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Abstract Number: 2595

Using Iphone Compass Application for the Assessment of Cervical Rotation in Patients with Ankylosing Spondylitis

Gokce Kenar, Berrin Zengin, Handan Yarkan, Pinar Cetin, Ismail Sari, Fatos Onen, Merih Birlik and Nurullah Akkoc, Rheumatology, Dokuz Eylul University School of Medicine, Izmir, Turkey

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Ankylosing spondylitis (AS) and range of motion

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Session Information

Title: Spondyloarthropathies and Psoriatic Arthritis - Clinical Aspects and Treatment III

Session Type: Abstract Submissions (ACR)

Background/Purpose

Cervical rotation reflects restriction of mobility in axial disease in ankylosing spondylitis (AS) and it can be assessed in several approaches based on the use of either an inclinometer, a goniometer or a tape measure.  New generations of smartphones are equipped with a  gyroscope and an accelerometer which in combination with a smartphone’s operating system or specific software applications can be used for various inclinometric functions. The aim of the study was to assess the reliability and validity  of using iphone built in compass application, as compared to using goniometer in the assessment of cervical rotation patients with AS.

Methods

The study sample included 20 AS patients (6 females, 14 males)  with a mean age of 47.8 (± 10.2) . BASMI scores were obtained from patient charts. Two examiners measured cervical rotation of each patient using iPhone4 compass application and also goniometer, twice with each method. A cap with a velcro patch on top and an iphone case with a Velcro patch on the bottom were  used to stabilize the iphone’s position during measurements.  Intra-rater and inter-rater reliability were examined with intra-class correlation coefficients (ICC). The agreement between the two methods was assessed by by Bland-Altman method

Results

The mean BASMI score of AS patients was 43 (±  22.7). The mean scores for BASDAI, ASDAS and BASFI were 3.7 (± 19.9) , 2.9  (± 0.96) and the 3.5 (± 2.4), respectively. We observed an excellent intra and inter-rater reliability  in the whole study sample for both methods (Table 1 and Table 2). Bland-Altman analysis also showed a good agreement between the two methods (iphone-goniometer) with a mean difference (bias) of -1.7 for examiner 1 (95% CI −5.9 to −2.7) and -4.6 for examiner 2 (95% CI -8.9 to -0.4). Upper and lower limits of agreement were 16.6 (95% CI 9 to 24.2) and −19.9 (95% CI −27.4 to -12.3 ), for examiner 1  and 13.1(95% CI 5.7 to 20.4) and -22.3 (95% CI  -29.6 to -15) for examiner 2.

Conclusion

Using iPhone compass application is a simple and accessible way of measuring cervical rotation in patients with AS.   Measurements obtained with iphone show excellent intra and inter-rater reliability and a very good agreement with measurements obtained with goniometer.

Table.1 Mean cervical rotation measurements (degrees) with iPhone and goniometer and Intra-rater reliability for both methods

 

Method

 Examiner 1

Examiner 2

Trial 1

(Mean ± SD)*

Trial 2

(Mean ± SD)*

ICC

95% CI for ICC

Trial 1

(Mean ± SD)*

Trial 2

(Mean ± SD)*

ICC

95% CI for ICC

Goniometer

 

46.8±16.5

46.3±16.5

0.98

0.97-0.99

46.5±16.9

46.4±16.6

0.98

0.97-0.99

iPhone

48.3±22.1

48.1±21.3

0.98

0.96-0.99

51.8±21.3

50.3±20.1

0.96

0.90-0.98

*Mean of the right and left cervical rotation

Table 2 Mean cervical rotation measurements (degrees) with iPhone and goniometer and inter-rater reliability for both methods

 

 

 

Examiner 1 

(Mean ± SD)*

 Examiner 2        (Mean ± SD)*

ICC

95% CI

Goniometer

 

46.6±16.44

46.5±16.91

0.99

0.97-0.99

iPhone4

48.2±21.6

51.05±20.49

0.93

0.84-0.97

*Mean of the two measurements by the same examiner


Disclosure:

G. Kenar,
None;

B. Zengin,
None;

H. Yarkan,
None;

P. Cetin,
None;

I. Sari,
None;

F. Onen,
None;

M. Birlik,
None;

N. Akkoc,
None.

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