Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article


Master of Science




Symonette, Caitlin

2nd Supervisor

Grewal, Ruby


3rd Supervisor

Ross, Douglas



Small joint range of motion (ROM) in the hand, traditionally measured in-person using a goniometer, is essential for diagnosis and monitoring of hand pathology. The COVID-19 pandemic highlighted the potential of remote care in mitigating geographic and socio-economic barriers to care. There is, however, an unmet need for validated and practical remote small joint ROM measurement techniques.

This thesis aimed to validate the reliability and concurrent validity of two remote measurement techniques: firstly, on-screen ROM measurement using a goniometer held up to a computer screen; secondly, a novel augmented reality (AR) web-application (DIGITS). Both techniques demonstrated high reliability and reasonable concurrent validity relative to in-person goniometry, the gold standard.

Their high reliability makes these techniques amenable to use in virtual clinics, particularly for monitoring of changes in digit ROM over time. Additionally, this work lays a foundation for further software development of AR-based measurement tools and validation in clinical populations.

Summary for Lay Audience

Measurement of finger movement is an important part of the hand examination in patients with hand injuries or conditions. Measuring finger joint movement can provide an indication of hand function, pathology and response to treatment. The COVID-19 pandemic demonstrated important advantages of providing patient care virtually, including reduced travel burden and cost-savings for patients. While some parts of the hand examination are amenable to telemedicine visits, measuring finger movement remotely is challenging. Previously proposed techniques for remote finger movement measurement are not feasible for use by patients and clinicians in a virtual clinic setting. Thus, there is a need for accessible and practical means of measuring finger movement remotely.

After providing a comprehensive review of the literature, the body of this thesis validates the reliability and accuracy of finger joint measurement relative to in-person measurement, which is the gold standard. The primary objective of this work is to validate two new remote measurement techniques to facilitate remote care for patients with hand injuries and conditions.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

Available for download on Monday, August 18, 2025