Head Alignment Research Articles

The role of biceps loading and muscle activation on radial head stability in anterior Monteggia injuries: An in vitro biomechanical study

IntroductionLittle evidence-based information is available to direct the optimal rehabilitation of patients with anterior Monteggia injuries. Purpose of the StudyThe aims of this biomechanical investigation were to (1) quantify the effect of biceps loading and (2) to compare the effect of simulated active and passive elbow flexion on radial head stability in anterior Monteggia injuries. Study DesignIn vitro biomechanical study. MethodsSix cadaveric arms were mounted in an elbow motion simulator. The effect of biceps loading, simulated active and passive elbow flexion motions was examined with application of 0N, 20N, 40N, 60N, 80N, and 100N of load. Simulated active and passive elbow flexion motions were then performed with the forearm supinated. Radial head translation relative to the capitellum was measured using an optical tracking system. After testing the intact elbows, the proximal ulna was osteotomized and realigned using a custom jig to simulate an anatomical reduction. We then sequentially sectioned the anterior radiocapitellar joint capsule, annular ligament, quadrate ligament, and the proximal and middle interosseous membrane to simulate soft tissue injuries commonly associated with anterior Monteggia fractures. ResultsGreater magnitudes of biceps loading significantly increased anterior radial head translation. However, there was no significant difference in radial head translation between simulated active and passive elbow flexion except in the final stage of soft tissue sectioning. There was a significant increase in anterior radial head translation with progressive injury states with both isometric biceps loading and simulated active and passive motion. ConclusionsOur results demonstrate that anatomic reduction of the ulna may not be sufficient to restore radial head alignment in anterior Monteggia injuries with a greater magnitude of soft tissue injury. In cases with significant soft tissue injury, the elbow should be immobilized in a flexed and supinated position to allow relaxation of the biceps and avoid movement of the elbow in the early postoperative period.

TO ASSESS THE KNOWLEDGE,ATTITUDE AND PRACTICE ABOUT PREHOSPITAL CARE OF TRAUMATIC SPINAL CORD INJURY AMONG EMS STUDENTS, PUNE,INDIA.

Background- Traumatic Spinal Cord injuries (TSCI) are defined as the key factors of mortality and disability. If acute trauma of spinal cord is not recognized and intervened it may cause secondary injury to spinal column. It is therefore very important to create an awareness amongst Emergency medical Services personnel regarding the initial first aid management and transportation of the patients afflicted with spinal cord injuries. Objective- To assess the Knowledge, Attitude and Practice about Prehospital care of Traumatic Spinal Cord Injury among Emergency Medical Service students Methods-The KAP study was conducted among 150 Postgraduate students of Emergency Medical Services at SCHS, Pune, India. The questionnaire consisted of 13 items based on 3 parameters -5 testing Knowledge, 5 measuring Attitude and 5 measuring Practice related to out hospital care of Traumatic Spinal Cord Injuries. Discussion- Majority of the students scored well in items testing the need to take care of maintaining the alignment of head, neck and spine. Majority students were aware of the importance of reassuring a responsive spinal injury patient and asking them not to move there head but a significant percentage of students answered incorrectly on when they should suspect a spinal injury. Conclusion- EMS students showed encouraging level of KAP with regards to TSCI but there are areas of improvement. Improving KAP of EMS students can significantly impact the outcome in spinal injury patients.

Recursos fisioterapêuticos nos desvios posturais da coluna vertebral: uma revisão integrativa

INTRODUÇÃO: Este estudo vai averiguar quais são as possibilidades de tratamento descritas na literatura para a escoliose, definida como curva lateral na coluna vertebral, apresentando uma leve rotação das vértebras. OBJETIVO: Identificar na literatura atual as principais técnicas fisioterapêuticas e seus benefícios para o tratamento da escoliose. MÉTODOS: Trata-se de uma revisão integrativa da literatura sobre os métodos fisioterapêuticos no tratamento da escoliose. Foram selecionados para esta revisão artigos publicados de 2009 a outubro de 2019 nas bases de dados eletrônicas Medline, Lilacs e SciELO, apenas artigos com tradução para o português foram considerados para esta revisão. RESULTADOS: Após a análise foram selecionados para esta revisão sete artigos para leitura na íntegra. Foram identificadas as seguintes condutas: técnica de pilates, reeducação postural global (RPG), isostretching, método klapp e cinesioterapia. Com os seguintes benefícios: melhora na postura, alinhamento da coluna vertebral torácica, melhora da flexibilidade, melhora da assimetria do tronco, diminuição da intensidade da dor, redução da curva escoliótica, melhora postural no alinhamento de cabeça, ombros, escápulas, ângulo de Talles, tronco, abdômen e pelve, aumento da força dos músculos flexores e extensores de tronco e redução do ângulo de Cobb da escoliose. CONCLUSÃO: Existem diversos métodos da fisioterapia com benéficos para o tratamento da escoliose, destacando o RPG e o pilates para a melhora da força, flexibilidade, dor e redução da curva escoliótica.

A temporary forward head posture decreases function of cervical proprioception.

Increased use of smartphones can cause abnormal alignment of head and neck, resulting in forward head posture (FHP). This can lead to change in the structures and function of the cervical vertebrae. The purpose of this study was to determine the impact on deep neck flexor muscles, proprioception, vestibular function, and balance of subjects with induced FHP by using smartphone. Twenty-two healthy persons were randomly divided into two groups. The FHP group maintained a craniovertebral angle (CVA) of <49° and a normal head posture group maintained a CVA of >50° watching the smartphone for 40 min. We measured the area of the longus colli and longus capitis muscles, cervical joint position sense, Romberg test, subjective visual vertical test, and subjective visual horizontal test. There was no significant difference in the deep neck flexor muscles, vestibular function, and static balance between the groups. However, there was a significant difference in the cervical proprioception (P<0.05). Proprioception may be considered to be the most influential factor in induced FHP by smartphone viewing.

Is forward head posture relevant to autonomic nervous system function and cervical sensorimotor control? Cross sectional study

BackgroundThere is a growing interest concerning the understanding of the sagittal configuration of the cervical spine as a clinical outcome. However, evaluating sensorimotor control and autonomic nervous system for participants with forward head posture (FHP) compared to strictly matched control participants with normal head alignment has not been adequately addressed. MethodsSensorimotor control variables include smooth pursuit neck torsion test(SPNT), Overall stability index (OSI) and left and right rotation repositioning accuracy. Autonomic nervous system function includes amplitude and latency of skin sympathetic response (SSR). We measured these variables in 80 participants with definite forward head posture (Craniovertebral angle less than 50 degrees) and 80 participants with age, gender, and BMI matched normal head alignment (Craniovertebral angle (CVA) more than 50 degrees). Differences in variable measures were examined using the parametric t-test. Pearson correlation was used to evaluate the relationship between FHP, sensorimotor control, and autonomic nervous system function. ResultsThe unpaired t-test analysis showed that there were statistically significant differences between the FHP group and control group for all of the sensorimotor measured variables including SPNT, OSI and left and right rotation repositioning accuracy (P < 0.001). Also, there was a significant difference in neurophysiological findings, including SSR amplitude (P = .005), but there was no significant difference for SSR Latency (P = .7). The CVA significantly correlated with all measured variables (P < 0.001). ConclusionsParticipants with FHP exhibited abnormal sensorimotor control and autonomic nervous system dysfunction compared to those with normal head alignment.

Head and Neck CT Atlases Alignment Based on Anatomical Priors Constraint

Head and Neck CT Atlases Alignment Based on Anatomical Priors Constraint

Self-aligning CMOS photodetector sensor for application on an NDB-based optical encoder

In this work, a complementary metal-oxide-semiconductor (CMOS) photodetector specifically designed to be used in a non-diffracting-beam (NDB) optical encoder is introduced. The sensor is aimed to address the critical alignment of the NDB-based optical encoder head and consists of a hexagonal array of photodiodes that can be interconnected among themselves. The photodiodes' interconnection is configured by means of static random access memory (SRAM) cells and transistors that operate as configurable connection switches between each photodiode and three of its neighbor photodiodes. This feature of the photodetector makes it possible to implement a search algorithm in order to find the photodiode where the NDB center impinges and then configure the appropriate detectivity pattern centered on that photodiode. It is shown that the new sensor design remarkably simplifies the alignment of the system.

TL 18086 - Forefoot axial radiographic study for the evaluation of metatarsal head alignment in the coronal plane

Introduction: Many authors consider differences in the relative length of metatarsal bones in the axial plane a cause of inadequate load distribution during gait, leading to metatarsalgia. The goal of surgical treatment is to realign the metatarsal formula. However, many studies have shown a 15% metatarsalgia recurrence rate after reconstructing the advocated metatarsal formula in the axial plane, questioning the importance of the alignment of the metatarsal heads in the coronal plane. Objective: To evaluate the alignment pattern of the metatarsal heads in the coronal plane in individuals with and without metatarsalgia. Methods: This cross-sectional study evaluated individuals aged 30 to 65 years, dividing them into 2 groups, one without foot pain, deformities or callosities and another with metatarsalgia between the 2nd, 3rd and 4th metatarsal bones. The individuals were selected according to inclusion and exclusion criteria and were included in the study after signing an informed consent form. After the selection, the subjects underwent one weight-bearing forefoot axial radiograph evaluating the coronal plane to measure the heights of the metatarsal heads and a weight-bearing anteroposterior foot radiograph to determine the length of each ray. Statistical analysis was performed to compare the measurements of the 2 groups. Results: In total, 106 individuals were divided into 2 groups, each comprising 106 feet, and evaluated. In the group with metatarsalgia, 32% patients were men, the mean age was 49.5 years, and 33 feet had hallux valgus. In the group without metatarsalgia, 51% patients were male, and the mean age was 44.6 years. The measured anthropometric variables did not differ significantly between groups. In both groups, the metatarsal heads were distributed in a curved line in the coronal plane, following the formula M1&lt;M2&gt;M3&gt;M4=M5. The distal support of the 1st ray was in a more plantar position in the group of patients with metatarsalgia (p=0.000). Conclusion: The metatarsal heads of the individuals of both groups were aligned in the coronal plane following the formula M1&lt;M2&gt;M3&gt;M4=M5. However, M1, M4 and M5 were at the same height in the group without metatarsalgia, whereas the M1 weight-bearing point was more plantar in the feet of patients with metatarsalgia.

Effects of carrying school bags on cervical and shoulder posture in static and dynamic conditions in adolescent students

Neck and Back Pain in Students is closely related to the school bags that they carry. There is a dearth of literature in terms of postural changes due to school bags in adolescents, especially those discussing postural changes in static and dynamic loading conditions. To assess the effects of weight, position, and time of school bag carriage in static and dynamic conditions on cervical and shoulder posture in adolescent students. Seventy adolescents (35 Females, 35 Males) between 10 and 15 years of age. Methods: Craniohorizontal Angle, Craniovertebral Angle, Sagittal Shoulder Posture, Anterior Head Alignment were assessed in 7 different conditions using Photographic Method and MB Ruler. Significant changes in Sagittal Shoulder Posture and Craniohorizontal Angle were found with unilateral school bag carriage as compared to minimal significant postural changes with bilateral carriage. Maximal significant postural changes, in terms of all outcome measures were noted during loaded dynamic activity. Craniovertebral Angle kept significantly reducing with time. Immediate assessments taken with a school bag weighing 13.5% of the body weight showed a significant decrement in the Craniohorizontal Angle. Even a bag weighing less than 10% of the body weight proved to bring about biomechanical changes, when assessments were taken during the activities that a child has to perform with a school bag (Post Standing, Post Walking, and During Walking).

Effects of adjustments to wheelchair seat to back support angle on head, neck, and shoulder postures in subjects with cerebral palsy

ABSTRACT A wheelchair is usually a source of mobility for people with moderate to severe cerebral palsy, who are unable to walk. They spend long periods of time sitting in their wheelchair, which can affect their head and neck alignment. Opening the seat to back support angle of the wheelchair can modify realignment of body segments and improve posture. Aims : To examine the effect of seat to back support angle adjustments on head, neck, and shoulder postural alignment in people with cerebral palsy. Methods : Nine participants with cerebral palsy who use a wheelchair for mobility sat in a research wheelchair. Sagittal head angle (SHA), cervical angle (CVA), and shoulder angle (SA) from photographs were examined using the Coach’s Eye device during three different seat to back support angles of the wheelchair (90°, 100°, 110°). Results : There were significant differences in mean SHA and CVA among the different seat to back support angles (p < .001). However, there was no significant difference in mean SA. Conclusion : Head (SHA) and (CVA) alignment was closest to neutral posture with seat to back support angles set at 110°. Thus, adjusting the wheelchair back support to a 110º would provide the most appropriate sagittal head and cervical angle for this population.

Evaluation of the modified radio-ulnar line in correlation with imaging features of the distal radio-ulnar joint osteoarthritis, using a 4D CT examination

Purpose: Modified Radio-Ulnar line (mRU) is a previously defined index of the Distal RadioUlnar Joint (DRUJ) and ulnar head alignment. The purpose of our study was to evaluate the association between mRU measurements using Four-Dimensional Computed Tomography (4DCT) examination with clinical symptoms and imaging features of DRUJ osteoarthritis (OA). Methods: In this IRB approved HIPAA compliant study, we scanned 18 wrists (10 patients with unilateral wrist pain and instability). Imaging of the contralateral asymptomatic side was also performed to aid the diagnosis in the symptomatic side. The 4DCT was obtained using a 320-row detector scanner (Aquilion One, Toshiba Medical Systems) in active pronation-supination. Our previous study confirmed the reliability of mRU measurements using 4DCT examination. The mRU measurements were performed in pronation, midpoint and supination by a fellowship trained MSK radiologist. Presence of symptoms (yes vs. no) and the Kellgren-Lawrence grade of OA (0-4) were assessed in correlation with mRU measurements in active motion. Results: The mRU values showed a significantly greater volar motion of the ulnar head in asymptomatic wrists (mRU mean values (P<0.001) in supination. Changes in the mRU measurements from pronation to midpoint (mean change: 0.11 (0.03), P:0.002) and to supination (0.19 (0.03), P<0.001) were significant only in the asymptomatic wrists. Unlike wrists with KL grade >=2, wrists with KL grade <2 had significant changes in the mRU values while moving from pronation to midpoint (mean change: 0.09, P:0.004) and from pronation to supination (0.14, P:0.059). The mRU values in pronation were not associated with the presence of symptoms or DRUJ OA. However, mRU values in supination were significantly correlated with both the presence of symptoms (correlation coefficient: 0.796, P<0.001) and KL grade of DRUJ OA (correlation coefficient: 0.647, P:0.005). Conclusions: while moving from pronation to supination, we observed that presence of clinical symptoms and imaging features of DRUJ OA severity were associated with restricted volar motion of the ulnar head (assessed by the mRU line).

The subjective perception of the vertical-a valuable parameter for determination of peripheral vestibular disorder in Menière's disease in the chronic phase?

The perception of verticality is mainly based on utricular afferent signals and central processing of the transmitted signals. However, there are also extracranial receptors that make aconsiderable contribution to the perception of verticality. With the subjective visual vertical (SVV) for the utricle and the subjective trunk vertical (STV), two different parameters are available that are not fully understood in terms of their response to physiologic and pathologic changes. The aim of this work was to determine SVV and STV under certain positions of the head and trunk as well as under the influence of Menière's disease (MD) as achronic vestibular disease. In aprospective clinical study, 26patients with MD and 39healthy volunteers were recruited. Subjects were examined with C‑SVV glasses and with the three-dimensional trunk excursion chair, while head and torso positions were varied. In both groups, SVV determination is clearly more accurate with anearth-vertical head alignment than with alateral head tilt (right: MM and control group: p = 0.001; left: MM p = 0.001, control group p = 0.000). If the torso is deflected laterally and the head is held straight, the SVV is significantly more accurate (left p = 0.003, right p = 0.015). The SRV was not affected by the presence of unilateral MD, while pathologic SVV values, if present, indicated the affected side. The results of our study support the assumption that in addition to SVV, SRV is an independent parameter for verticality perception and differs from the SVV in terms of lateralizing aperipheral vestibular deficit. These results suggest that the STV may depend not only on utricular function but also on extracranial afferent signals, and not be significantly altered by the presence of a hydropic peripheral vestibular lesion.

Effects of a muscular stretching and strengthening school-based exercise program on posture, trunk mobility, and musculoskeletal pain among elementary schoolchildren - a randomized controlled trial

Abstract Introduction: The exercise benefits for the most prevalent postural changes require proper investigation, with large samples, control group, and concealed allocation. Objective: To assess the effects of a muscular stretching and strengthening school-based exercise program on posture, trunk mobility, and musculoskeletal pain among elementary schoolchildren. Method: Three hundred students from three schools in Brazil were evaluated. Stretching and strengthening exercises, twice a week, for eight weeks in group sessions were provided by one physiotherapist. The control group did not undergo any intervention. Head, back and shoulder posture were qualitatively evaluated. Head and trunk alignment were evaluated using the Posture Assessment Software. Cervical, thoracic, low back and upper limb pain were assessed for the last seven days. The trunk mobility was recorded through the flexibility of the posterior chain. Posture, pain and trunk mobility were recorded at baseline and after the intervention. Groups were compared using χ2 test, two-way MANOVA, and two-way ANOVA, with α set at 5%. Results: Shoulder posture showed significant results (P = 0.04), the intervention group showed the lower worsening rate. In the quantitative evaluation, a statistically significant difference was observed between assessments (P &lt; 0.01 for head and trunk; ES = 0.53) but not between groups. The intervention group had a higher percentage of improvement in the overall musculoskeletal pain (P = 0.04; ES = 0.54). Mobility decreased an average of 1.8° in the control group and increased 5.0° in the intervention group, without statistical significance. Conclusion: The program was effective in reducing pain level and shoulder misalignment at the intervention group.

MRT as a Major Component of Physical Therapy Intervention for a Child with Congenital Muscular Torticollis: A Case Report

Congenital muscular torticollis (CMT) is a rare congenital musculoskeletal disorder characterised by unilateral shortening of the sternocleidomastoid muscle. It presents in newborn infants or young children with a reported incidence ranging from 0.3% to 2%. The Matrix concept was developed by Dr. Ulrich Randoll at the University of Erlangen Germany. According to this concept, life is a rhythmic movement. Diseases are disturbances until total stop. Basic therapy must be re-adaptation of rhythms on levels of cell biological regulation. This article reports a case of a 4months old female child successfully managed by Matrix Rhythm Therapy as a major part of physiotherapy for left side congenital muscular torticollis.The purpose of the case report is to find the efficacy of Matrix Rhythm Therapy on the neck movement and head alignment of a child with left side congenital muscular torticollis. Intervention included MRT,AROM, assisted movements in the neck region. Changes in the amounts of lateral head till were documented using still photography. The result of the study showed that child assumed a midline head posture in sitting position by the fifth session of therapeutic intervention (nine days).

Effects of Age on Dual-Task Walking While Listening

This study examined the effects of age on single- and dual-task listening and walking during virtual street crossing. Seventeen younger and 12 older adults participated. In each listening trial, three sentences were presented simultaneously from separate locations. Participants were instructed to report the target sentence. Predictability of the target sentence location was varied. Treadmill walking was measured using motion analysis. Measures included word recognition accuracy, head and trunk angles, and spatiotemporal gait parameters. Older adults exhibited a more upright head alignment and less variability in stride time during dual-tasking, particularly under less certain target sentence location conditions. Younger adults’ walking was unaffected by dual-task demands. Together, the results indicate greater postural prioritization in older adults than young.

Dual Mode Optical Measurement Sensor for 3D Surface Reconstruction and Crack Detection

A dual mode optical measurement sensor was developed to measure free form surfaces and detects cracks revealed with liquid penetrant test. The fusion of a multi-line laser triangulation sensor with texture images, acquired by the sensor, allows the detection of the crack and the calculation of position and orientation for proper positioning and alignment of a friction stir welding head for crack repair. In order to test the proposed procedure, the sensor was mounted on a motorized linear stage to measure a simulated crack on a pipe section. Results show that the crack can be detected and the 3D position and orientation can be defined on the reconstructed surface for crack repair procedures.

Hallux Valgus

Category: Bunion Introduction/Purpose: Abnormal motion of the first tarsometatarsal (TMT) joint disrupts the anatomic alignment of the metatarsal head, sesamoid complex and proximal first phalanx. This anatomic disruption combined with the deforming forces of the extensor hallucis longus, adductor tendons, and extensor hallucis brevis result in a hallux valgus deformity. First TMT arthrodesis or the Lapidus procedure has been described as treatment for moderate to severe hallux valgus deformities by correcting hypermobility and restoring anatomic alignment of the first ray. The aim of this study was to evaluate the safety of a percutaneous approach to the Lapidus procedure and its relation to anatomic structures. Methods: A percutaneous, modified Lapidus procedure was performed on 19 embalmed cadaveric feet under fluoroscopic guidance. The specimens were then dissected to identify the extensor hallucis longus (EHL), extensor hallucis brevis (EHB), tibialis anterior (TA), median branch of the superficial peroneal nerve (MBSPN), intermediate branch of the superficial peroneal nerve (IBSPN), deep peroneal neurovascular bundle (DPNVB) and saphenous vein (SV). The structures were localized with reference to percutaneous burr and screw placement during the procedure. Results: The tibialis anterior and intermediate branch of the superficial peroneal nerve were a mean of 3.75 millimeters (mm) and 5.08 mm from the closest burr or screw placement. The extensor hallucis longus and extensor hallucis brevis were at greatest risk under the new approach with mean distances of .92 to 4.08 mm to nearby instrumentation. The extensor hallucis longus or extensor hallucis brevis were either directly pierced or &lt;2 mm from instrumentation on 26 occasions. A terminal branch of the saphenous vein was also either pierced or within 2 mm of instrumentation on 4 occasions. The deep peroneal neurovascular bundle and median branch of superficial peroneal nerve were relatively safe, coming within 2 mm of percutaneous burr or screw placement on only 2 occasions each. Conclusion: The minimally invasive percutaneous Lapidus arthrodesis provides a safe alternative to the traditional, open approach for patients with moderate to severe hallux valgus deformities. This may be a beneficial alternative to conventional open Lapidus procedures by minimizing soft tissue dissection. Further clinical studies must be performed to compare deformity correction, fusion rate, and complications with the modified percutaneous Lapidus procedure.

Quantitative Approach Based on Wearable Inertial Sensors to Assess and Identify Motion and Errors in Techniques Used during Training of Transfers of Simulated c-Spine-Injured Patients

Patients with suspected spinal cord injuries undergo numerous transfers throughout treatment and care. Effective c-spine stabilization is crucial to minimize the impacts of the suspected injury. Healthcare professionals are trained to perform those transfers using simulation; however, the feedback on the manoeuvre is subjective. This paper proposes a quantitative approach to measure the efficacy of the c-spine stabilization and provide objective feedback during training. Methods. 3D wearable motion sensors are positioned on a simulated patient to capture the motion of the head and trunk during a training scenario. Spatial and temporal indicators associated with the motion can then be derived from the signals. The approach was developed and tested on data obtained from 21 paramedics performing the log-roll, a transfer technique commonly performed during prehospital and hospital care. Results. In this scenario, 55% of the c-spine motion could be explained by the difficulty of rescuers to maintain head and trunk alignment during the rotation part of the log-roll and their difficulty to initiate specific phases of the motion synchronously. Conclusion. The proposed quantitative approach has the potential to be used for personalized feedback during training sessions and could even be embedded into simulation mannequins to provide an innovative training solution.

Evolution of postural alignment in preschool and school phases: A longitudinal study

Abstract Aim: To identify postural variations in the positioning of the head, cervical spine and shoulders of children in two phases - preschool and school. Methods: This was a longitudinal study, a convenience sample with 99 children of both genders, in preschool (5-6 years old) and school (8-11 years old) phases. The postural alignment of the head, cervical spine and shoulders was evaluated through computerized photogrammetry and analyzed by SAPo software. Results: Differences were found between preschool and school phases, but only the variables of shoulder angle (SA) and forward head distance (FHD) were significantly different (SA = 32.79 [30.49 - 35.09] and 35.84 [33.53 - 38.15] p = 0.026, respectively; FHD = 8.40 [8.07 - 8.73] and 11.23 [10.94-11.52] p <0.001, respectively). A positive correlation was obtained between forward head distance and body mass (rho= 0.597, p <0.001). Conclusion: There are changes in head and shoulder alignment between preschool and school phases, with protrusion of shoulders and forward head distance findings in children who have evolved their posture. Therefore, parents should be aware of children’s posture, and health and education professionals should be involved in screening and prevention programs.

Inter- and intra-tester reliability of the acute brain injury physiotherapy assessment (ABIPA) in patients with acquired brain injury

ABSTRACTBackground: The Acute Brain Injury Physiotherapy Assessment (ABIPA) is a new outcome measure with face validity and sensitivity to change in the early stages of neuromotor recovery after acquired brain injury (ABI). Reliability of physiotherapists using the tool has not been established.Objective: Determine inter- and intra-tester reliability of physiotherapists using the ABIPA.Methods: An observational study using video-recorded assessments of patient performance (n = 7) was undertaken with two cohorts of physiotherapists: those receiving training (n = 23) and those provided with guidelines only (n = 7) to administer the ABIPA.Results: Across all physiotherapists (n = 30), inter-tester reliability was excellent (α ≥ 0.9) for total ABIPA score. All individual items, except trunk alignment in supine (α = 0.5), showed excellent or good internal consistency (α ≥ 0.7). For intra-tester reliability, substantial or perfect agreement was achieved for eight items (weighted Kappa Kw ≥ 0.6), moderate agreement for four items (Kw = 0.4–0.6) and three items achieved fair agreement (alignment head supine: Kw = 0.289; alignment trunk supine: Kw = 0.387 and tone left upper limb: Kw = 0.366).Conclusion: Physiotherapists are highly consistent using the ABIPA but several items may need revision to improve intra-tester reliability.