Abstract
BackgroundFew digitizers can measure the complexity of upright human postural displacements in six degrees of freedom of the head, rib cage, and pelvis.MethodsIn 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. Using the PosturePrint® internet computer system, head, rib cage, and pelvic postures were calculated as rotations (Rx, Ry, Rz) in degrees and translations (Tx, Tz) in millimeters. For reliability, two different types (liberal = ICC3,1 & conservative = ICC2,1) of inter- and intra-examiner correlation coefficients (ICC) were calculated. Standard error of measurements (SEM) and mean absolute differences within and between observers' measurements were also determined.ResultsAll of the "liberal" ICCs were in the excellent range (> 0.84). For the more "conservative" type ICCs, four Inter-examiner ICCs were in the interval (0.5–0.6), 10 ICCs were in the interval (0.61–0.74), and the remainder were greater than 0.75. SEMs were 2.7° or less for all rotations and 5.9 mm or less for all translations. Mean absolute differences within examiners and between examiners were 3.5° or less for all rotations and 8.4 mm or less for all translations.ConclusionFor the PosturePrint® system, the combined inter-examiner and intra-examiner correlation coefficients were in the good (14/44) and excellent (30/44) ranges. SEMs and mean absolute differences within and between examiners' measurements were small. Thus, this posture digitizer is reliable for clinical use.
Highlights
Few digitizers can measure the complexity of upright human postural displacements in six degrees of freedom of the head, rib cage, and pelvis
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]
Computerized postural digitization/assessment procedures should allow for accurate quantitative evaluation of postural impairments so that improvement or worsening of a patient's abnormality can be succinctly documented
Summary
Few digitizers can measure the complexity of upright human postural displacements in six degrees of freedom of the head, rib cage, and pelvis. Guidelines for evidence based care include postural evaluation as a primary physical examination procedure to be performed on presenting patients [1,2]. There are several tools available for clinical use. These include simple photographic techniques and plumbline measures [3,4,5,6], simple goniometers, inclinometers and linear devices [79], placing known sized blocks between postural regions [8], various computer assisted methods including electrogoniometers [10], electromagnetic movement systems [11,12], computer assisted digitization systems [13,14,15], and 3D ultrasound-based motion analysis device for the cervical spine [16]. Computerized postural digitization/assessment procedures should allow for accurate quantitative evaluation of postural impairments so that improvement or worsening of a patient's abnormality can be succinctly documented
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