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Intra-rater and inter-rater reliability of Surgimap Spine software for measuring spinal postural angles from digital photographs

Bulletin of Faculty of Physical Therapy volume 20, pages 193–199 (2015)Cite this article

Abstract

Background and purpose

An accurate noninvasive measurement of spinal angles is crucial for detecting postural problems and for assessing therapeutic intervention for students in school. This study was conducted to evaluate the intra-rater and inter-rater reliability of Surgimap Spine software for measuring spinal postural angles from digital photos of adolescents in schools.

Participants and methods

Twenty-two adolescent students of both sexes (10 boys and 12 girls) participated in this reliability study. The researcher took four photographs of each adolescent from different standing views; at intra-rater analysis, one rater analyzed the four photos at three different time, whereas at inter-rater analysis three raters analyzed them once. Reliability was quantified with intraclass correlation coefficient (ICC), repeated measurement analysis (RMA), and standard of measurement error (SEM).

Results

Intra-rater reliability of all spinal postural angles [head tilt, shoulder tilt, pelvic tilt from anterior view, scapular tilt, gaze angle, craniovertebral angle, trunk angle, lumbar angle, pelvic tilt from lateral view, and sway angle for right and left sides] showed excellent results, with ICC above 0.9, whereas ICC for pelvic tilt from the posterior view (0.813) was very good. SEM ranged from 0.28 to 1.5° and RMA showed no statistical difference between measurements of the same rater. ICC values for inter-rater reliability of all spinal postural angles ranged from 0.836 to 0.992. SEM ranged from 0.3 to 1.63° and RMA showed no statistical difference in measurements between different raters.

Conclusion

Surgimap Spine software is a reliable method for measuring spinal postural angles of adolescents from different views in standing position from digital photographs.

References

  1. Grimmer-Somers K, Milanese S, Louw Q. Measurement of cervical posture in the sagittal plane. Manip Physiol Ther J 2008; 31:509–517.

    Article  Google Scholar 

  2. Van Biljon I, Wilders CJ. The prevalence of posture deformities among black African children in selected schools in the North West Province. Presented as a poster at the South African Spud and Recreation Conference; 7–9 September 2006; Potchefstroom, South Africa.

  3. Muyor JM, Sánchez-Sánchez E, Sanz-Rivas D, López-Miñarro PA. Sagittal spinal morphology in highly trained adolescent tennis players. Sport Sci Med J 2013; 12: 588–593.

    Google Scholar 

  4. Bubanj S, Živković M, Živković D, Milenković S, Bubanj R, Stanković R, et al. The incidence of sagittal postural deformities among high school students: preliminary study. Acta Kinesiol 2012; 6:27–30.

    Google Scholar 

  5. Iunes DH, Cecilio MBB, Dozza MA, Almeida PR. Quantitative photogrammetric analysis of the Klapp method for treating idiopathic scoliosis. Rev Bras Fisioter (São Carlos) 2010; 14:133–40.

    Article  Google Scholar 

  6. Beach T, Parkinson R, Sothart P, Callaghan J. Effects of prolonged sitting on the passive flexion stiffness of the in vivo lumbar spine. Spine 2005; 5:145–154.

    Article  Google Scholar 

  7. Korovessis P, Koureas G, Zacharatos S, Papazisis Z. Backpacks, back pain, sagittal spinal curves and trunk alignment in adolescents: a logistic and multinomial logistic analysis. Spine 2005; 30:247–255.

    Article  Google Scholar 

  8. Biddle S, Cavill N, Sallis J. Health enhancing physical activity for young people: statement of the United Kingdom expert consensus conference. Pediatr Exercise Sci 2001; 13:12–25.

    Article  Google Scholar 

  9. Ferreira EA, Duarte M, Maldonado EP, Bersanetti AA, Marques AP. Quantitative assessment of postural alignment in young adults based on photographs of anterior, posterior, and lateral views. Manip Physiol Ther J 2011; 34:371–380.

    Article  Google Scholar 

  10. Kendall FP, Mccreary EK, Provance P, Rodgers MM, Romani WA. Muscles: testing and function with posture and pain. 5th ed. Baltimore: Lippincott Williams and Wilkins; 2005.

    Google Scholar 

  11. McEvoy MP, Grimmer K. Reliability of upright posture measurements in primary school children. BMC Musculoskelet Disord 2005; 29:6–35.

    Google Scholar 

  12. Fortin C, Feldman DE Cheriet F, Gravel D, Gauthier F, Labelle H. Reliability of a quantitative clinical posture assessment tool among persons with idiopathic scoliosis. Physiother 2012; 98:64–75.

    Article  Google Scholar 

  13. Souza JA, Pasinato F, Basso D, Corrêa ECR, da Silva AMT. Biophotogrammetry: reliability of measurements obtained with a posture assessment software (SAPO). Rev Bras Cineantropom Desempenho Hum 2011; 13:299–305.

    Article  Google Scholar 

  14. Wu W, Liang J, Du Y, Tan X, Xiang X, Wang W, et al. Reliability and reproducibility analysis of the Cobb angle and assessing sagittal plane by computer-assisted and manual measurement tools. BMC Musculoskelel Disord 2014; 15: 33.

  15. Ferreira EAG, Duarte M, Maldonado EP, Burke TN, Marques AP. Postural assessment software (PAS/SAPO): validation and reliability. Clinics (São Paulo, Brazil) 2010; 65:675–81.

    Article  Google Scholar 

  16. Perry M, Smith A, Straker L, Coleman J, O’sullivan P. Reliability of sagittal photographic spinal posture assessment in adolescents. Adv Physiother 2008; 10:66–75.

    Article  Google Scholar 

  17. Grimmer K, Brenton D, Milanese S, Pirunsan U, Trott P. Adolescent standing postural response to backpack loads: a randomised controlled experimental study. BMC Musculoskelet Disord 2002; 3:1–10.

    Article  Google Scholar 

  18. Normand MC, Descarreaux M, Harrison DD, Harrison DE, Perron DL, Ferrantelli JR, et al. Three dimensional evaluation of posture in standing with the Posture Print: an intra- and inter-examiner reliability study. Chiropr Osteopat 2007; 24:15–23.

    Article  Google Scholar 

  19. Ramprasad M, Alias J, Raghuveer AK. Effect of backpack weight on postural angles in preadolescent children. Indian Pediatr 2010; 47:573–580.

    Article  Google Scholar 

  20. Mahajan S, Sen S, Bhardwaj B. Correlation between stress and discomfort with biomechanical posture in chronic computer users. IJAR 2013; 1: 323–330.

    Google Scholar 

  21. Straker LM, O’Sullivan PB, Smith A, Perry M. Computer use and habitual spinal posture in Australian adolescents. Public Health Reports 2007; 122:634–643.

    Article  Google Scholar 

  22. Weir JP. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. Strength Conditioning Res J 2005; 19:231–240.

    Google Scholar 

  23. Hayes K, Walton JR, Szomor ZR, Murrell GA. Reliability of five methods for assessing shoulder range of motion. Aus Physiother J 2001; 47: 289–294.

    Article  CAS  Google Scholar 

  24. Jordan K, Dziedzic K, Jones PW, Onq BN, Dawes PT. The reliability of the three-dimensional FASTRAK measurement system in measuring cervical spine and shoulder range of motion in Healthy subjects. Rheumatology 2000; 39:382–388.

    Article  CAS  Google Scholar 

  25. Dunk NM, Chung YY, Compton DS, Callaghan JP. The reliability of quantifying upright standing postures as a baseline diagnostic clinical tool. Manip Physiol Ther J 2004; 27:91–96.

    Article  Google Scholar 

  26. Christensen HW, Nilsson N. The ability to reproduce the neutral zero position of the head. Manip Physiol Ther J 1999; 22:26–28.

    Article  CAS  Google Scholar 

  27. Swinkels A, Dolan P. Spinal position sense is independent of the magnitude of movement. Spine 2000; 25:98–105.

    Article  CAS  Google Scholar 

  28. Dunk NM, Lalonde J, Callaghan JP. Implications for the use of postural analysis as a clinical diagnostic tool: reliability of quantifying upright standing spinal postures from photographic images. Manip Physiol Ther J 2005; 28:386–392.

    Article  Google Scholar 

  29. Beaudoin L, Zabjek KF, Leroux MA, Coillard C, Rivard CH. Acute systematic and variable postural adaptations induced by an orthopaedic shoe lift in control subjects. Eur Spine J 1999; 8:40–45.

    Article  CAS  Google Scholar 

  30. Strimpakos N, Sakellari V, Gioftsos G, Papathanasiou M, Brountzos E, Kelekis D, et al. Cervical spine ROM measurements: optimizing the testing protocol by using a 3D ultrasound-based motion analysis system. Cephalgia 2005; 25:1133–45.

    Article  CAS  Google Scholar 

  31. Van Maanen CJ, Zonnenberg AJ, Elvers JW, Oostendorp RA. Intra/inter-rater reliability of measurements on body posture photographs. Cranio 1996; 14:326–31.

    Article  Google Scholar 

  32. Iunes DH, Castro FA, Salgado HS, Moura IC, Oliveira AS, Bevilaqua-Grossi D. Intra and inter-rater reliability and repeatability of postural evaluation by photogrammetry. Rev Bras Fisioter 2005; 9: 327–34.

    Google Scholar 

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Authors and Affiliations

  1. Department of Basic Science, Faculty of Physical Therapy, Beni-Suef University, 4 Ten St, Ebn Elrasheed, Rod El-Farag, 11231, Beni-Suef, Egypt

    Nesma A. Helmya & Omaima M. Kattabeib

  2. Department of Basic Science, Faculty of Physical Therapy, Cairo University, Cairo, Egypt

    Mohsen M. El-Sayyadb

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  1. Nesma A. Helmya
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  2. Mohsen M. El-Sayyadb
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  3. Omaima M. Kattabeib
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Correspondence to Nesma A. Helmya.

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Helmya, N.A., El-Sayyadb, M.M. & Kattabeib, O.M. Intra-rater and inter-rater reliability of Surgimap Spine software for measuring spinal postural angles from digital photographs. Bull Fac Phys Ther 20, 193–199 (2015). https://doi.org/10.4103/1110-6611.174719

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  • DOI: https://doi.org/10.4103/1110-6611.174719

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