TY - JOUR
T1 - Validity and reliability of a wearable-controlled serious game and goniometer for telemonitoring of wrist fracture rehabilitation
AU - Meijer, Henriëtte A. W.
AU - Graafland, Maurits
AU - Obdeijn, Miryam C.
AU - Schijven, Marlies P.
AU - Goslings, J. Carel
N1 - Funding Information: The ReValidate! project received funding by the Growing Games Program (Dutch Game Garden, iMMovator, Dutch Games Association and the Economic Board Utrecht), grant number CB00018 (partial funding for salary of H.A.W. Meijer), and by a grant from the CZ Fund, the Netherlands. The sponsor had no role of any sort in the study design. Publisher Copyright: © 2021, The Author(s).
PY - 2021
Y1 - 2021
N2 - Purpose: To determine the validity of wrist range of motion (ROM) measurements by the wearable-controlled ReValidate! wrist-rehabilitation game, which simultaneously acts as a digital goniometer. Furthermore, to establish the reliability of the game by contrasting ROM measurements to those found by medical experts using a universal goniometer. Methods: As the universal goniometer is considered the reference standard, inter-rater reliability between surgeons was first determined. Internal validity of the game ROM measurements was determined in a test–retest setting with healthy volunteers. The reliability of the game was tested in 34 patients with a restricted range of motion, in whom the ROM was measured by experts as well as digitally. Intraclass-correlation coefficients (ICCs) were determined and outcomes were analyzed using Bland–Altman plots. Results: Inter-rater reliability between experts using a universal goniometer was poor, with ICCs of 0.002, 0.160 and 0.520. Internal validity testing of the game found ICCs of − 0.693, 0.376 and 0.863, thus ranging from poor to good. Reliability testing of the game compared to medical expert measurements, found that mean differences were small for the flexion–extension arc and the radial deviation-ulnar deviation arc. Conclusion: The ReValidate! game is a reliable home-monitoring device digitally measuring ROM in the wrist. Interestingly, the test–retest reliability of the serious game was found to be considerably higher than the inter-rater reliability of the reference standard, being healthcare professionals using a universal goniometer. Trial registration number: (internal hospital registration only) MEC-AMC W17_003 #17.015.
AB - Purpose: To determine the validity of wrist range of motion (ROM) measurements by the wearable-controlled ReValidate! wrist-rehabilitation game, which simultaneously acts as a digital goniometer. Furthermore, to establish the reliability of the game by contrasting ROM measurements to those found by medical experts using a universal goniometer. Methods: As the universal goniometer is considered the reference standard, inter-rater reliability between surgeons was first determined. Internal validity of the game ROM measurements was determined in a test–retest setting with healthy volunteers. The reliability of the game was tested in 34 patients with a restricted range of motion, in whom the ROM was measured by experts as well as digitally. Intraclass-correlation coefficients (ICCs) were determined and outcomes were analyzed using Bland–Altman plots. Results: Inter-rater reliability between experts using a universal goniometer was poor, with ICCs of 0.002, 0.160 and 0.520. Internal validity testing of the game found ICCs of − 0.693, 0.376 and 0.863, thus ranging from poor to good. Reliability testing of the game compared to medical expert measurements, found that mean differences were small for the flexion–extension arc and the radial deviation-ulnar deviation arc. Conclusion: The ReValidate! game is a reliable home-monitoring device digitally measuring ROM in the wrist. Interestingly, the test–retest reliability of the serious game was found to be considerably higher than the inter-rater reliability of the reference standard, being healthcare professionals using a universal goniometer. Trial registration number: (internal hospital registration only) MEC-AMC W17_003 #17.015.
KW - Distal radius fracture
KW - Goniometer
KW - Range of motion
KW - Rehabilitation
KW - Serious game
KW - Telemonitoring
UR - http://www.scopus.com/inward/record.url?scp=85105013699&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00068-021-01657-5
DO - https://doi.org/10.1007/s00068-021-01657-5
M3 - Article
C2 - 33885912
SN - 1863-9933
JO - European journal of trauma
JF - European journal of trauma
ER -