This study aims to investigate the clinimetric properties of the iPhone Level application as a suitable alternative to the Back Range of Motion device in assessing lumbar range of motion, including flexion, extension, and lateral flexion.
Range of motion measurement is vital in physiotherapy for assessing deficits, establishing diagnoses, and planning interventions. Digital advancements now allow Range of motion assessment through devices and applications, such as the back range of motion, which is a gold standard for measuring lateral flexion due to its validity. Furthermore, studies indicate that the iPhone Level app effectively measures Range of motion in various joints, demonstrating good reliability and validity. This study aims to evaluate the reliability and concurrent validity of the iPhone Level application specifically for measuring lumbar flexion, extension, and side bending Range of motion.
Study Type
OBSERVATIONAL
Enrollment
120
The BROM device consists of an inclinometer for measuring sagittal plane motions (flexion/extension) and a gravity goniometer/compass for lateral flexion. Participants stood upright with feet apart. Measurements were taken for flexion, extension, and bilateral lateral flexion. Three trials per movement were recorded and averaged.
The iPhone Level app was placed at T12-L1 and S1-S2 spinal levels. Lumbar flexion and extension ROM was calculated by subtracting S1-S2 angle from T12-L1 angle. For lateral flexion, the app was placed at T12 and S2 and the same subtraction method applied. Three trials per movement were recorded and averaged.
Cairo University
Giza, Egypt
assessment of flexion and extension range of motion using inclinometer
During lumbar flexion and extension measurements using the Back Range of Motion (BROM) device, patients stand upright with extended knees and feet approximately 17 centimeters apart. For flexion, they bend forward to touch the floor, while for extension, they bend backward with crossed arms. An inclinometer is secured over the sacrum, and its position is centered to record readings in degrees. An L-shaped slide arm measures the distance between the T12 and S1 spinous processes. The device isolates lumbar motion from pelvic motion, and the stationary flexion/extension unit minimizes errors, enhancing measurement accuracy.
Time frame: at baseline
assessment of lateral flexion range of motion using inclinometer
For measuring lumbar lateral flexion, the subject's sides are parallel to a wall to prevent compensatory forward trunk flexion. An inclinometer is secured over the sacral region at S1, using a belt for stability. A gravity goniometer is placed on the upper thoracic region to capture trunk angular displacement during side bending. The inclinometer is levelled and zeroed before movement, allowing for precise measurement of lateral lumbar movement while reducing thoracic and pelvic compensations. Accurate placement of the device is essential for reliable results. The subject slides their hand down the thigh, keeping weight on the opposite leg to ensure the measurement reflects true lateral flexion.measures\]
Time frame: at baseline
assessment of flexion and extension range of motion using smartphone
To measure lumbar flexion range of motion (ROM) using the iPhone Level app, participants are positioned standing upright with feet shoulder-width apart. T12-L1 and S1-S2 spinal levels are identified through palpation and marked on the skin. The iPhone is placed at these levels to record angles during maximum lumbar flexion. Total lumbar flexion ROM is calculated by subtracting the angle at S1-S2 from T12-L1. Subjects perform maximum lumbar flexion and extension with straight knees, and measurements are taken across three trials.
Time frame: at baseline
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
assessment of lateral flexion range of motion using smartphone
During the measurement of lumbar side bending using the iPhone Level application, the subject will stand in a neutral upright position with feet shoulder-width apart and hands placed on the hips to prevent arm movement from influencing the measurement. The spinous processes of T12 and S2 are identified and marked on the skin. The iPhone is first placed and zeroed at the T12 level, and the subject is instructed to bend sideways (toward one side) as far as possible without lifting the heels or rotating the trunk. The device remains aligned at T12 to capture the angular displacement. The same procedure is repeated with the device positioned at S2, and the final lumbar side bending range of motion is calculated by subtracting the angle at S2 (pelvic movement) from that at T12 (trunk movement). This method isolates lumbar lateral flexion and has shown good reliability and validity in clinical settings
Time frame: at baseline