Validity and Reliability of the Knee Joint Proprioceptive Sensory Measurements using a Smartphone

스마트폰을 이용한 무릎관절 고유수용성 감각 측정의 타당도와 신뢰도 검증

Kim, Myung-Chul;Kim, Nam-Jae;Lee, Min-Soo;Moon, So-Ra

  • Received : 2015.06.22
  • Accepted : 2015.08.04
  • Published : 2015.11.30


PURPOSE: We aims to promote the development of proprioception measurement using smartphones, goniometers, and laser pointers as compared to the conventional use of electrogoniometer measurement. METHODS: Measurements using an electrogoniometer were previously proved to be reliabile and valid. Among E-university students, 20 who had no fracture, operation history, or inflammatory arthritis were examined. These subjects had not performed regular exercise in the past 3 months. Proprioception measurements were performed using four different measurement tools, three times per day, for test-retest analysis. RESULTS: No notable test-retest differences were noted for any of the measurement methods (P>0.05). With regard to the test-retest reliability for each measurement method, we observed that the readings from both the electrogoniometer and smartphone have high reliability (ICC>0.80), whereas the readings from the laser pointer have moderate reliability (ICC>0.60). When assessing the concurrent validity between electrogoniometers with individual measurements, we did not observe any notable difference between the smartphone and electrogoniometer (P>0.05) and these tools in fact showed high correlation (r>0.60, P<0.05) and a moderate reliability (ICC>0.60). Moreover, there was no notable difference in between electrogoniometers and laser pointers (P<0.05). CONCLUSION: CONCLUSION: The findings of this suggested that proprioception can be measured by using smart-phones, and proved that this method has sufficient credibility. Moreover, we noted that the concurrent validity with smartphones was high in comparison with the conventional electrogoniometer, which also indicates the validity and credibility. Based on these findings, we conclude that the measurement of proprioception by using a smartphone can be widely adopted.


Electrogoniometer;Joint position sense;Knee joint;Laser pointer;Proprioception;Proprioception measurement;Smartphone


  1. Baker V, Bennell K, Stillman B, et al. Abnormal knee joint position sense in individuals with patellofemoral pain syndrome. J Orthop Res. 2002;20(2):208-14.
  2. Bennell, Kim L, Hinman RS, et al. Relationship of knee joint proprioception to pain and disability in individuals with knee osteoarthritis. J Orthop Res. 2003;21(5): 792-7.
  3. Bedekar N, Suryawanshi M, Rairikar S, et al. Inter and intra-rater reliability of mobile device goniometer in measuring lumbar flexion range of motion. J Back Musculoskelet Rehabil. 2014;27(2):161-6.
  4. Boulos MNK, Wheeler S, Tavares C, et al. How smartphones are changing the face of mobile and participatory healthcare: an overview with example from eCAALYX. BioMedical Engineering Online. 2011;10(1):24.
  5. Bronner S, Agraharasamakulam S, Ojofeitimi S, et al. Reliability and validity of electrogonio metry measurement of lower extremity movement. J Med Eng Thechnol. 2010;34(3):232-42.
  6. Carey LM. Somatosensory loss after stroke. Crit Rev Phys Rehabil Med. 1995;7:51-91.
  7. Choi YH, You BG, Jung HB, et al. The Effects of Knee Joint Taping on The Lower Extremity Muscle Fatigue and Proprioception of the Normal Adult. J Korean Soc Phys Ther. 2002;14(4):323-30.
  8. Hoon JR, Stashimko, Nagae LM, et al. Sensory and motor deficits in children with cerebral palsy bornpreterm correlate with diffusion tensor imaging abnormalities in thalamocortical path ways. Developmental Medicine & Child Neurology. 2009;51(9):697-704.
  9. Hwang JS, Lee DS, Jo YJ, et al. Measurement of Proprioception of the Knee in Hemiplegic Patients using an Isokinetic Dynamo meter. Journal of Rehabilitation. 2010;34(1):27-33.
  10. Jordan J, Luta G, Renner J, et al. Knee pain and Knee Osteoarthritis Severity in Se lf-reported Task Specific Disability. University of North Carolina School of Medicine. 1997;24(7):1344-9.
  11. Kim DK, Go EH, Lee KS, et al. The Influences of Visual Information and Different Elevations of Medially Wedged Insoles on Knee Joint Proprioception in Healthy Persons. Phys Ther Kor. 2005;12(1):22-7.
  12. Kim JH, Go MJ, Hwang JH, et al. The Effects of Knee Pain on the Quadriceps Strength, Proprioception and Balance in Patients with Knee Osteoarthritis. Journal of Sport. 2013;31(1):1-6.
  13. Knoop J, Steultien MP, Van der LM, et al. Proprioception in knee osteoarthritis. Osteoarthritis Cartilage. 2011; 19(4):381-8.
  14. Milanese S, Gordon S, Buettner P, et al. Reliability and concurrent validity of knee angle measurement: Smartphone app versus universal goniometer used by experienced and novice clinicians. Man Ther. 2014;19(6):569-74.
  15. Oh SJ, Yang SJ, Ha JG. The Effectiveness of Joint Position Sense Test in Evaluating the Proprioceptive Function after Anterior Cruciate Ligament Reconstruction. Journal of Sports. 2011;29(2):83-8.
  16. Ozdalga E, Ozdalga A, Ahuja N. The smartphone in medicine: a review of current and potential use among physicians and students. Journal of Medical Internet Research. 2012;14(5):128.
  17. Park SB, Gi HS, Jo DS, et al. The effects of muscle fatigue in the shoulder of the proprioceptive sense. Journal of Rehabilitation. 2010;34(1):54-8.
  18. Perlau R, Frank C, Fick G. The effect of elastic bandages of human knee proprioception in the uninjured population. Am J Sports Med 1995;23(2):251-5.
  19. Roberts D, Ageberg E, Andersson G. Clinical measurements of proprioception, muscle strength and laxity in relation to function in the ACL-injured knee. Knee Surgery Sports Traumatol Arthrosc. 2007;15(1):9-16.
  20. Shin SH, Ro du H, Lee OS, et al. Within-day reliability of shoulder range of motion measurement with a smartphone. Man Ther. 2012;17(4):298-304.
  21. Sin WS, Kim TH, Yang HS. The Influence of Different Quantitative Knowledge of Results on Performance Error During Lumbar Proprioceptive Sensation Training. Phys Ther Kor. 2004;11(3):11-8.
  22. Whetzel, Stevenson, Sharman, et al. The Effect of Ischemic Preconditioning on the Recovery of Skeletal Muscle Follosing to urniquet Ischemia. Plast Reconstr Surg. 1997;100(7):1767-75.
  23. Werner BC, Holzgrefe RE, Griffin JW, et al. Validation of an innovative method of shoulder range-of-motion measurement using a smartphone clinometer application. J Shoulder Elbow Surg. 2014;23(11):e275-e82.
  24. Yang JM, Kim SY. The effect of continuous Passive Motion and Continuous Active Motion on Joint Proprioception After Total Knee Replacement. Korean Academy Physther Science. 2010;17(2):41-52.
  25. Yu SS. The Effect of the Motor Learning through the Visual Information on Motor Performance and Adaptation of Muscles. Master's Thesis. Daegu University. 2010.
  26. Zhu R, Zhou Z. A real-time articulated human motion tracking using tri-axis inertial/magnetic sensors package, IEEE Transactions on Neural Systems and Rehabilitation Engineering. 2004;12(2):295-302.

Cited by

  1. Validation of Joint Position Sense of Dorsi-Plantar Flexion of Ankle Measurements Using a Smartphone vol.23, pp.3, 2017,