Virtual goniometric measurement in patients with hand and forearm injuries: a double-blind psychometric study

Purpose Accurate assessment of joint range of motion (ROM) is essential for hand and wrist disorders, and virtual tools need validation as telehealth use rises. This study evaluated the validity and reliability of virtual goniometry versus manual goniometry for wrist and finger ROM in 42 adults with hand or wrist injuries.Methods In a double-blind, cross-sectional study, 42 patients (32.2 ± 14.2 years) were recruited. ROM of the wrist and fingers was measured using a standard manual goniometer and a web-based virtual goniometer (Protractor v3.1.2). Criterion validity was assessed with Spearman’s correlation and Bland–Altman analysis; intra- and inter-rater reliability with ICCs; measurement error with SEM and MDC95.Results Manual goniometry was followed by virtual assessment of 298 joints, 240 analyzed. Virtual goniometry showed high validity (ρ = 0.956, p < 0.001) with minimal bias (−0.47°). Intra- and inter-rater reliability were excellent for MCP, PIP, and DIP flexion (ICC = 0.93–0.99), but lower for wrist (ICC = 0.34) and thumb IP flexion (ICC = 0.29). Most MDC95 values were acceptable (