Intra and interrater reliability of spinal sagittal curves and mobility using pocket goniometer IncliMed ® in healthy subjects

Abstract

BACKGROUND:

Radiographic examination is the gold standard to evaluate spine curves, but ionising radiations limit routine use. Non-invasive methods, such as skin-surface goniometer(IncliMed^®) should be used instead.

OBJECTIVE:

To evaluate intra- and interrater reliability to assess sagittal curves and mobility of the spine with IncliMed^®.

METHODS:

a reliability study on agonistic football players. Thoracic kyphosis, lumbar lordosis and mobility of the spine were assessed by IncliMed^®. Measurements were repeated twice by each examiner during the same session with between-rater blinding. Intrarater and interrater reliability were measured by Intraclass Correlation Coefficient(ICC), 95% Confidence Interval (CI 95%) and Standard Error of Measurement (SEM).

RESULTS:

Thirty-four healthy female football players (19.17 ± 4.52 years) were enrolled. Statistical results showed high intrarater (0.805-0.923) and interrater (0.701-0.886) reliability (ICC > 0.8). The obtained intra- and interrater SEM were low, with overall absolute intrarater values between 1.39° and 2.76° and overall interrater values between 1.71° and 4.25°.

CONCLUSIONS:

IncliMed^® provides high intra- and interrater reliability in healthy subjects, with limited Standard Error of Measurement. These results encourage its use in clinical practice and scientific research.

Keywords

Spine mobility non-invasive spinal sagittal curves measure reliability Intraclass Correlation Coefficient Standard Error of Measurement

References

Saad

, Colombo

, Ribeiro

, Joao

. Reliability of photogrammetry in the evaluation of the postural aspects of individuals with structural scoliosis. J Bodyw Mov Ther. 2012; 16: 210-216.

Gori

, Münzel

. Biological effects of low-dose radiation: of harm and hormesis. Eur Heart J. 2012; 33(3): 292-295.

De Gonzalez

, Darby

. Risk of cancer from diagnostic x-rays: Estimates for the UK and 14 other countries. Lancet. 2004; 363: 345-351.

Morrissy

, Goldsmith

, Hall

, Kehl

, Cowie

. Measurement of the Cobb angle on radiographs of patients who have scoliosis. Evaluation of intrinsic error. J Bone Joint Surg Am. 1990; 72: 320-7.

Corona

, Sanders

, Luhmann

, Diab

, Vitale

. Reliability of radiographic measures for infantile idiopathic scoliosis. J Bone Joint Surg Am. 2012; 94(12): e86.

Gstoettner

, Sekyra

, Walochnik

, Winter

, Wachter

, Bach

. Inter- and intraobserver reliability assessment of the Cobb angle: Manual versus digital measurement tools. Eur Spine J. 2007; 16: 1587-1592.

Negrini

, Aulisa

, Circo

, de Mauroy

, Durmala

, Zaina

. 2011 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis. 2012; 7(1): 3.

Negrini

, Negrini

, Santambrogio

, Sibilla

. Relation between static angles of the spine and a dynamic event like posture: approach to the problem. In: Three Dimensional Analysis of Spinal Deformities. Edited by D'Amico M, Merolli A, Santambrogio GC, vol. 1. Amsterdam: IOS Press - Ohmsha; 1995: 209-214.

Beauchamp

, Labelle

, Grimard

, Stanciu

, Poitras

, Dansereau

. Diurnal variation of Cobb angle measurement in adolescent idiopathic scoliosis. Spine. 1993; 18: 1581-1583.

10.

Zaina

, Atanasio

, Ferraro

, Fusco

, Negrini

, Romano

, Negrini

. Review of rehabilitation and orthopedic conservative approach to sagittal plane diseases during growth: hyperkyphosis, junctional kyphosis, and Scheuermann disease. Eur J Phys Rehabil Med. 2009; 45: 595-603.

11.

Kotwicki

, Negrini

, Grivas

, Rigo

, Maruyama

, Durmala

, Zaina

. Methodology of evaluation of morphology of the spine and the trunk in idiopathic scoliosis and other spinal deformities - 6th SOSORT consensus paper. Scoliosis. 2009; 4: 26.

12.

Kotwicki

. Evaluation of scoliosis today: examination, X-rays and beyond. Disabil Rehabil. 2008; 30: 742-751.

13.

Zaina

, Atanasio

, Negrini

. Clinical evaluation of scoliosis during growth: description and reliability. Stud Health Technol Inform. 2008; 135: 125-138.

14.

Negrini

, Aulisa

, Ferraro

, Fraschini

, Masiero

, Simonazzi

, Tedeschi

, Venturin

, et al. Italian guidelines on rehabilitation treatment of adolescents with scoliosis or other spinal deformities. Eura Medicophys. 2005; 41(2): 183-201.

15.

Illés

and Somoskeöy

. The EOS^TM imaging system and its uses in daily orthopaedic practice. International orthopaedics. 2012; 36(7): 1325-1331.

16.

Ferraro

, Masiero

, Venturin

, Mazzon

, Nalon

. La misurazione della cifosi toracica in età evolutiva con un metodo non invasivo. In: Di Benedetto P, Giorgini T, Luchi MT, eds. Temi di Riabilitazione. Trieste: Libreria Goliardica. 1996: 97-104.

17.

D'Osualdo

, Schierano

, Iannis

. Validation of clinical measurement of kyphosis with a simple instrument, the arcometer. Spine. 1997; 22: 408-13.

18.

Korovessis

, Petsinis

, Papazisis

, Baikousis

. Prediction of thoracic kyphosis using the Debrunner kyphometer. J Spinal Disord. 2001; 14: 67-72.

19.

de Oliveira

, Candotti

, La Torre

, Pelinson

PPT

, Furlanetto

, Kutchak

, et al. Validity and reproducibility of the measurements obtained using the flexicurve instrument to evaluate the angles of thoracic and lumbar curvatures of the spine in the sagittal plane. Rehabil Res Pract. 2012: 1-9.

20.

Van Blommestein

, Lewis

, Morrissey

, MacRae

. Reliability of measuring thoracic kyphosis angle, lumbar lordosis angle and straight leg raise with an inclinometer. Open Spine J. 2012; 4: 10-15.

21.

Czaprowski

, Pawlowska

, Gebicka

, Sitarski

, Kotwicki

. Intra- and inter-observer repeatability of the assessment of anteroposterior curvatures of the spine using Saunders digital inclinometer. Ortopaedic Traumatol Rehabil. 2012; 14: 145-153.

22.

Willner

. Spinal pantograph: A non-invasive technique for describing kyphosis and lordosis in the thoraco-lumbar spine. Acta Orthop Scand. 1981; 52: 525-529.

23.

Perriman

, Scarvell

, Hughes

, Ashman

, Lueck

, Smith

. Validation of the flexible electrogoniometer for measuring thoracic kyphosis. Spine. 2010; 35: 633-640.

24.

D'Amico

, D'Amico

, Roncoletta

, et al. 3D biomechanical skeleton model and processing procedure for posture and movement analysis. Eur Med Phys. 2007; 43(Suppl. 1 to No. 3).

25.

D'Osualdo

, Schierano

, Soldano

, Isola

. New tridimensional approach to the evaluation of the spine through surface measurement: the BACES system. J Med Eng Technol. 2002; 26: 95-105.

26.

Zubovic

, Davies

, Berryman

. New method of scoliois deformity assessment: ISIS2 System. Stud health technol Inform. 2008; 140: 157-60.

27.

Dickman

, Caspi

. Assessment of Scoliosis with Ortelius 800: Preliminary Results. Clinical Application Notes. 2001: 1-7.

28.

Assous

, et al. Reliability of Quantec scanning in predicting curve progression in early onset scoliosis. Journal of Bone & Joint Surgery, British Volume. 2006; 88(Suppl 2): 228-229.

29.

Schülein

, Mendoza

, Malzkorn

, Harms

, Skwara

. Rasterstereographic evaluation of interobserver and intraobserver reliability in postsurgical adolescent idiopathic scoliosis patients. J Spinal Disord Tech. 2013; 26(4): E143-9.

30.

Mannion

, Knecht

, Balaban

, Dvorak

and Grob

. A new skin-surface device for measuring the curvature and global and segmental ranges of motion of the spine: reliability of measurements and comparison with data reviewed from the literature. Eur Spine J. 2004; 13: 122-136.

31.

Fölsch

, Schlögel

, Lakemeier

, Wolf

, Timmesfeld

and Skwara

. Test-retest reliability of 3D ultrasound measurements of the thoracic spine. J Inj Funct Rehabil. 2012; 4: 335-341.

32.

Barrett

, McCreesh

, Lewis

. Reliability and validity of non-radiographic methods of thoracic kyphosis measurement: A systematic review. Manual therapy. 2014; 19(1): 10-17.

33.

Gravina

, Ferraro

, Frizziero

, Ferraro

, Masiero

. Goniometer evaluation of thoracic kyphosis and lumbar lordosis in subjects during growth age: A validity study. Stud Health Technology Inform. 2012; 176: 247-251.

34.

Eliasziw

, Young

, Woodbury

, Fryday-Field

. Statistical methodology for the concurrent assessment of interrater and intrarater reliability: using goniometric measurements as an example. Phys Ther. 1994; 74: 777-88.

35.

Weir

. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res. 2005; 19: 231-240.

36.

Fleiss

. The design and analysis of clinical experiments. New York, NY: John Wiley & Sons Inc; 1986.

37.

Shrout

, Fleiss

. Intraclass correlations: Uses in assessing rater reliability. Psychological Bulletin. 1979; 86: 420-428.

38.

Donner

, Eliasziw

. Sample size requirements for reliability studies. Stat Med. 1987; 6: 441-448.

39.

Perdriolle

. La Scoliose: son etude tridimensionnelle. Paris: Maloine; 1979.

40.

Blicharska

, Brzek

, Durmala

. Short-term effect (ATR, Kasperczyk's Scale, chest's mobility) of using of physiotherapy method in the treatment of AIS - pilot study. Stud Health Technol Inform. 2012; 176: 387-92.

41.

Fabian

. Evaluation of lung function, chest mobility, and physical fitness during rehabilitation of scoliotic girls. Ortop Traumatol Rehabil. 2009; 12(4): 301-309.

42.

Masiero

, Bonaldo

, Pigatto

, Lo Nigro

, Ramonda

, Punzi

. Rehabilitation treatment in patients with ankylosing spondilytis stabilized with tumor necrosis factor inhibitor therapy. A randomized controlled trial. The journal of rheumatology. 2011; 38: 7.

43.

Masiero

, Poli

, Bonaldo

, Pigatto

, Ramonda

, Lubrano

, Punzi

, Maffulli

. Supervised training and home-based rehabilitation in patients with stabilized ankylosing spondylitis on TNF inhibitor treatment: A controlled clinical trial with a 12-month follow-up. Clin Rehabil. 2013; 28(6): 562-572.

44.

Bland

, Altman

. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986; 8: 307-10.

45.

Bland

, Altman

. Applying the right statistics: Analyses of measurement studies. Ultrasound Obstet Gynecol. 2003; 22: 85-93.

46.

Walter

, Eliasziw

, Donner

. Sample size and optimal designs for reliability studies. Statistics in Medicine. 1998; 17: 101-110.

47.

Lewis

, Valentine

. Clinical measurement of the thoracic kyphosis. A study of the intra-rater reliability in subjects with and without shoulder pain. BMC Musculoskelet Disord. 2010; 11: 39.

48.

Melvin

, Sylvia

, Udo

, Helmut

, Paletta

and Adrian

. Reproducibility of rasterstereography for kyphotic and lordotic angles, trunk length and trunk inclination, a reliability study. Spine. 2010; 35: 1353-1358.

49.

Leroux

, Zabjek

, Simard

, Badeaux

, Coillard

and Rivard

. A non-invasive anthropometric technique for measuring kyphosis and lordosis, an application for idiopathic scoliosis. Spine. 2000; 25: 1689-1694.

50.

Greendale

, Nili

, Huang

, Seeger

, Karlamangla

. 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: 1897-1905.

51.

Kellis

, Adamou

, Tzilios

and Emmanouilidou

. Reliability of spinal range of motion in healthy boys using a skin-surface device. J Manipulative Physiol Ther. 2008; 31: 570-576.

52.

Ripani

, Di Cesare

, Giombini

, Agnello

, Fagnani

and Pigozzi

. Spinal curvature: Comparison of frontal measurements with the spinal mouse and radiographic assessment. J Sports Med Phys Fitness. 2008; 48: 488-494.