Goniometric Measurement Lacks Reliability

Are physical therapists putting too much faith in the reliability of goniometric measurements? A recent study by Mullaney et al. (http://www.ncbi.nlm.nih.gov/pubmed/20557263) out of the Nicholas Institute of Sports Medicine and Athletic Trauma addressed this very issue. In the case of intra-tester reliability of shoulder ROM measurements (flexion, external rotation, and internal rotation), a change of 6-11 degrees is necessary to be sure that a true change has occurred. For comparison of measures made by two different therapists (inter-tester), a change of 15 degrees is required to be certain a true change has occurred. As a co-author of this study, I was alarmed by these findings because oftentimes my patients are denied visits by insurance companies solely based on such measurements.