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


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).


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.


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


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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).

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  • adolescent
  • photographic analysis
  • reliability
  • spinal postural angles
  • Surgimap Spine software