Validity of the HALO ^TM digital goniometer for measuring cervical range of motion: A comparative study with the cervical range of Motion ^TM device

ObjectiveThis study evaluated the validity of the HALO™ digital goniometer compared to the Cervical Range of Motion (CROM™) device for assessing cervical range of motion (ROM) in a sample of 20 patients with cervicogenic headache (CGH).MethodsROM was measured simultaneously using both devices across six movement planes at two time points, at baseline and 4 weeks later. Intraclass correlation coefficients (ICCs) were used to assess agreement, and Bland-Altman analyses evaluated measurement bias.ResultsResults showed excellent to good agreement between the HALO™ and CROM™ for most movements (ICC = 0.880 to 0.994), with flexion, extension, and left rotation demonstrating excellent reliability (ICC > 0.9). Left side flexion and right rotation showed good agreement (ICC = 0.888 and 0.880, respectively), while right side flexion had lower (moderate) agreement (ICC = 0.688, 95% CI [-0.073 to 0.902]). Bland-Altman analysis indicated that the HALO™ tended to slightly overestimate ROM in several directions, with statistically significant yet clinically negligible (<5° difference) biases for flexion, side flexion, and right rotation, indicating that the clinical interchangeability between the two devices may be limited for these movements.ConclusionThe HALO™ demonstrated good validity compared to the CROM™ for measuring cervical ROM in individuals with CGH. Both its portability and ease of use make it a viable alternative. However, variability observed in side flexion and the modest sample size suggest that caution is warranted, and further validation in larger and more diverse populations is needed before it can be considered interchangeable with the CROM™.