Reliability of Using a Handheld Tablet and Application to Measure Lower-Extremity Alignment Angles.

Context: Landing kinematics have been identified as a risk factor for knee injury. Detecting atypical kinematics in clinical settings is important for identifying individuals at risk for these injuries.

Objective: To determine the reliability of a handheld tablet and application (app) for measuring lower-extremity kinematics during drop vertical-jump landings.

Design: Measurement reliability.

Setting: Laboratory.

Participants: 23 healthy young adults with no lower-extremity injuries and no contraindications for jumping and landing.

Intervention: Subjects performed 6 drop vertical jumps that were captured with an iPad2 and analyzed with a KinesioCapture app by 2 novice and 2 experienced raters. Three trials each were captured in the frontal and sagittal planes.

Main Outcome Measures: Frontal-plane projection angles, knee flexion, and hip flexion at initial contact and maximum knee flexion were measured. ICC and SEM were calculated to determine intertrial and interrater reliability. One-way ANOVAs were used to examine differences between the measured angles of the raters.

Results: Average intertrial reliability ranged from .71 to .98 for novice raters and .77 to .99 for experienced raters. SEMs were 2.3-4.3° for novice raters and 1.6-3.9° for experienced raters. Interrater ICC2,1 was.39-.98 for the novice raters and .69-.93 for the experienced raters. SEMs were smallest with the experiences raters, all less than 1.5°.

Conclusion: A handheld tablet and app is promising for evaluating landing kinematics and identifying individuals at risk for knee injury in a clinical setting. Intertrial reliability is good to excellent when using average trial measures. Interrater reliability is fair to excellent depending on experience level. Multiple trials should be assessed by a single rater when assessing lower-extremity mechanics with a handheld tablet and app, and results may vary with experience level or training.