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ORIGINAL PAPER
Evaluations of the spinal curvatures in the sagittal plane: reference measurements, categorization, discriminatory and diagnostic accuracy
1
Department of Physiotherapy, Santa Catarina State University, Florianópolis, Brazil
2
CIPER, Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
3
Comprehensive Health Research Center, Department of Sports and Health, School of Health and Human Development, University of Évora, Portugal
4
Department of Physiotherapy and Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
5
Rural Department of Allied Health, La Trobe University, Bendigo, Australia
6
Leonardo da Vinci University Center, Blumenau, Brazil
Submission date: 2021-03-02
Acceptance date: 2021-10-06
Publication date: 2021-12-14
Physiother Quart. 2021;29(4):74-80
KEYWORDS
TOPICS
ABSTRACT
Introduction:
This study aimed to propose a categorization of body postures and to provide indexes/scores for the postural patterns.
Methods:
The body posture of the 3 spinal regions in 180 asymptomatic young people, mean age: 16.1 (0.77) years, was evaluated quantitatively in the sagittal plane (cinemetry and the curvature index). The same images were presented to experts who, by way of qualitative analyses, provided the postural diagnosis of each curvature for all of the young people. Individuals with the same postural patterns were grouped together and the qualitative data were crossed with the quantitative values. Thus, scores were attributed to normal curvature, tendencies, and deviations. The one-way ANOVA test for independent samples was used to compare the patterns and the Bonferroni post-hoc test served to analyse effects between neighbouring changes. The mean difference and the 95% confidence interval were also calculated to compare the patterns. An alpha level of 5% was adopted for all analyses. The sensitivity, specificity, positive and negative likelihood ratios, and the predictive value for the suggested reference intervals were calculated to determine the diagnostic accuracy.
Results:
Significantly different scores were attributed to the postural pattern curves: ≤ 0: curve inversion; 0.1–10: rectification; 10.1–11: tendency for rectification; 11.1–14: normal; 14.1–15: tendency for hyperlordosis/hyperkyphosis; > 15: hyperlordosis/hyperkyphosis. The scores presented great discriminatory capacity and diagnostic accuracy among the postural patterns.
Conclusions:
This categorization could aid researchers and health professionals in evaluating postural deviations.
This study aimed to propose a categorization of body postures and to provide indexes/scores for the postural patterns.
Methods:
The body posture of the 3 spinal regions in 180 asymptomatic young people, mean age: 16.1 (0.77) years, was evaluated quantitatively in the sagittal plane (cinemetry and the curvature index). The same images were presented to experts who, by way of qualitative analyses, provided the postural diagnosis of each curvature for all of the young people. Individuals with the same postural patterns were grouped together and the qualitative data were crossed with the quantitative values. Thus, scores were attributed to normal curvature, tendencies, and deviations. The one-way ANOVA test for independent samples was used to compare the patterns and the Bonferroni post-hoc test served to analyse effects between neighbouring changes. The mean difference and the 95% confidence interval were also calculated to compare the patterns. An alpha level of 5% was adopted for all analyses. The sensitivity, specificity, positive and negative likelihood ratios, and the predictive value for the suggested reference intervals were calculated to determine the diagnostic accuracy.
Results:
Significantly different scores were attributed to the postural pattern curves: ≤ 0: curve inversion; 0.1–10: rectification; 10.1–11: tendency for rectification; 11.1–14: normal; 14.1–15: tendency for hyperlordosis/hyperkyphosis; > 15: hyperlordosis/hyperkyphosis. The scores presented great discriminatory capacity and diagnostic accuracy among the postural patterns.
Conclusions:
This categorization could aid researchers and health professionals in evaluating postural deviations.
REFERENCES (32)
1.
Trigueiro MJ, Massada L, Garganta R. Back pain in Portuguese schoolchildren: prevalence and risk factors. Eur J Public Health. 2013;23(3):499–503; doi: 10.1093/eurpub/cks105.
2.
Smith A, O’Sullivan P, Straker L. Classification of sagittal thoraco-lumbo-pelvic alignment of the adolescent spine in standing and its relationship to low back pain. Spine. 2008;33(19):2101–2107; doi: 10.1097/BRS.0b013e31817ec3b0.
3.
Kratenová J, Zejglicová K, Malý M, Filipová V. Prevalence and risk factors of poor posture in school children in the Czech Republic. J Sch Health. 2007;77(3):131–137; doi: 10.1111/j.1746-1561.2007.00182.x.
4.
Izzo R, Guarnieri G, Guglielmi G, Muto M. Biomechanics of the spine. Part I: spinal stability. Eur J Radiol. 2013;82(1):118–126; doi: 10.1016/j.ejrad.2012.07.024.
5.
Adams MA, Dolan P. Spine biomechanics. J Biomech. 2005;38(10):1972–1983; doi: 10.1016/j.jbiomech.2005.03.028.
6.
Vialle R, Ilharreborde B, Dauzac C, Lenoir T, Rillardon L, Guigui P. Is there a sagittal imbalance of the spine in isthmic spondylolisthesis? A correlation study. Eur Spine J. 2007;16(10):1641–1649; doi: 10.1007/s00586-007-0348-4.
7.
Popova D, Mitova S, Gramatikova M. Research of innovative system abilities for postural analysis and postural disorders assessment. Act Phys Educ Sport. 2015;5(1):30–32.
8.
Ghandhari H, Hesarikia H, Ameri E, Noori A. Assessment of normal sagittal alignment of the spine and pelvis in children and adolescents. Biomed Res Int. 2013;2013:842624; doi: 10.1155/2013/842624.
9.
D’Osualdo F, Schierano S, Cisotti C. The evaluation of the spine through the surface. The role of surface measurements in the evaluation and treatment of spine diseases in young patients. Eur Med Phys. 2002;38(3):147–152.
10.
Fedorak C, Ashworth N, Marshall J, Paull H. Reliability of the visual assessment of cervical and lumbar lordosis: how good are we? Spine. 2003;28(16):1857–1859; doi: 10.1097/01.BRS.0000083281.48923.BD.
11.
Vrtovec T, Pernus F, Likar B. A review of methods for quantitative evaluation of spinal curvature. Eur Spine J. 2009;18(5):593–607; doi: 10.1007/s00586-009-0913-0.
12.
Briggs AM, Wrigley TV, Tully EA, Adams PE, Greig AM, Bennell KL. Radiographic measures of thoracic kyphosis in osteoporosis: Cobb and vertebral centroid angles. Skeletal Radiol. 2007;36(8):761–767; doi: 10.1007/s00256-007-0284-8.
13.
Tizabi AAT, Mahdavinejad R, Azizi A, Jafarnejadgero T, Sanjari M. Correlation between height, weight, BMI with standing thoracic and lumbar curvature in growth ages. World J Sport Sci. 2012;7(1):54–56; doi: 10.5829/idosi.wjss.2012.7.1.64109.
14.
Roussouly P, Pinheiro-Franco JL. Sagittal parameters of the spine: biomechanical approach. Eur Spine J. 2011;20(Suppl. 5):578–585; doi: 10.1007/s00586-011-1924-1.
15.
Roobottom CA, Mitchell G, Morgan-Hughes G. Radiation-reduction strategies in cardiac computed tomographic angiography. Clin Radiol. 2010;65(11):859–867; doi: 10.1016/j.crad.2010.04.021.
16.
Gstoettner M, Sekyra K, Walochnik N, Winter P, Wachter R, Bach CM. Inter- and intraobserver reliability assessment of the Cobb angle: manual versus digital measurement tools. Eur Spine J. 2007;16(10):1587–1592; doi: 10.1007/s00586-007-0401-3.
17.
Mac-Thiong J-M, Labelle H, Berthonnaud E, Betz RR, Roussouly P. Sagittal spinopelvic balance in normal children and adolescents. Eur Spine J. 2007;16(2):227–234; doi: 10.1007/s00586-005-0013-8.
18.
Been E, Kalichman L. Lumbar lordosis. Spine J. 2014;14(1):87–97; doi: 10.1016/j.spinee.2013.07.464.
19.
Somoskeöy S, Tunyogi-Csapó M, Bogyó C, Illés T. Accuracy and reliability of coronal and sagittal spinal curvature data based on patient-specific three-dimensional models created by the EOS 2D/3D imaging system. Spine J. 2012;12(11):1052–1059; doi: 10.1016/j.spinee.2012.10.002.
20.
Fortin C, Ehrmann Feldman D, Cheriet F, Labelle H. Clinical methods for quantifying body segment posture: a literature review. Disabil Rehabil. 2011;33(5):367–383; doi: 10.3109/09638288.2010.492066.
21.
Patias P, Grivas TB, Kaspiris A, Aggouris C, Drakoutos E. A review of the trunk surface metrics used as scoliosis and other deformities evaluation indices. Scoliosis. 2010;5:12; doi: 10.1186/1748-7161-5-12.
22.
Greendale GA, Nili NS, Huang M-H, Seeger L, Karlamangla AS. The reliability and validity of three non-radiological measures of thoracic kyphosis and their relations to the standing radiological Cobb angle. Osteoporos Int. 2011;22(6):1897–1905; doi: 10.1007/s00198-010-1422-z.
23.
Harrison DE, Haas JW, Harrison DD, Holland B, Janik T. Sagittal skin contour of the cervical spine: interexaminer and intraexaminer reliability of the flexicurve instrument. J Manipulative Physiol Ther. 2005;28(7):516–519; doi: 10.1016/j.jmpt.2005.07.009.
24.
Winter RB, Lonstein JE, Denis F. Sagittal spinal alignment: the true measurement, norms, and description of correction for thoracic kyphosis. J Spinal Disord Tech. 2009;22(5):311–314; doi: 10.1097/BSD.0b013e31817dfcc3.
25.
Harlick JC, Milosavljevic S, Milburn PD. Palpation identification of spinous processes in the lumbar spine. Man Ther. 2007;12(1):56–62; doi: 10.1016/j.math.2006.02.008.
26.
Hunt MA, Birmingham TB, Jenkyn TR, Giffin JR, Jones IC. Measures of frontal plane lower limb alignment obtained from static radiographs and dynamic gait analysis. Gait Posture. 2008;27(4):635–640; doi: 10.1016/j.gaitpost.2007.08.011.
27.
Schwertner DS, Oliveira R, Mazo GZ, Gioda FR, Kelber CR, Swarowsky A. Body surface posture evaluation: construction, validation and protocol of the SPGAP system (Posture Evaluation Rotating Platform System). BMC Musculoskelet Disord. 2016;17:204; doi: 10.1186/s12891-016-1057-0.
28.
Fritz JM, Wainner RS. Examining diagnostic tests: an evidence-based perspective. Phys Ther. 2001;81(9):1546–1564; doi: 10.1093/ptj/81.9.1546.
29.
Jaeschke R, Guyatt GH, Sackett DL, Guyatt G, Bass E, Brill-Edwards P, et al. Users’ guides to the medical literature. III. How to use an article about a diagnostic test. B. What are the results and will they help me in caring for my patients? JAMA. 1994;271(9):703–707; doi: 10.1001/jama.1994.03510330081039.
30.
ElBayomi FEA, Ibrahim FF, Ibrahim MM. Corrective exercises specific for adolescent idiopathic scoliosis presented with bilateral leg pain: a case report describing an adaptive program and the recorded improvement as expressed by Cobb angle. Physiother Quart. 2020;28(4):55–60; doi: 10.5114/pq.2020.96237.
31.
Krawczky B, Pacheco AG, Mainenti MRM. A systematic review of the angular values obtained by computerized photogrammetry in sagittal plane: a proposal for reference values. J Manipulative Physiol Ther. 2014;37(4):269–275; doi: 10.1016/j.jmpt.2014.01.002.
32.
Wilczyński J, Lipińska-Stańczak M, Wilczyński I. Body posture defects and body composition in school-age children. Children. 2020;7(11):204; doi: 10.3390/children7110204.
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