The Influence of Contextual and Theoretical Expertise on Generic and Occupation-Specific Lifting Strategy.

OBJECTIVE: To determine whether (i) low back loads and/or (ii) kinematic coordination patterns differed across theoretical expert, contextual expert and novice groups when completing both generic and occupation-specific lifts. BACKGROUND: Experience has been proposed as a factor that could reduce biomechanical exposures in lifting, but the literature reports mixed effects. The inconsistent relationship between experience and exposures may be partially attributable to the broad classification of experience and experimental lifting protocols not replicating the environment where experience was gained. METHODS: Purposive sampling was used to recruit 72 participants including theoretical experts (formal training on lifting mechanics), contextual experts (paramedics), and novices. Participants performed 10 barbell and crate (generic) lifts, as well as backboard and stretcher (occupation-specific) lifts while whole-body kinematics and ground reaction forces were collected. Peak low back compression and anteroposterior shear loads normalized to body mass, as well as kinematic coordination patterns, were calculated as dependent variables. RESULTS: No significant differences in low back loads were observed across expertise groups. However, significant differences were seen in kinematic coordination patterns across expertise groups in occupation-specific lifts, but not in generic lifts. CONCLUSION: Increasing expertise is unlikely to minimize low back loads in lifting. However, contextual expertise did influence lifting kinematics, but only when performing occupationally specific lifts. APPLICATION: Contextual expertise may help lifters adopt lifting kinematics that enhance the tolerance of their musculoskeletal system to withstand applied loads, but does not seem to reduce the applied low back loads relative to noncontextual expert groups.

Can we enable individuals to reach further down without rounding their backs before beginning a lift? Examining the influence of starting foot and trunk position on reach depth.

There is disagreement regarding the efficacy of 'safe' lifting recommendations for reducing low back disorder risk. These recommendations commonly focus on minimising lumbar spine flexion, which limits the range of allowable starting lift positions for that person. This study evaluated whether starting postural adaptations could allow a person to reach down further without rounding their lumbar spine before beginning a lift. Reach displacement was measured as participants performed a series of maximal reach tasks under different combinations of stance width, foot orientation and trunk inclination, with their lumbar spine motion restricted. There were no interactions between any of the three postural adaptations or any effect of stance width or trunk inclination. Seventy-nine percent of participants achieved their greatest reach displacement with their feet externally rotated, which contributed to a 4 cm greater reach displacement compared to a neutral foot orientation (p < 0.001).Practitioner summary: This study examined whether aspects of initial posture could influence the ability to adhere to 'safe' lifting recommendations across a range of lift heights. As a component of lifting (re)training interventions, practitioners should consider starting lift posture adaptations (e.g. manipulating foot external rotation) to improve capacity to adhere to recommendations.

Quantifying how functional and structural personal factors influence biomechanical exposures in paramedic lifting tasks.

It is unknown how structural (sex, stature, body mass) and functional (strength, flexibility) personal factors influence lifting strategy in paramedic work. We explored whether variance in peak low back forces and kinematic coordination patterns could be explained by structural and functional personal factors in paramedic lifting tasks. Seventy-two participants performed backboard and stretcher lifts. Peak low back forces normalised to body mass, as well as kinematic coordination patterns, were calculated as dependent variables. Being female, stronger, shorter, having higher body mass, and/or having greater lower body range of motion (ROM) were all independently associated with lower normalised low back forces across backboard and stretcher lifting. Females and stronger individuals seemed to define a movement objective to consistently minimise compressive forces, while individuals with greater hip ROM consistently minimised anteroposterior shear forces. The efficacy of improving strength and hip ROM to reduce low back forces in paramedic lifting should be investigated.Practitioner summary: Females, stronger individuals, and individuals with greater hip range of motion consistently exhibited lower normalised low back forces in paramedic lifting. Improving strength and hip range of motion via training is a potential proactive ergonomics approach to reduce peak low back forces in paramedic lifting tasks.

Functional Movement Screen Task Scores and Joint Range-of-motion: A Construct Validity Study.

Little is known about the construct validity of the Functional Movement Screen (FMS). We aimed to assess associations between FMS task scores and measures of maximum joint range-of-motion (ROM) among university varsity student-athletes from 4 sports (volleyball, basketball, ice hockey, and soccer). Athletes performed FMS tasks and had their maximum ankle, hip and shoulder ROM measured. Multivariable linear regression was used to estimate associations between FMS task scores and ROM measurements. 101 university student-athletes were recruited (52 W/49 M; mean age 20.4±1.9 years). In general, athletes with higher FMS task scores had greater ROM compared to those with lower task scores. For example, athletes who scored 2 on the FMS squat task had 4° (95% CI, 1° to 7°) more uni-articular ankle dorsiflexion ROM compared with those who scored 1, while those who scored 3 on the FMS squat task had 10° (4° to 17°) more uni-articular ankle dorsiflexion ROM compared with those who scored 1. Large variation in ROM measurements was observed. In sum, substantial overlap in joint ROM between groups of athletes with different FMS task scores weakens the construct validity of the FMS as an indicator of specific joint ROM.

Mechanical Energy Expenditure at Lumbar Spine and Lower Extremity Joints During the Single-Leg Squat Is Affected by the Nonstance Foot Position.

ABSTRACT: Hirsch, SM, Chapman, CJ, Frost, DM, and Beach, TAC. Mechanical energy expenditure at lumbar spine and lower extremity joints during the single-leg squat is affected by the nonstance foot position. J Strength Cond Res 36(9): 2417-2426, 2022-Previous research has shown that discrete kinematic and kinetic quantities during bodyweight single-leg squat (SLS) movements are affected by elevated foot positioning and sex of the performer, but generalizations are limited by the high-dimensional data structure reported. Using a 3D inverse dynamical linked-segment model, we quantified mechanical energy expenditure (MEE) at each joint in the kinetic chain, the total MEE (sum of MEE across aforesaid joints), and the relative contribution of each joint to total MEE during SLSs performed with elevated foot positioned beside stance leg (SLS-Side), and in-front of (SLS-Front) and behind (SLS-Back) the body. Total MEE differed between SLS variations ( p = 0.002), with the least amount observed in the SLS-Back (effect size [ES] = 0.066-0.069). Approximately 50% of total MEE was contributed by the knee joint in each SLS variation, whereas MEE at the ankle, hip, and lumbar spine (in absolute and relative terms) varied complexly as a function of the elevated foot position. Total MEE ( p = 0.0192, ES = 0.852) and the absolute MEE at the knee and spine was greater in men across the SLS variations performed ( p = 0.025-0.036, ES = 0.715-0.766), but only the lumbar spine contribution to total MEE was larger in men across all SLS variations ( p = 0.045, ES = 0.607). Otherwise, there were no other sex-specific responses observed. Biomechanically, SLS movements are generally "knee-dominant," but changing elevated foot position effectively redistributes MEE among other joints in the linkage. Consistent with the previous conclusions reached based on discrete kinematic and kinetic data, not all SLSs are equal.

Comparison of 5 Normalization Methods for Knee Joint Moments in the Single-Leg Squat.

Ratio scaling is the most common magnitude normalization approach for net joint moment (NJM) data. Generally, researchers compute a ratio between NJM and (some combination of) physical body characteristics (eg, mass, height, limb length, etc). However, 3 assumptions must be verified when normalizing NJM data this way. First, the regression line between NJM and the characteristic(s) used passes through the origin. Second, normalizing NJM eliminates its correlation with the characteristic(s). Third, the statistical interpretations following normalization are consistent with adjusted linear models. The study purpose was to assess these assumptions using data collected from 16 males and 16 females who performed a single-leg squat. Standard inverse dynamics analyses were conducted, and ratios were computed between the mediolateral and anteroposterior components of the knee NJM and participant mass, height, leg length, mass × height, and mass × leg length. Normalizing NJM-mediolateral by mass × height and mass × leg length satisfied all 3 assumptions. Normalizing NJM-anteroposterior by height and leg length satisfied all 3 assumptions. Therefore, if normalization of the knee NJM is deemed necessary to address a given research question, it can neither be assumed that using (any combination of) participant mass, height, or leg length as the denominator is appropriate nor consistent across joint axes.

Regulating Movement Frequency and Speed: Implications for Lumbar Spine Load Management Strategies Demonstrated Using an In Vitro Porcine Model.

The relationship between internal loading dose and low-back injury risk during lifting is well known. However, the implications of movement parameters that influence joint loading rates-movement frequency and speed-on time-dependent spine loading responses remain less documented. This study quantified the effect of loading rate and frequency on the tolerated cumulative loading dose and its relation to joint lifespan. Thirty-two porcine spinal units were exposed to biofidelic compression loading paradigms that differed by joint compression rate (4.2 and 8.3 kN/s) and frequency (30 and 60 cycles per minute). Cyclic compression testing was applied until failure was detected or 10,800 continuous cycles were tolerated. Instantaneous weighting factors were calculated to evaluate the cumulative load and Kaplan-Meier survival probability functions were examined following nonlinear dose normalization of the cyclic lifespan. Significant reductions in cumulative compression were tolerated when spinal units were compressed at 8.3 kN/s (P < .001, 67%) and when loaded at 30 cycles per minute (P = .008, 45%). There was a positive moderate relationship between cumulative load tolerance and normalized cyclic lifespan (R2 = .52), which was supported by joint survivorship functions. The frequency and speed of movement execution should be evaluated in parallel to loading dose for the management of low-back training exposures.

Spine loading during laboratory-simulated fireground operations - inter-individual variation and method of load quantification.

Spine loading data are needed to design low-back health-preserving ergonomic interventions for firefighters. Study objectives were to quantify spine loads during simulated fireground operations using simple (polynomial) and advanced (EMG-assisted musculoskeletal model) methods and to describe the variation in spine loads between performers (N = 20). Spine compression forces differed by as much as 5.5 times bodyweight between individuals performing identical tasks. Anteroposterior and mediolateral shear forces varied by as much 3.2 and 2.1 times bodyweight between individuals performing the same tasks, respectively. Large variations in spine load magnitudes were documented regardless of whether simple or advanced quantification methods were used. Results suggest that low-back loading demands on the fireground would vary widely depending on the physical characteristics of individual firefighters, movement strategies employed, and tasks performed. Thus, personalised ergonomic interventions are warranted to regulate spine loading and load tolerance in firefighters. Practitioner summary: Even when performing the same work, the associated spine loading demands will vary widely across people due to differences in their body sizes, shapes, and movement strategies. Therefore, personalised interventions are needed to regulate spine loading and load tolerance in workers (e.g. obesity prevention, physical capacity-building exercise, and movement [re]training).

The Effects of Filter Cutoff Frequency on Musculoskeletal Simulations of High-Impact Movements.

Estimation of muscle forces through musculoskeletal simulation is important in understanding human movement and injury. Unmatched filter frequencies used to low-pass filter marker and force platform data can create artifacts during inverse dynamics analysis, but their effects on muscle force calculations are unknown. The objective of this study was to determine the effects of filter cutoff frequency on simulation parameters and magnitudes of lower-extremity muscle and resultant joint contact forces during a high-impact maneuver. Eight participants performed a single-leg jump landing. Kinematics was captured with a 3D motion capture system, and ground reaction forces were recorded with a force platform. The marker and force platform data were filtered using 2 matched filter frequencies (10-10 Hz and 15-15 Hz) and 2 unmatched filter frequencies (10-50 Hz and 15-50 Hz). Musculoskeletal simulations using computed muscle control were performed in OpenSim. The results revealed significantly higher peak quadriceps (13%), hamstrings (48%), and gastrocnemius forces (69%) in the unmatched (10-50 Hz and 15-50 Hz) conditions than in the matched (10-10 Hz and 15-15 Hz) conditions (P < .05). Resultant joint contact forces and reserve (nonphysiologic) moments were similarly larger in the unmatched filter categories (P < .05). This study demonstrated that artifacts created from filtering with unmatched filter cutoffs result in altered muscle forces and dynamics that are not physiologic.

Verbal Instructions Acutely Affect Drop Vertical Jump Biomechanics--Implications for Athletic Performance and Injury Risk Assessments.

Biomechanical quantities acquired during the drop vertical jump (DVJ) are used in the assessment of athletic performance and injury risk. The objective was to examine the impact of different verbal instructions on spatiotemporal, kinematic, and kinetic variables commonly included in such assessments. Ten men and 10 women from local varsity and club volleyball, basketball, figure skating, and track and field teams volunteered to participate. The athletes performed DVJs after given instructions to minimize ground contact time (CT), maximize jump height (HT), and synchronously extend the lower extremity joints (EX). Between the CT, HT, and EX conditions, body segment and joint angles were compared together with characteristics of vertical ground reaction force (GRF), whole-body power output, stiffness, and center-of-mass displacement time histories. Verbal instructions were found to influence nearly all of the spatiotemporal, body segment and joint kinematic, and kinetic variables that were statistically analyzed. Particularly noteworthy was the finding that athletic performance indices (e.g., jump height, power output, vertical stiffness, and reactive strength index) and lower extremity injury risk markers (e.g., peak vertical GRF and frontal plane knee angle) were significantly different (p ≤ 0.05) between the CT, HT, and EX conditions. The findings of this study suggest that verbal instructions should be controlled and/or clearly documented when using the DVJ to assess athletic performance potential and injury risk. Moreover, practitioners who devise performance enhancement and injury prevention strategies based on DVJ assessments are advised to consider that "coaching" or "cueing" during the task execution could impact conclusions drawn.

FMS Scores Change With Performers' Knowledge of the Grading Criteria-Are General Whole-Body Movement Screens Capturing "Dysfunction"?

Deficits in joint mobility and stability could certainly impact individuals' Functional Movement Screen (FMS) scores; however, it is also plausible that the movement patterns observed are influenced by the performers' knowledge of the grading criteria. Twenty-one firefighters volunteered to participate, and their FMS scores were graded before and immediately after receiving knowledge of the movement patterns required to achieve a perfect score on the FMS. Standardized verbal instructions were used to administer both screens, and the participants were not provided with any coaching or feedback. Time-synchronized sagittal and frontal plane videos were used to grade the FMS. The firefighters significantly (p < 0.001) improved their FMS scores from 14.1 (1.8) to 16.7 (1.9) when provided with knowledge pertaining to the specific grading criteria. Significant improvements (p < 0.05) were also noted in the deep squat (1.4 [0.7]-2.0 [0.6]), hurdle step (2.1 [0.4]-2.4 [0.5]), in-line lunge (2.1 [0.4]-2.7 [0.5]), and shoulder mobility (1.8 [0.8]-2.4 [0.7]) tests. Because a knowledge of a task's grading criteria can alter a general whole-body movement screen score, FMS or otherwise, observed changes may not solely reflect "dysfunction." The instant that individuals are provided with coaching and feedback regarding their performance on a particular task, the task may lose its utility to evaluate the transfer of training or predict musculoskeletal injury risk.

The Influence of Load and Speed on Individuals' Movement Behavior.

Because individuals' movement patterns have been linked to their risk of future injury, movement evaluations have become a topic of interest. However, if individuals adapt their movement behavior in response to the demands of a task, the utility of evaluations comprising only low-demand activities could have limited application with regard to the prediction of future injury. This investigation examined the impact of load and speed on individuals' movement behavior. Fifty-two firefighters performed 5 low-demand (i.e., light load, low movement speed) whole-body tasks (i.e., lift, squat, lunge, push, and pull). Each task was then modified by increasing the speed, external load, or speed and load. Select measures of motion were used to characterize the performance of each task, and comparisons were made between conditions. The participants adapted their movement behavior in response to the external demands of a task (64 and 70% of all the variables were influenced [p ≤ 0.05] by changing the load and speed, respectively), but in a manner unique to the task and type of demand. The participants exhibited greater spine and frontal plane knee motion in response to an increase in speed when compared with increasing loads. However, there were a large number of movement strategies exhibited by individual firefighters that differed from the group's response. The data obtained here imply that individuals may not be physically prepared to perform safely or effectively when a task's demands are elevated simply because they exhibit the ability to perform a low-demand activity with competence. Therefore, movement screens comprising only low-demand activities may not adequately reflect an individual's capacity, or their risk of injury, and could adversely affect any recommendations that are made for training or job performance.

Exercise-Based Performance Enhancement and Injury Prevention for Firefighters: Contrasting the Fitness- and Movement-Related Adaptations to Two Training Methodologies.

Using exercise to enhance physical fitness may have little impact on performers' movement patterns beyond the gym environment. This study examined the fitness and movement adaptations exhibited by firefighters in response to 2 training methodologies. Fifty-two firefighters were assigned to a movement-guided fitness (MOV), conventional fitness (FIT), or control (CON) group. Before and after 12 weeks of training, participants performed a fitness evaluation and laboratory-based test. Three-dimensional lumbar spine and frontal plane knee kinematics were quantified. Five whole-body tasks not included in the interventions were used to evaluate the transfer of training. FIT and MOV groups exhibited significant improvements in all aspects of fitness; however, only MOV exhibited improvements in spine and frontal plane knee motion control when performing each transfer task (effect sizes [ESs] of 0.2-1.5). FIT exhibited less controlled spine and frontal plane knee motions while squatting, lunging, pushing, and pulling (ES: 0.2-0.7). More MOV participants (43%) exhibited only positive posttraining changes (i.e., improved control), in comparison with FIT (30%) and CON (23%). Fewer negative posttraining changes were also noted (19, 25, and 36% for MOV, FIT, and CON). These findings suggest that placing an emphasis on how participants move while exercising may be an effective training strategy to elicit behavioral changes beyond the gym environment. For occupational athletes such as firefighters, soldiers, and police officers, this implies that exercise programs designed with a movement-oriented approach to periodization could have a direct impact on their safety and effectiveness by engraining desirable movement patterns that transfer to occupational tasks.

The influence of precision requirements and cognitive challenges on upper extremity joint reaction forces, moments and muscle force estimates during prolonged repetitive lifting.

Prolonged repetitive lifting is a whole-body exertion. Despite this, the roles and physical exposures of the upper extremities are frequently neglected. The influence of precision requirements and cognitive distractions on upper extremity responses when lifting was evaluated by quantifying several biomechanical upper extremity quantities. Nine participants completed four 30-min lifting tasks with and without simultaneous cognitive distractions and/or precision placement constraints. Specific metrics evaluated were joint reaction forces and moments (wrist, elbow and shoulder) and modelled shoulder muscle forces (38 defined shoulder muscle mechanical elements). The addition of a precision requirement increased several metrics by up to 43%, while the addition of the cognitive distraction task had minimal influence. Furthermore, several metrics decreased by up to 14% after the first 10 min of lifting, suggesting a temporal change of lifting strategy. PRACTITIONER SUMMARY: Lifting tasks often include precision placements and cognitive demands. This study shows that precision placement during prolonged repetitive lifting increases upper extremity forces and moments, while the addition of a cognitive task is benign. Furthermore, field assessments of repetitive lifting should include observations longer than 10 min, as adaptive strategies appear to be adopted.

Physical fitness improvements and occupational low-back loading - an exercise intervention study with firefighters.

The impact of exercise on firefighter job performance and cardiorespiratory fitness has been studied extensively, but its effect on musculoskeletal loading remains unknown. The aim of this study was to contrast the physical fitness and low-back loading outcomes of two groups of firefighters who completed different exercise programmes. Before and after 12 weeks of exercise, subjects performed a physical fitness test battery, the Functional Movement Screen™ (FMS) and simulated job tasks during which peak L4/L5 joint compression and reaction shear forces were quantified using a dynamic biomechanical model. Subjects who exercised exhibited statistically significant improvements (p < 0.05) in body composition, cardiorespiratory fitness, muscular strength, power, endurance and flexibility, but FMS scores and occupational low-back loading measures were not consistently affected. Firefighters who are physically fit are better able to perform essential job duties and avoid cardiac events, but short-term improvements in physical fitness may not necessarily translate into reduced low-back injury risk.

Using the Functional Movement Screen™ to evaluate the effectiveness of training.

The Functional Movement Screen™ (FMS) has demonstrated some efficacy in the prediction of injuries and is thus used by many practitioners to make recommendations for exercise. However, questions remain regarding its utility as a means to evaluate the effectiveness of training. Sixty firefighters volunteered to participate, and their FMS scores were examined before and after 12 weeks of training. Individuals were graded on how they chose to perform rather than how they could perform. The participants were assigned to 1 of 3 groups: intervention 1, intervention 2, or control. The 2 intervention groups received three 1.5-hour training sessions each week and differed in the emphasis that was placed on movement quality. Sagittal and frontal plane videos were used to grade the FMS with 3 methods: the standard 0-3 scale, a 100-point scale that weighted specific compensations (research standard), and a modified 100-point scale whereby grades were assigned based on the total number of compensations present. There were no significant differences in the total FMS scores for any group posttraining. However, the scores of 85% of the firefighters who did not receive training did change. The 100-point scale methods resulted in more FMS score changes posttraining, but the between-group interactions were identical to those found with the standard scoring method. The control group's scores were not consistent pretraining and posttraining; thus, the influence of each intervention could not be evaluated. Currently, the FMS might provide a momentary impression of general movement quality, although further efforts would likely assist in the development of better ways to implement the test, interpret the results, and generate reliable scores.

The influence of resistance bands on frontal plane knee mechanics during body-weight squat and vertical jump movements.

The purpose of this study was to examine the impact of wearing a resistance band around the distal thigh on frontal plane knee mechanics during bodyweight squat and jumping exercises. Three closed-kinetic-chain exercises were examined, including: (1) bodyweight squat, (2) countermovement jump, and (3) squat jump. For each exercise, three experimental conditions were tested: (1) control condition with no band; (2) light-tension band applied around the distal thighs; and (3) medium-tension band applied around the distal thighs. Two dependent measures were used for analyses: (1) knee width normalized to ankle width and (2) peak external knee moment. In the absence of any feedback, application of the resistance bands failed to promote 'neutral' knee alignment when squatting and jumping. The stiffest resistance band resulted in significantly lower (p = 0.002) peak-width index values during the ascent phase of the countermovement jump. Additionally, the use of the medium-tension band resulted in significantly larger (p = 0.002) peak knee abduction moments compared to the no bands condition during the descent portion of the bodyweight squat and countermovement jump exercises. These findings conflict with previous clinical case reports on the proprioceptive response induced by resistance bands.

Kinematic adaptations to restricting spine motion during symmetrical lifting.

When lifting an object from the ground a person has many possible whole-body movement solutions to accomplish the task. It is unclear why lifters use most of their available lumbar spine flexion range-of-motion despite many ergonomic guidelines advising against doing so. Experimentally restricting spine motion and observing compensatory movement strategies is one approach to address this knowledge gap. A kinematic analysis was performed on 16 participants who completed symmetrical lifting tasks with and without wearing a spine motion-restricting device. Sagittal trunk, lumbar spine, and lower extremity kinematics, along with stance width and foot orientation in the transverse plane were evaluated between restricted and unrestricted lifting conditions. Restricting spine motion required greater ankle dorsiflexion (p < 0.001), knee flexion (p < 0.001), and hip flexion (p < 0.001) motion in comparison to unrestricted lifting. Motion was reallocated such that hip flexion showed the largest increase in restricted lifting, followed by ankle dorsiflexion, then knee flexion compared to unrestricted lifting. Trunk inclination decreased (i.e., more upright) in restricted compared to unrestricted lifting (p < 0.001). Neither stance width (p = 0.163) nor foot orientation (p = 0.228) were affected by restricting spine motion. These adaptive movements observed indicate lower extremity joint motion must be available and controlled to minimize lumbar spine flexion during lifting.

A comparison of augmented feedback and didactic training approaches to reduce spine motion during occupational lifting tasks.

Manual handling training may be improved if it relied on the provision of individualized, augmented feedback about key movement features. The purpose of this study was to compare the reduction in sagittal spine motion during manual lifting tasks following two training approaches: didactic (DID) and augmented feedback (AUG). Untrained participants (n = 26) completed lifting tests (box, medication bag, and paramedic backboard) and a randomly-assigned intervention involving 50 practice box lifts. Lifting tests were performed immediately before and after training, and one-week after interventions. Both groups exhibited reductions in spine motions immediately and one-week after the interventions. However, the AUG intervention group elicited significantly greater reductions in 5 of 12 between-group comparisons (3 tasks × 4 spine motion variables). The results of the current study support the use of augmented feedback-based approaches to manual handling training over education-based approaches.

Adjacent Joint Restriction Differentially Influences Intra- and Inter-rater Reliability and Agreement of Goniometric Measurements.

BACKGROUND: Reliability and agreement of goniometric measurements can be altered by variations in measurement technique such as restricting adjacent joints to influence bi-articular muscles. It is unknown if the influence of adjacent joint restriction is consistent across different range of motion (ROM) tests, as this has yet to be assessed within a single study. Additionally, between-study comparisons are challenged by differences between methodology, participants and raters, obscuring the development of a conceptual understanding of the extent to which adjacent joint restriction can influence goniometric ROM measurements. PURPOSE: To quantify intra- and inter-rater reliability and levels of agreement of goniometric measurements across five ROM tests, with and without adjacent joint restriction. STUDY DESIGN: Descriptive reliability study. METHODS: Three trained and experienced raters made two measurements of bilateral ankle dorsiflexion, first metatarsophalangeal dorsiflexion, hip extension, hip flexion, and shoulder flexion, with and without adjacent joint restriction. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), along with participant, measurement/rater and random error variance were estimated. RESULTS: Eleven females (age 21.4 ±2.3 years) and 19 males (age 22.1 ±2.8 years) participated. Adjacent joint restriction did not influence the reliability and agreement in a consistent way across the five ROM tests. Changes in the inter-rater reliability and agreement were more pronounced compared to the intra-rater reliability and agreement. Assessing variance components (participant, measurement/rater and random error variance) that are used to calculate the ICC and SEM, improved interpretation of ICC and SEM scores. CONCLUSION: The effects of adjacent joint restriction on reliability and agreement of goniometric measurements depend on the ROM test and should be considered when comparing measurements between multiple raters. Reporting variance components that are used to calculate the ICC and SEM can improve interpretation and may improve between-study comparisons, towards developing a conceptual framework to guide goniometric measurement technique. LEVEL OF EVIDENCE: 3b.