Validity of a Quantitative Clinical Measurement Tool of Trunk Posture in Idiopathic Scoliosis

Study Design. Concurrent validity between postural indices obtained from digital photographs (two-dimensional [2D]), surface topography imaging (three-dimensional [3D]), and radiographs. Objective. To assess the validity of a quantitative clinical postural assessment tool of the trunk based on photographs (2D) as compared to a surface topography system (3D) as well as indices calculated from radiographs. Summary of Background Data. To monitor progression of scoliosis or change in posture over time in young persons with idiopathic scoliosis (IS), noninvasive and nonionizing methods are recommended. In a clinical setting, posture can be quite easily assessed by calculating key postural indices from photographs. Methods. Quantitative postural indices of 70 subjects aged 10 to 20 years old with IS (Cobb angle, 15°–60°) were measured from photographs and from 3D trunk surface images taken in the standing position. Shoulder, scapula, trunk list, pelvis, scoliosis, and waist angles indices were calculated with specially designed software. Frontal and sagittal Cobb angles and trunk list were also calculated on radiographs. The Pearson correlation coefficients (r) was used to estimate concurrent validity of the 2D clinical postural tool of the trunk with indices extracted from the 3D system and with those obtained from radiographs. Results. The correlation between 2D and 3D indices was good to excellent for shoulder, pelvis, trunk list, and thoracic scoliosis (0.81 > r < 0.97; P < 0.01) but fair to moderate for thoracic kyphosis, lumbar lordosis, and thoracolumbar or lumbar scoliosis (0.30 > r < 0.56; P < 0.05). The correlation between 2D and radiograph spinal indices was fair to good (−0.33 to −0.80 with Cobb angles and 0.76 for trunk list; P < 0.05). Conclusion. This tool will facilitate clinical practice by monitoring trunk posture among persons with IS. Further, it may contribute to a reduction in the use of radiographs to monitor scoliosis progression.

[1]  Orit Shechtman,et al.  Foundations of Clinical Research: Applications to Practice, 2nd Edition, Leslie Gross Portney, Mary P. Watkins. Prentice Hall, Upper Saddle River, NJ (2000), 752 pages. $60 , 2001 .

[2]  Jack C Y Cheng,et al.  The effect of backpack weight on the standing posture and balance of schoolgirls with adolescent idiopathic scoliosis and normal controls. , 2006, Gait & posture.

[3]  M Kaliszer,et al.  Surface Topography, Cobb Angles, and Cosmetic Change in Scoliosis , 2001, Spine.

[4]  K. Grimmer,et al.  Bmc Musculoskeletal Disorders Reliability of Upright Posture Measurements in Primary School Children , 2005 .

[5]  J. C. Cool,et al.  A biomechanical analysis of the vertebral and rib deformities in structural scoliosis , 1999, European Spine Journal.

[6]  A Comparison of Radiographic and Electrogoniometric Angles in Adolescent Idiopathic Scoliosis , 1996, Spine.

[7]  Farida Cheriet,et al.  Accuracy assessment of human trunk surface 3D reconstructions from an optical digitising system , 2006, Medical and Biological Engineering and Computing.

[8]  Farida Cheriet,et al.  Reliability of trunk shape measurements based on 3-D surface reconstructions , 2007, European Spine Journal.

[9]  L. Straker,et al.  Classification of Sagittal Thoraco-Lumbo-Pelvic Alignment of the Adolescent Spine in Standing and Its Relationship to Low Back Pain , 2008, Spine.

[10]  T. Grivas,et al.  Pathogenesis of idiopathic scoliosis. The Nottingham concept. , 1992, Acta orthopaedica Belgica.

[11]  Martin Descarreaux,et al.  Three dimensional evaluation of posture in standing with the PosturePrint: an intra- and inter-examiner reliability study , 2007, Chiropractic & osteopathy.

[12]  P. Korovessis,et al.  Prediction of Scoliotic Cobb Angle With the Use of the Scoliometer , 1996, Spine.

[13]  Farida Cheriet,et al.  Prediction of anterior scoliotic spinal curve from trunk surface using support vector regression , 2005, Eng. Appl. Artif. Intell..

[14]  Jean-Louis Thonnard,et al.  Influence of structural pelvic disorders during standing and walking in adolescents with idiopathic scoliosis. , 2005, The spine journal : official journal of the North American Spine Society.

[15]  Jean Dansereau,et al.  Indices of torso asymmetry related to spinal deformity in scoliosis. , 2002, Clinical biomechanics.

[16]  N J Oxborrow,et al.  Assessing the child with scoliosis: the role of surface topography , 2000, Archives of disease in childhood.

[17]  C. MacDonncha,et al.  A reliable technique for the assessment of posture: assessment criteria for aspects of posture. , 2000, The Journal of sports medicine and physical fitness.

[18]  Bert Verdonck,et al.  The reliability of quantitative analysis on digital images of the scoliotic spine , 2002, European Spine Journal.

[19]  A. G. Veldhuizen,et al.  The aetiology of idiopathic scoliosis: biomechanical and neuromuscular factors , 2000, European Spine Journal.

[20]  A. Schultz,et al.  Trunk Muscle Myoelectric Activities in Idiopathic Scoliosis , 1983, Spine.

[21]  K. Zabjek,et al.  Evaluation of segmental postural characteristics during quiet standing in control and Idiopathic Scoliosis patients. , 2005, Clinical biomechanics.

[22]  Validation of a Non-Invasive Method of Measuring the Surface Curvature of the Erect Spine , 1994 .

[23]  T N Theologis,et al.  Early Detection of Progression in Adolescent Idiopathic Scoliosis by Measurement of Changes in Back Shape With the Integrated Shape Imaging System Scanner , 1997, Spine.

[24]  Jack R Engsberg,et al.  Relationships between spinal landmarks and skin surface markers. , 2008, Journal of applied biomechanics.

[25]  M. Descarreaux,et al.  Postural development in school children: a cross-sectional study , 2007, Chiropractic & osteopathy.

[26]  L. Lenke,et al.  Prospective Dynamic Functional Evaluation of Gait and Spinal Balance Following Spinal Fusion in Adolescent Idiopathic Scoliosis , 2001, Spine.

[27]  J. Sevastik,et al.  Accuracy and applicability of measurement of the scoliotic angle at the frontal plane by Cobb's method, by Ferguson's method and by a new method , 2004, European Spine Journal.

[28]  W. P. Bunnell.  An objective criterion for scoliosis screening. , 1984, The Journal of bone and joint surgery. American volume.

[29]  C. Vaughan,et al.  Photographic measurement of upper-body sitting posture of high school students: A reliability and validity study , 2008, BMC musculoskeletal disorders.