Review Article

Mobile Phone-Based Joint Angle Measurement for Functional Assessment and Rehabilitation of Proprioception

Table 1

Characteristics of the different studies that have been examined.

Study Population
(Sample size and age)
AppReferenceBody segmentMovementTypeResults
Validity Reliability
IntraobserverInterobserver

Tousignant-Laflamme et al., 2013 [11]Healthy volunteers
(28, 23 ± 6 years)
Clinometer and Compass on iPhoneEyeglasses with three inclinometersHeadFlexion/extension/rotationActive
CROM
ICC between 0.50 and 0.65 but <0.50 for rotationICC = 0.65–0.85ICC < 0.60

Quek et al., 2014 [12]Healthy  volunteers
(21, 31 ± 9 years)
Customized Android3D motion analyses systemHeadFlexion/extension/rotationActive
CROM
ICC = 0.53–0.98, Spearman’s = 0.52–0.98ICC = 0.82–0.90 but poor in rotation: ICC = 0.05–0.33N/A

Shin et al., 2012 [13]Healthy  volunteers
(41, 52.7 ± 17.5 
years)
Clinometer on AndroidDouble armed goniometerShoulderForward flexion/abduction/external
and internal rotation and abduction
Passive and
active ROM
LOA = 10–40° 

Pearson’s correlation coefficient (PCC) = 0.79–0.97
except for 
= 0.63–0.68 (internal rotation at 90° abduction)

Werner et al., 2014 [14]Healthy volunteers (24) and symptomatic patients (15)Clinometer on iPhoneVisual estimation and standard goniometerShoulderForward flexion/abduction/external
and internal rotation
Passive
ROM
For healthy volunteers, ICC > 0.60 and SEM < 4.3° 
For symptomatic patients, ICC > 0.80 and SEM < 0.1°
N/AFor healthy volunteers, ICC > 0.60 and SEM < 10.1° 
For symptomatic patients, ICC > 0.60 and SEM < 5.8°

Mitchell et al., 2014 [15]Healthy volunteers (94)GetMyRom and DrGoniometer on iPhoneStandard goniometerShoulderExternal rotationActive
ROM
ICC = 0.94ICC = 0.94ICC = 0.79

Oïhénart et al., 2012 [16]Healthy volunteers (5)iShould on iPhone or iPod touch3D kinematic sensorsShoulderAnterior elevation and extension/abduction/adduction/internal
and external rotation
Active
ROM
Mean difference (%): 1.09 for RAV and 0.60 for scoreN/AN/A

Johnson et al., 2015 [17] Healthy volunteers (1)Customized AndroidDouble-armed goniometer and full-scale motion captureShoulderAbductionPassive
ROM
Mean difference in B&A plots = −1.7° (seated position) and 1.4° (supine position)CCC > 0.992CCC > 0.989

Ferriero et al., 2011 [18]Healthy volunteers (28 pictures!)DrGoniometer on iPhonePlastic universal goniometerElbowElbow placed at different anglesPassive
ROM
LOA = +4.51°, −5.75°ICC = 0.998ICC = 0.998

Ockendon and Gilbert, 2012 [19]Healthy  volunteers
(5, 30–40 years)
Knee goniometer on iPhoneTelescopic-armed goniometerKneeFlexionPassive
ROM
LOA = 15.2° 
PCC = 0.947
PCC = 0.982PCC = 0.994

Hambly et al., 2012 [20]Healthy  volunteers
(96, 31 ± 11 years)
Knee goniometer on iPhoneTelescopic-armed goniometerKneeFlexionActive
ROM
PCC = 0.932 
paired -test indicates significant difference but not clinically significant
ICC = 0.894 
PCC = 0.795
N/A

Jones et al., 2014 [21]Healthy  volunteers
(36, 60.6 ± 6.2 years)
Simple goniometer on iPhoneUniversal goniometerKneeLunge forwardActive
ROM
LOA = 13.1° 
= 0.96–0.98
ICC = 0.97–0.99N/A

Milanese et al., 2014 [22]Healthy volunteers (6)Knee goniometer on iPhoneUniversal goniometerKneeFlexionPassive
ROM
CCCexpert = 0.982 
CCCnovice = 0.983 
CCCensemble = 0.991 
CPP = −0.51 
SEM < 2.7° (gonio) 
SEM < 1.4° (apps)
CCCexpert > 0.998 
CCCnovice > 0.997



CCCexpert > 0.996 
CCCnovice > 0.998 
CCCtogether = 0.997



Rwakabayiza et al., 2013 [23]Healthy volunteers (20) and symptomatic patients (20)Knee goniometer on iPhoneUniversal goniometerKneeFlexion/extensionActive and
passive ROM
On 6 patients 
ICC = 0.54 (Smartphone) in active extension 
ICC = 0.92 (Smartphone) in active flexion (better than goniometer)
ICChealthy = 0.85 (0.75–0.94) 
ICCsymptomatic = 0.98 (0.96–0.99)
ICChealthy = 0.12 (0.00–0.25) 
ICCsymptomatic = 0.24 (0.00–0.45)

Bruyneel and Bridon, 2015 [24]Healthy  volunteers
(41, 18–26 years)
Clinometer on iPhoneHand-held bilevel inclinometerKneeExtensionPassive
ROM
N/AICC > 0.76 (inclinometer) 
ICC > 0.72 (Smartphone) 
MDC < 5°
ICC > 0.64 (inclinometer) 
ICC > 0.64 (Smartphone) 
MDC < 8°

Jenny 2013 [25]Symptomatic patients
(10, 69 years)
Angle on iPhoneNavigation systemKneeFlexion/extensionPassive
ROM
LOA = 27.4°  
-test not significant 
Spearman’s = 0.99 
B&A: good coherence
ICC = 0.81ICC = 0.79

Ferriero et al., 2013 [26]Healthy volunteers (1)DrGoniometer on iPhoneUniversal goniometerKneeDifferent knee angles measurementPassive
ROM
LOA = −7.5°/+10.71°  
B&A
ICC = 0.958ICC = 0.994

Jenny et al., 2015 [27]Symptomatic patients
(10, 69 ± 10.8)
Goniometer Pro and DrGoniomter on iPhoneNavigation systemKneeFlexion/extensionPassive
ROM
Strong correlation and a good coherence (Levene’s test, ANOVA test, Wilcoxon’s test, Kendall’s test, Spearman’s test, and B&A). Inclinometer results differedN/AN/A

Andrea et al., 2014 [28]Symptomatic patients (35)“SmartJoint” Android and iOS applicationKT 100KneeLachman’s testNCMean 
ICC = 0.797 (uninvolved knee) 
ICC = 0.987
(involved knee)

ICC = 0.973 (uninvolved knee) 
ICC = 0.989 (involved knee)

ICC = 0.957 (uninvolved knee) 
ICC = 0.992 (involved knee)

Yoon et al., 2014 [29]Healthy volunteers (10, 22.2 ± 1.69 years)TiltMeter on iPhoneDigital inclinometerHipMeasure of femoral neck anteversionPassive
ROM
Similarly ICC = 0.95 
SEM = 1.9°–2.2°
= 0.85 
SEM = 4.1°

Peters et al., 2012 [30]Symptomatic patients (50, 67 years from 31 to 84)Angle and Camera Protractor on iPhoneX-RaysHipMeasurements for total hip arthroplastyNCDifferences are under 5% between pre- and postopN/AN/A

Charlton et al., 2015 [31]Healthy  volunteers
(20, 23.8 ±4.6 years)
Hip ROM testerCamera marker based 3DMAHipFlexion/abduction/adduction/supine internal
and external rotation
Passive
ROM
(for 6 movements) 
= 0.71 (for supine external rotation)
(for 4 movements) 
= 0.63–0.68 (for 3 movements)
N/A

Vohralik et al., 2014 [32]Healthy  volunteers
(20, 21–28 years)
iHandy Level on iPhoneDigital inclinometerAnkleAnkle dorsiflexion rangeActive
ROM
CPP = 0.99 = 0.97 = 0.76

Williams et al., 2013 [33]Healthy  volunteers
(20, 40 ± 12 years)
TiltMeter on iPhoneDigital inclinometerAnkleWeight bearing lunge testActive
ROM
ICC = 0.83 = 0.81–0.85 = 0.80–0.96

Kolber et al., 2013 [34]Healthy  volunteers
(30, 25.6 ± 2.1 years)
iHandy Level on iPhoneBubble inclinometerSpinalThoracolumbopelvic flexion, isolated lumbar flexion, thoracolumbopelvic extension right lateral flexion, and left lateral flexionActive
ROM

LOA = 18–30°

Izatt et al., 2012 [35]NC (8 torso)Scoligauge on iPhoneScoliometerSpinalNCPassiveLOA = 6.2°ICC 95% = ±3.2°ICC = 0.92 (absolute agreement definition) 
IC 95% = ±4.9°

Franko et al., 2012 [36]NC (60 angles)Scoligauge on iPhoneScoliometerSpinalSixty angles randomly selectedPassiveCPP = 0.99N/AN/A

Balg et al., 2014 [37]Symptomatic patients (34)Scoligauge on iPhoneScoliometerSpinalScoliosis anglesActiveICC = 0.947 
Mean difference = 0.4°
ICC = 0.961 
Mean difference = 0.0°
ICC = 0.901 
Mean difference = 0.1°

Qiao et al., 2014 [38]Symptomatic patients
(64, 15.7 year)
Scoligauge on iPhoneScoliometerSpinalScoliosis anglesActiveMean angles are similarICC (scoliometer) = 0.954 
ICC (apps) = 0.965
ICC (scoliometer) = 0.943 
ICC (apps) = 0.964