Confiabilidade interexaminador de medidas cervicais por aplicativo durante teleatendimento em adultos saudáveis

Abstract

Introduction: Inertial sensor-based applications have been validated for measuring cervical range of motion (ROM) in in-person settings. However, their use has been expanding to telehealth settings, even without robust evidence on the reliability of remote measurements, especially in the absence of a healthcare professional. Objective: To evaluate the inter-rater consistency of video-guided cervical range of motion (ROM) assessments in healthy subjects during telehealth settings. Materials and Methods: This reliability study was conducted with healthy adults and approved by the Ethics Committee (report no. 6,333,45). Cervical ROM was assessed with the Clinometer© application in two settings: in-person and via telehealth, with the assistance of a companion. One evaluator performed the in-person measurements, and subsequently, two different evaluators assisted the companions with the remote measurements. Data were collected using a standardized protocol and analyzed using descriptive statistics and Intraclass Correlation Coefficient (ICC) using Jamovi software (α = 0.05). Results: The final sample consisted of 31 participants (15 women and 16 men; mean age: 24.2 ± 3.6 years). Interrater reliability was classified as excellent for all movements evaluated. The ICC values were: flexion (ICC = 0.906; 95% CI: 0.815–0.945; p < 0.001), extension (ICC = 0.894; 95% CI: 0.792–0.947; p < 0.001), right lateral bending (ICC = 0.959; 95% CI: 0.917–0.980; p < 0.001) and left lateral bending (ICC = 0.834; 95% CI: 0.686–0.916; p < 0.001). Bland-Altman analysis confirmed good inter-rater agreement, with mean differences close to zero and clinically acceptable limits of agreement. Conclusion: Although remote assessment of cervical ROM using an application showed good inter-examiner reproducibility, intra-examiner comparisons between in-person and remote contexts revealed significant inconsistencies, requiring further validation in this environment.