Reliability of 2 functional goniometric methods for measuring forearm pronation and supination active range of motion

Study Design: Test-retest reliability study. Objectives: To determine intra- and intertester reliability of the hand-held pencil (HHP) and the plumbline goniometer (PIG) methods for measuring active forearm pronation and supination motions in individuals with and without injuries. Background: The distal forearm method has been considered the gold standard for measuring forearm pronation and supination motion. The HHP and PLG, however, are 2 more functional methods for measuring forearm motions, though limited information on the psychometric properties of these tests is currently available. Methods and Measures: Intra- and intertester reliability of the HHP and PIG methods were determined in 40 subjects of convenience (20 injured and 20 noninjured). Two testers performed 3 repeated measurements for each motion and method on all subjects. Intraclass correlation coefficients (ICC3.1 for intratester reliability, ICC2.3 for intertester reliability) and standard error of measurements (SEMs) were determined. Results: The ICCs for the measurements of pronation and supination using the HHP and PLG methods were high (range, 0.86-0.98) for individuals with and without injuries, with the reliability for the PLG method being equal or slightly greater than the HHP method for the majority of pronation and supination measurements. Intratester ICCs were higher (SEMs were conversely lower) than intertester ICCs for nearly all measurements. The ICC values were generally the same or higher for individuals with injuries compared to individuals without injuries. Conclusions: The HHP and PLG are highly reliable methods for measuring functional forearm pronation and supination. Because plumbline goniometers are not commercially available and the instrumentation for the HHP method is readily accessible, clinicians should consider the latter as their method of choice for measuring functional forearm pronation and supination.