Anterior and right lateral images were captured and seventeen landmarks were identified on them. Intraclass correlation coefficients ICCs were calculated for each of 13 postural measures to evaluate inter-rater agreement on the first visit fully or minimally clothedas well as intra-rater agreement between the first and second visits minimally clothed.
During the minimally clothed exam, inter-rater agreement was almost perfect for four measures and substantial for four measures. Intra-rater agreement between two minimally clothed exams was almost perfect for two measures and substantial for five measures.
To maximize inter- and intra-rater agreement, postural screening using this mobile application should be conducted with subjects wearing minimal clothing. Assessing static standing posture via PSM gives repeatable measures for anatomical landmarks that were found to have substantial or almost perfect agreement. Our data also suggest that this technology may also be useful for diagnosing forward head posture. J Phys Ther Sci. ICCs were stronger for translations versus angulations.
This application may have utility in clinical and research settings. PostureScreen as an Outcome Assessment Tool. The subjects were divided into groups depending on their static and dynamic occlusion features. The postural parameters were then compared between these groups. There were no statistically significant differences regarding protrusion and right lateral movement. Poor ergonomics in the dental practice not only causes MSP, but can also lead to postural deviations as a result of an imbalance in muscle function.
The correlation between the regions of deviation and the regions of pain showed that the shoulder region was more significant than other regions.
Preventive strategies to minimize the risk of developing these health problems are highly recommended. J Contemp Dent Pract. Shoulder translation varied significantly between conditions in the sagittal plane.
Rib translation varied significantly between conditions in the coronal plane. Tablet use produced postures that were statistically different than the other devices.Thank you for visiting nature. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser or turn off compatibility mode in Internet Explorer.
Postural Screening for Adolescent Idiopathic Scoliosis with Infrared Thermography
School scoliosis screening SSS is recommended by researchers as a means of early detection of AIS to prevent its progression in school-aged children. The traditional screening technique for AIS is the forward bending test because it is simple, non-invasive and inexpensive. The use of infrared IR thermography for screening purposes based on the findings of previous studies on the asymmetrical paraspinal muscle activity of scoliotic patients compared with non-scoliotic subjects was explored in this study.
IR thermography is performed with an IR camera to determine the temperature differences in paraspinal muscle activity. A statistical analysis showed that scoliotic subjects demonstrate a statistically significant difference between the left and right sides of the regions of interest. This difference could be due to the higher IR emission of the convex side of the observed area, thereby creating a higher temperature distribution.
However, future studies could also consider a larger sample of both non-scoliotic and scoliotic subjects to further validate the findings. Adolescent idiopathic scoliosis AIS is a multifactorial, three-dimensional 3D deformity of the spine and trunk. AIS can appear and sometimes progress during any of the rapid periods of growth in children 1.
Since the s, research has shown that the early detection of scoliosis is effective in preventing its progression 2 ; therefore, school scoliosis screening is recommended by researchers 34. Early detection reduces the number of cases that require surgery through non-surgical interventions 5. Despite criticisms of the effectiveness of school screening, primarily regarding unnecessary referrals and the high cost 6there are studies that justify the cost and effectiveness of school screening.
For example, Lee et al. Most of the cost lies in human resources and follow-up. Therefore, school scoliosis screening SSS should be conducted for the purpose of early detection.
Fong et al. After conducting a meta-analysis, they could not provide a definite conclusion regarding the effectiveness of screening due to variations in screening methods and sample size. However, they found that the forward bending test FBT has a higher referral rate and less precision when it is the only means of assessment compared with that of other screening methods that use more than one form of screening. Based on this result, they suggested that SSS programmes that use the FBT as the only assessment tool are subjective and insufficient for providing a reliable and precise diagnosis; therefore, an additional test aside from the FBT is recommended.
Adams 9the leading expert on spinal deformity during his time, described the FBT as a screening technique to assess the likelihood of scoliosis during a series of twelve lectures that were presented from to The FBT is still widely used today because it is the most conventional means of screening for AIS, and the technique is simple, non-invasive and inexpensive. Despite these advantages, there have been numerous criticisms against the FBT, and many researchers have reached similar conclusions to that reported by Luk et al.
The former test is used to screen out most of the non-scoliotic cases. When these two tests constitute the most important components of a scoliosis screening programme, the programme is predictive and sensitive, with a low referral rate However, one of the more recent techniques that is gaining popularity for measuring the surface topography of scoliotic patients is a light-sectioning method called rasterstereography RS 13 It uses a structured light to project parallel fringes onto the back of a patient while a digital photograph is taken.
Unfortunately, the use of surface topography as a screening tool still faces a number of limitations. For example, it requires specialized operational and evaluation skills. This tool is also not widely available Another major disadvantage is the length of the screening time Finally, the transportation of the screening device is restrictive due to its size, which makes it difficult to utilize in situations where the equipment needs to be transported between schools for SSS programmes.
This study originated from requests for an alternative screening tool to optical techniques for SSS as an additional test aside from the FBT.Find researchers, research outputs e. View all 3. View all 1. Lund University Login for staff. Research Portal Find researchers, research outputs e. Home Research Outputs Is seeing just believing? Measurement properties of visual a Is seeing just believing? Overview Cite BibTeX.
Abstract Rupture of the anterior cruciate ligament ACL is a common knee injury among young physically active populations. The injury results in impaired physical functions, such as joint instability, limitations in daily activities and sport-specific activities, and worse movement quality, e. Postural orientation is defined as the ability to maintain alignment between body segments, and undesirable postural orientation is suggested to be a risk factor for subsequent injury.
However, there is a need for a systematic feasible approach to evaluate postural orientation in the clinical setting, such as with visual assessment. Therefore, the primary aim of this thesis was to develop and evaluate clinically feasible measures of postural orientation in participants with or without lower extremity injury. Secondary aims were to evaluate sex differences in postural orientation and the association between postural orientation and other measures of physical function and self-reported outcomes, in men and women undergoing rehabilitation after ACL reconstruction.
One systematic review with meta-analysis was conducted to summarize measurement properties of visual assessment of postural orientation in healthy populations, and populations with lower extremity injury paper I. Evaluation of measurement properties i.
Sex differences in POE scores i. This thesis shows that visual assessment of the segment-specific POE knee medial-to-foot position KMFP is associated with two-dimensional and three-dimensional kinematic variables, and shows moderate to almost perfect reliability for the KMFP in healthy populations. For other segment-specific POEs or for patients with lower extremity injury there were not enough studies to permit any synthesis.
The evaluation of measurement properties face validity, interpretability, and internal consistency of visual assessment of POEs during a variety of functional tasks in patients with ACL injury, resulted in the final test battery of 5 functional tasks single-leg mini squat, stair descending, forward lunge, singe-leg hop for distance, and side-hop and 6 segment-specific POEs foot pronation, KMFP, femur medial to shank, femoral valgus, deviation of pelvis in any plane, and deviation of trunk in any plane.
The results from this thesis indicate that visual assessment of the segment-specific POE KMFP is valid and reliable in healthy populations. However, there is limited evidence of measurement properties for visual assessment of other segment-specific POEs, and in patients with lower extremity injuries. The test battery for visual assessment of POEs showed no floor or ceiling effects, high internal consistency, and good inter-rater reliability in patients with ACL injury.
This indicates that visual assessment of POEs can be used in patients with ACL injury, both in research and in clinical practice. Furthermore, the results suggest that postural orientation should be evaluated separately for men and women, and that the POE subscale ADL could be used to help clinicians to decide when it is time to progress to jumping exercises during rehabilitation of ACL injuries. Sport Sciences Department of Health Sciences. Total downloads No data available.
Measurement properties of a test battery to assess postural orientation during functional tasks in patients undergoing anterior cruciate ligament injury rehabilitation. Measurement properties of visual rating of postural orientation errors of the lower extremity - A systematic review and meta-analysis.
Motion analysis systems can be used for this purpose, but they are expensive, require a high degree of technical experience and are not easily accessible.
A simpler method is needed to quantify static posture. Research objective: Assess validity and inter and intra rater reliability using an iPad with a 3-D camera to evaluate posture and postural deformity. Method: A 3-D model of a lying posture, created using an iPad with a 3-D camera, was compared to a Qualisys motion analysis system of the same lying posture, the latter used as the gold standard.
Markers on the trunk and the leg were captured by both systems, and results from distance and angle measurements were compared. Results: All intra-class correlation coefficient values were above 0. Significance: A 3-D model of a person, with markers on anatomical landmarks, created with an iPad with a 3-D camera, is a valid and reliable method of quantifying static posture. Conclusion: An iPad with a 3-D camera is a relatively inexpensive, valid and reliable method to quantify static posture in a clinical environment.
Nafn: 1-s2.Metrics details. The aim of this study was to perform a preliminary assessment, and a reliability test, of the algorithm designed to provide a more reliable way of localizing anatomical back shape landmarks for school screening subjects. A 3D Orthoscreen system, designed for postural deformity telediagnostics, using the structural light method, was used for school screening [ 23 ]. Clouds of dots were acquired for every subject.
POTSI, DAPI, kyphosis and lordosis were measured, after marker-less landmarking of anatomical back structures, manually and automatically, for the same subjects. Their clouds of dots were acquired and saved.Pronation vs Supination, A very simple explanation
Clouds were retrieved and analyzed utilizing 3D Orthoscreen system. An operator trained professional retrieved 3D data and analyzed by pointing landmarks manually or automatically. After landmarking, procedure Indices and angular measurements were calculated by the system. MedCalc statistical software Version Intra-class correlation coefficients, for manual and automatic raters, were calculated for all assessed parameters. Strong, and almost perfect, agreement was found for sagittal plane curvature measurements kyphosis and lordosis.
Manual measurements, for average measures was 0. Manual measurements, for average measures 0. Manual, for average measures 0. Manual measurements was 0. Strong, and almost perfect, agreement we found for sagittal plane curvature measurements kyphosis and lordosis may coincide with the method of measurement Debrunner like method. It may depend on the formula used for Index's calculation.
Further studies, and development of the algorithm, and source of inadequacies, shall be considered to improve automatic calculation reliability.
Osteoporosis International. Google Scholar. J Biomed Opt. Download references. This article is published under license to BioMed Central Ltd. Reprints and Permissions. Glinkowski, W. Manual versus automatic indices assessment based on a marker-less, three dimensional, structural light surface topography postural evaluation.
Preliminary study. Scoliosis 8, O24 Download citation. Published : 03 June In the Global postural re-education GPR evaluation, posture alterations are associated with anterior or posterior muscular chain impairments.
Our goal was to assess the reliability of the GPR muscular chain evaluation. Design: Inter-rater reliability study. Fifty physical therapists PTs and two experts trained in GPR assessed the standing posture from photographs of five youths with idiopathic scoliosis using a posture analysis grid with 23 posture indices PI.
The PTs and experts indicated the muscular chain associated with posture alterations. The GPR muscular chain evaluation has good reliability for most posture indices. GPR evaluation should help guide physical therapists in targeting affected muscles for treatment of abnormal posture patterns.
Correction of posture is an important aim of physical therapy for persons with orthopaedic or neurologic impairments. Posture alterations can be associated with modifications in muscular moments which can change joint alignment and cause movement impairment syndromes [ 1 ].
These impairments can affect functional activities and restrict the active life [ 2 ]. Sahrmann [ 3 ] states that the evaluation of posture leads to the understanding of the impact of muscle imbalance on the observed posture alterations. Thus, physical therapists must work on reducing these imbalances releasing muscle tension and tightness and increasing muscle strength in order to improve posture.
Various authors have described methods for evaluation of muscle action in relation to posture alterations [ 14 - 9 ]. Muscle imbalance associated with posture alterations are explained by the anatomy and physiology of the involved muscles [ 15 ]. Kendall et al. Souchard [ 6 ] describes muscles as being organized into two main static postural chains: the anterior and posterior muscular chains.
Muscular chains are an ensemble of muscles defined according to their localization as well as their functional role which can explain posture alterations and movement dysfunctions [ 610 - 12 ]. Specific posture patterns caused by muscle chain retractions have been associated with lower back or neck pain among elite athletes in muscular power competitions [ 12 ] and functional disabilities in an adult with hemiparesis [ 13 ].
Despite the lack of studies linking muscular chain impairments to abnormal posture patterns and dysfunction, it seems that global muscular chain stretching is more effective than analytic muscle stretching to improve function and quality of life for several pathologic conditions including respiratory, musculoskeletal and neurological problems [ 7 - 913 - 15 ].
According to Souchard [ 6 ], it is important to evaluate posture in a global fashion in order to establish appropriate treatments that target muscles in these muscular chains. Souchard [ 6 ] divides postural evaluation into three components. For example an anterior type would present with shoulders rolled forward, an exaggeration of sagittal vertebral curves and valgus of the lower limbs.
A posterior type would typically present as someone with elevated shoulders, decrease in sagittal vertebral curves and varus of the lower limbs. A mixed type presents anterior and posterior characteristics.
The aim of this evaluation is to identify anterior or posterior muscles responsible for the observed posture alterations. The third part of the evaluation involves the possibility for correction of the posture alterations and compares posture in standing and sitting positions.
Comparison between standing and sitting posture helps determine which muscular chain anterior or posterior contributes more to a specific posture alteration. These different steps allow the clinician to select the necessary stretching postures and sensorimotor integration exercises to be used for treatment.
Documenting impaired posture is also recommended in the Guide to Physical Therapist Practice [ 16 ]. Actual posture assessment tools both in the laboratory and in the clinical setting allow for quantification of observed posture alterations, producing numerical indices [ 17 - 24 ].
However, they do not provide guidance in interpreting muscle imbalances that are inherent in the various posture alterations. The evaluation of muscles related to posture alterations is helpful to identify and understand the inherent muscular causes as well as for selecting appropriate posture re-education exercises. To our knowledge, the reliability of the GPR muscle component evaluation has not been reported.
Thus, the objectives of our study were 1 to determine the inter-rater reliability of the evaluation of muscular chains and their associated posture alterations, from photographs of adolescents presenting with idiopathic scoliosis; 2 to verify the impact of clinical experience on the level of reliability of muscular chain evaluation; and 3 to verify the agreement of posture and muscular chain evaluations observed by physical therapists and two experts instructors in GPR.
Muscular chain impairments were determined by the two experts according to standards taught in GPR which can be found in GPR literature [ 671314 ].Few digitizers can measure the complexity of upright human postural displacements in six degrees of freedom of the head, rib cage, and pelvis. In a University laboratory, three examiners performed delayed repeated postural measurements on forty subjects over two days. Three digital photographs left lateral, AP, right lateral of each of 40 volunteer participants were obtained, twice, by three examiners.
Examiners placed 13 markers on the subjects before photography and chose 16 points on the photographic images. Standard error of measurements SEM and mean absolute differences within and between observers' measurements were also determined. SEMs were 2. Mean absolute differences within examiners and between examiners were 3.
SEMs and mean absolute differences within and between examiners' measurements were small. Thus, this posture digitizer is reliable for clinical use. Guidelines for evidence based care include postural evaluation as a primary physical examination procedure to be performed on presenting patients [ 12 ].
For example, in the fifth edition of the AMA guidelines, standing posture evaluation is recommended as part of a comprehensive but focused spine-related physical examination of the cervical, thoracic, and lumbar spines [ 1 ].
Regarding postural measurement methods, there are several tools available for clinical use. These include simple photographic techniques and plumbline measures [ 3 - 6 ], simple goniometers, inclinometers and linear devices [ 7 - 9 ], placing known sized blocks between postural regions [ 8 ], various computer assisted methods including electrogoniometers [ 10 ], electromagnetic movement systems [ 1112 ], computer assisted digitization systems [ 13 - 15 ], and 3D ultrasound-based motion analysis device for the cervical spine [ 16 ].
In today's evidence based health care arena, it is unacceptable to evaluate patients with non-objective measures. Several computer assisted postural measurement systems have been studied for measurement reliability [ 10 - 16 ]. Problematically, several of these investigations have suffered from an incomplete analysis, including use of only one examiner, small sample sizes, and measurement of only one region of the body, or a limited number of degrees of freedom of postural displacements [ 10 - 16 ].
Forty student participants underwent a posture evaluation by three examiners, randomly, once each on consecutive days in a University laboratory. They were not privy to the results of each other's measurements. Participants reviewed the approved Institutional Review Board IRB study protocol, provided informed consent for their participation, and their rights were protected. Since we desired to determine the health status of our participants, participants filled out a four-part Numerical Rating Scale NRS of 0—10, with 0 being no pain and 10 being severe painand an SF health questionnaire.
Photographs are obtained with a digital camera. The camera height is at Three such camera and wall grid stations were set up in the University's laboratory with partitions between stations.
Participants stood 61 cm two feet from the center of the wall grid. In the AP view, along a line perpendicular from the center of the wall grid, participants positioned their feet such that the perpendicular bisected mid stance. While setting up the wall grid and camera, from mid wall grid, a perpendicular was drawn on the floor outward for 2.
The camera was placed on this line. In each of the two lateral views, the participants' ankles were placed such that the mid ankle bisection was directly inline with the perpendicular from mid wall grid.
Clinical Gait Assessment
In this manner, each participant was positioned with their feet centered relative to the camera and grid reference frame. The participants were asked to wear tight fitting clothes in order for examiners to find various anatomical sites.
The examiners two of whom are co-authors placed 13 markers on each participant before taking the three photographs. For the photographs, participants were instructed to stand, nod their head up and down twice with their eyes closed and then assume what they felt to be a neutral body posture. In this stance, the eyes were opened and the subject refrained from motion. The set of photographs was processed through a secure internet website, where only the coordinates of the markers are available to the computer program i.
Participant with markers before photography. This figure shows one of the three photographs left lateral view used in the setting used for this posture reliability study in a university laboratory. AP view anatomical markers. Reprinted with permission from Biotonix, Montreal, Quebec, Canada. Lateral view anatomical markers.
The computer program calculated postural displacements using these markers.