org/10.1186/s12891-021-03995-2
Gulrandhe, P., Yadav, V., & Naqvi, W. M. (2023). Correlation between foot posture and hamstring muscle tightness. Cureus, 15(7). https://doi.org/https://doi.org/10.7759/cureus.42046
Hopper, D., Conneely, M., Chromiak, F., Canini, E., Berggren, J., & Briffa, K. (2005). Evaluation of the effect of two massage techniques on hamstring muscle length in competitive female hockey players.
Physical Therapy in Sport, 6(3), 137-145.
https://doi.org/https://doi.org/10.1016/j.ptsp.2005.04.003
Keogh, J. W., Cox, A., Anderson, S., Liew, B., Olsen, A., Schram, B., & Furness, J. (2019). Reliability and validity of clinically accessible smartphone applications to measure joint range of motion: A systematic review. PloS one, 14(5), e0215806.
https://doi.org/https://doi.org/10.1371/journal.pone.0215806
Khan, Q. A., Iqbal, M. A., Shah, R., Abidin, S. Z. U., & Ahmad, U. (2023). Immediate Effect of Functional Dry Needling on the Length of
Shortened Hamstring Muscle; A Quasi-Experimental Study. Journal Riphah College of Rehabilitation Sciences, 11(02).
https://doi.org/https://dx.doi.org/10.53389/JRCRS.2023110211
Krishna, H., Pk, S., & Dhote, C. (2021). Comparison between immediate effect of neural mobilization and myofascial release of suboccipital muscle on hamstring length in younger adults—an interventional study.
Int. J. Sci. Healthc. Res, 6, 438-445.
https://doi.org/https://doi.org/10.52403/ijshr.20210771
Liu, H., Shen, Y., Xiong, Y., Zhou, H., Mao, Y., Shen, Q., Hong, W., Liu, M., Liu, Y., & Qiu, L. (2022). Psychometric Properties of Four Common Clinical Tests for Assessing Hamstring Flexibility in Young
Adults. Frontiers in Physiology, 13, 911240.
https://doi.org/https://doi.org/10.3389/fphys.2022.911240
Medeiros, D. M., Miranda, L. L. P., Marques, V. B., de Araujo RibeiroAlvares, J. B., & Baroni, B. M. (2019). Accuracy of the functional movement screen (fmstm) active straight leg raise test to evaluate hamstring flexibility in soccer players. International Journal of Sports
Physical Therapy, 14(6), 877. https://doi.org/http://dx.doi.org/10.26603/ijspt20190877
Miley, E., May, J., Albertin, E., Takahashi, E., Goodman, C., & Pettaway, A. (2019). Reliability and validity for measuring active hip rotation with the clinometer smartphone application™. Journal of Rehabilitation Sciences & Research, 6(4), 193-199.
https://doi.org/https://doi.org/10.30476/jrsr.2019.82397.1031
Miyachi, Y., Ito, M., Furuta, K., Ban, R., Hanamura, S., & Kamiya, M. (2022). Reliability and validity of lower limb joint range of motion measurements using a smartphone. Nagoya J. Med. Sci, 84, 7-18.
https://doi.org/https://doi.org/10.18999/nagjms.84.1.7
Monreal, C., Luinstra, L., Larkins, L., & May, J. (2020). Validity and intrarater reliability using a smartphone clinometer application to measure active cervical range of motion including rotation measurements in supine. Journal of sport rehabilitation, 30(4), 680-
Mutungi, G., & Ranatunga, K. (1998). Temperature‐dependent changes in the viscoelasticity of intact resting mammalian (rat) fast‐and slowtwitch muscle fibres. The Journal of physiology, 508(1), 253-265. https://doi.org/https://doi.org/10.1111/j.1469-7793.1998.253br.x
Muyor, J. M. (2017). Validity and reliability of a new device (WIMU®) for measuring hamstring muscle extensibility. International Journal of
Sports Medicine, 38(09), 691-695.
https://doi.org/https://doi.org/10.1055/s-0043-108998
Neto, T., Jacobsohn, L., Carita, A. I., & Oliveira, R. (2015). Reliability of the active-knee-extension and straight-leg-raise tests in subjects with flexibility deficits. Journal of sport rehabilitation, 24(4). https://doi.org/http://dx.doi.org/10.1123/jsr.2014-0220
Norris, E. S., Wright, E., Sims, S., Fuller, M., & Neelly, K. (2016). The reliability of smartphone and goniometric measurements of hip range of motion. Journal of Rehabilitation Sciences & Research, 3(4), 77-84. https://doi.org/https://doi.org/10.30476/jrsr.2016.41104
Olivencia, O., Godinez, G. M., Dages, J., Duda, C., Kaplan, K., & Kolber, M. J. (2020). The reliability and minimal detectable change of the Ely and active knee extension tests. International Journal of Sports
Physical Therapy, 15(5), 776.
https://doi.org/https://doi.org/10.26603/ijspt20200776
Osailan, A., Jamaan, A., Talha, K., & Alhndi, M. (2021). Instrument assisted soft tissue mobilization (IASTM) versus stretching: A comparison in effectiveness on hip active range of motion, muscle torque and power in people with hamstring tightness. Journal of bodywork and movement therapies, 27, 200-206. https://doi.org/https://doi.org/10.1016/j.jbmt.2021.03.001
Pawar, A., Phansopkar, P., Gachake, A., Mandhane, K., Jain, R., & Vaidya, S. (2021). A review on impact of lower extremity muscle Length. Journal of Pharmaceutical Research International, 33(35A), 158-164. https://doi.org/https://doi.org/10.9734/JPRI%2F2021%2FV33I35A31 885
Portney, L. G., & Watkins, M. P. (2009). Foundations of clinical research: applications to practice (Vol. 892). Pearson/Prentice Hall Upper Saddle River, NJ.
Pourahmadi, M. R., Ebrahimi Takamjani, I., Sarrafzadeh, J., Bahramian, M.,
Mohseni‐Bandpei, M. A., Rajabzadeh, F., & Taghipour, M. (2017). Reliability and concurrent validity of a new iP hone® goniometric application for measuring active wrist range of motion: a crosssectional study in asymptomatic subjects. Journal of anatomy, 230(3), 484-495. https://doi.org/https://doi.org/10.1111/joa.12568
Reese, N. B., & Bandy, W. D. (2016). Joint range of motion and muscle length testing-E-book. Elsevier Health Sciences.
Reurink, G., Goudswaard, G. J., Oomen, H. G., Moen, M. H., Tol, J. L., Verhaar, J. A., & Weir, A. (2013). Reliability of the active and passive knee extension test in acute hamstring injuries. The American journal of sports medicine, 41(8), 1757-1761.
https://doi.org/https://doi.org/10.1177/0363546513490650
Salemi, P., Shadmehr, A., & Fereydounnia, S. (2021). The Immediate Effect of Static Hamstring Stretching on Dynamic Balance and Gait Biomechanical Variables in Athletes With Hamstring Tightness: A Preliminary Study. Journal of Modern Rehabilitation, 15(3), 141-150.
https://doi.org/https://doi.org/10.18502/jmr.v15i3.7749
Sherazi, F., Waqar, S., Khalid, M., Saleem, K., Kiani, S. K., & Shahzad, M. (2022). Effect of knee joint mobilization on hamstring muscle length in patient with knee osteoarthritis. The Rehabilitation Journal, 6(04), 468-
St-Pierre, M.-O., Sobczak, S., Fontaine, N., Saadé, N., & Boivin, K. (2020). Quantification and reliability of hip internal rotation and the FADIR test in supine position using a smartphone application in an asymptomatic population. Journal of Manipulative and Physiological
Therapeutics, 43(6), 620-626. https://doi.org/https://dx.doi.org/10.1016/j.jmpt.2019.10.009
Vohralik, S. L., Bowen, A. R., Burns, J., Hiller, C. E., & Nightingale, E. J. (2015). Reliability and validity of a smartphone app to measure joint range. American journal of physical medicine & rehabilitation, 94(4), 325-330.
https://doi.org/https://doi.org/10.1097/phm.0000000000000221
Werner, B. C., Holzgrefe, R. E., Griffin, J. W., Lyons, M. L., Cosgrove, C. T., Hart, J. M., & Brockmeier, S. F. (2014). Validation of an innovative method of shoulder range-of-motion measurement using a smartphone clinometer application. Journal of shoulder and elbow surgery, 23(11), e275-e282. https://doi.org/http://dx.doi.org/10.1016/j.jse.2014.02.030 Whyte, E., Doinn, T. Ó., Downey, M., & O’Connor, S. (2021). Reliability of a smartphone goniometric application in the measurement of hip range of motion among experienced and novice clinicians. Journal of sport rehabilitation, 30(6), 969-972.
https://doi.org/https://doi.org/10.1123/jsr.2020-0165
Zunko, H., & Vauhnik, R. (2021). Reliability of the weight-bearing ankle dorsiflexion range of motion measurement using a smartphone goniometer application. PeerJ, 9, e11977.
)