Enhanced training protocol improves concurrent validity of CLA Insight wireless inclinometry for lumbar range of motion assessment: A 317-participant validation study.

Authors

Dror Robinson, Muhammad Khatib, Eitan Lavon, Alon Senderovich, Feras Qawasmi, Assil Mahamid, Hamza Murad, Waseem Abu Rashed, Mustafa Yassin

Published in

Journal of manipulative and physiological therapeutics. Volume 49. Issue 1. Sep 25, 2026. Epub Sep 25, 2026.

Abstract

The purpose of this study was to evaluate the concurrent validity and test-retest reliability of CLA Insight wireless inclinometry for lumbar range of motion (ROM) assessment compared with dual inclinometry and to assess whether enhanced training protocols improve measurement accuracy.
This prospective validation study enrolled 317 adults with chronic low back pain (86 initial cohort, 231 subsequent cohort following enhanced training). Participants underwent same-day lumbar ROM assessment using both CLA wireless inclinometry (2 trials) and dual inclinometry in 4 directions (flexion, extension, lateral bending). Concurrent validity was assessed using intraclass correlation coefficients (ICC[3,1]) and Bland-Altman analysis. Test-retest reliability compared trial 1 vs trial 2 measurements.
In the combined data set, CLA demonstrated excellent concurrent validity (ICC = 0.929; 95% confidence interval [CI], 0.900-0.950; r = 0.886; P < .001) with minimal bias (-1.59°) and acceptable 95% limits of agreement (-10.27° to 7.08°). Enhanced training improved validity from good (ICC = 0.709) in the initial cohort to excellent (ICC = 0.992) in the subsequent cohort, representing a clinically meaningful enhancement in measurement agreement. Test-retest reliability was excellent (ICC = 0.974; MDC95 = 3.87°). Manual clinical estimates showed poor agreement with objective measurements, overestimating ROM by 17°-19°. Over 12-month follow-up, flexion ROM improved by +11.24° (P < .001), and the composite CORESCORE neurological index improved significantly from 64.9 to 73.3 (paired-t P < .001).
CLA Insight wireless inclinometry demonstrates excellent concurrent validity and test-retest reliability for lumbar ROM assessment when combined with standardized training protocols. Enhanced training significantly improves measurement accuracy, providing an implementation framework for clinical adoption.

PMID:
42950151
Bibliographic data and abstract were imported from PubMed on 29 Oct 2026.

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