Virtual Reality vs Goniometry: Intraclass Correlation Coefficient to Determine Inter-Rater Reliability for Measuring Shoulder Range of Motion.

Allied health curricula typically include instruction in standardized use of goniometers for examination, despite the fact that previous studies indicate limited inter-rater reliability. This imperfect variability is magnified in larger healthcare or rehabilitation settings since having the same clinician repeat goniometric measures is not always feasible. This study explored the use of virtual reality (VR) as a possible alternative for consistent and reliable shoulder measurements to indicate progress or lack thereof. In a single-blinded study involving physical and occupational therapy students (n=2 each), the inter-rater reliability involving shoulder range of motion (ROM) was tested using a VR technology system (Oculus Rift device and XRHealth software) and compared with the standardized goniometric methods taught in the curriculum. The study found inter-rater reliability for shoulder abduction for the goniometer was "poor-moderate-good," while the VR showed consistent "poor-good" intraclass correlation coefficient (ICC) interpretations. However, shoulder flexion goniometry showed "moderate-good," while the VR demonstrated "moderate-excellent" and "good-excellent" with left flexion being statistically different (p<0.05). In addition, 65% of subjects (total n=40) stated a preference for having their shoulder ROMs taken with the VR method. Incorporating VR technology into the allied health profession curricula may be a time that has come, especially given the current pandemic circumstances.