Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jan 18, 2017; 8(1): 68-76
Published online Jan 18, 2017. doi: 10.5312/wjo.v8.i1.68
Reliability and concurrent validity of postural asymmetry measurement in adolescent idiopathic scoliosis
Ashleigh Prowse, Berit Aslaksen, Marie Kierkegaard, James Furness, Paul Gerdhem, Allan Abbott
Ashleigh Prowse, James Furness, Allan Abbott, Faculty of Health Science and Medicine, Bond University, Gold Coast, Queensland 4229, Australia
Berit Aslaksen, Marie Kierkegaard, Department of Physiotherapy, Karolinska University Hospital, SE-17177 Huddinge, Sweden
Marie Kierkegaard, Department of Neurobiology, Care Sciences and Society (NVS), Division of Physiotherapy, Karolinska Institutet, SE-17177 Huddinge, Sweden
Paul Gerdhem, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-17177 Huddinge, Sweden
Allan Abbott, Department of Medical and Health Sciences, Division of Physiotherapy, Faculty of Health Sciences, Linköping University, SE-58183 Linköping, Sweden
Author contributions: Aslaksen B and Abbott A contributed to the study conception, design and data acquisition; Kierkegaard M and Abbott A contributed to data analysis; Prowse A, Furness J and Abbott A contributed to the interpretation of data; Prowse A, Aslaksen B, Kierkegaard M, Furness J, Gerdhem P and Abbott A contributed to the drafting, critical revision and final approval of the manuscript.
Institutional review board statement: The study was reviewed and approved by the Swedish Research Council Regional Ethics Committee in Stockholm, Sweden (Dnr: 2012/172-31/4) and from Bond University Health Research Ethics Committee in 2014 (RO 1896).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrolment.
Conflict-of-interest statement: The authors have no conflict of interests. The authors have no financial or other interest in the product.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at allan.abbott@liu.se. Participants gave informed consent for data sharing of anonymized data.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Allan Abbott, PhD, Med, MSc, Physio, Grad, Cert, Clin, Ed, BExSci, Department of Medical and Health Sciences, Division of Physiotherapy, Faculty of Health Sciences, Linköping University, Lasarettsgatan, SE-58183 Linköping, Sweden. allan.abbott@liu.se
Telephone: +46-13-282495 Fax: +46-13-145004
Received: July 22, 2016
Peer-review started: July 27, 2016
First decision: September 6, 2016
Revised: September 17, 2016
Accepted: October 17, 2016
Article in press: October 18, 2016
Published online: January 18, 2017
Abstract
AIM

To investigate the reliability and concurrent validity of the Baseline® Body Level/Scoliosis meter for adolescent idiopathic scoliosis postural assessment in three anatomical planes.

METHODS

This is an observational reliability and concurrent validity study of adolescent referrals to the Orthopaedic department for scoliosis screening at Karolinska University Hospital, Stockholm, Sweden between March-May 2012. A total of 31 adolescents with idiopathic scoliosis (13.6 ± 0.6 years old) of mild-moderate curvatures (25°± 12°) were consecutively recruited. Measurement of cervical, thoracic and lumbar curvatures, pelvic and shoulder tilt, and axial thoracic rotation (ATR) were performed by two trained physiotherapists in one day. The intraclass correlation coefficient (ICC) was used to determine the inter-examiner reliability (ICC2,1) and the intra-rater reliability (ICC3,3) of the Baseline® Body Level/Scoliosis meter. Spearman’s correlation analyses were used to estimate concurrent validity between the Baseline® Body Level/Scoliosis meter and Gold Standard Cobb angles from radiographs and the Orthopaedic Systems Inc. Scoliometer.

RESULTS

There was excellent reliability between examiners for thoracic kyphosis (ICC2,1 = 0.94), ATR (ICC2,1 = 0.92) and lumbar lordosis (ICC2,1 = 0.79). There was adequate reliability between examiners for cervical lordosis (ICC2,1 = 0.51), however poor reliability for pelvic and shoulder tilt. Both devices were reproducible in the measurement of ATR when repeated by one examiner (ICC3,3 0.98-1.00). The device had a good correlation with the Scoliometer (rho = 0.78). When compared with Cobb angle from radiographs, there was a moderate correlation for ATR (rho = 0.627).

CONCLUSION

The Baseline® Body Level/Scoliosis meter provides reliable transverse and sagittal cervical, thoracic and lumbar measurements and valid transverse plan measurements of mild-moderate scoliosis deformity.

Keywords: Reliability, Validity, Scoliosis, Posture, Assessment

Core tip: The Baseline® Body Level/Scoliosis meter is inexpensive, easily administered and provides reliable transverse and sagittal cervical, thoracic and lumbar measurements as well as valid transverse plan measurements of mild-moderate scoliosis deformity.