Accuracy and Reliability of Wearable Devices, Image Analysis Software, and Smartphone Apps for Hand Goniometry: A Systematic Review

) but had low telehealth integration scores (TIS = 38 out of 50). Image analysis systems had high reliability (interclass correlation coefficient [ICC] > .67) and telehealth usability (TIS = 42) but lacked accuracy (MD 1°-35°). Similarly, smartphone apps had low accuracy (MD 1°-12°) but high reliability (ICC > 0.83). No single device class outperforms others across all metrics. Future studies should focus on creating technologies that combine the strengths of multiple device classes.