Quantitative Assessment of Postural Alignment in Young Adults Based on Photographs of Anterior, Posterior, and Lateral Views

Correlation between physical activity and anthropometric measurements among children and adolescents

OBJECTIVES

The purpose of this study was to measure the association between the level of physical activity and sedentary conditions with anthropometric measurements of children and adolescents.

METHODS

This cross-sectional descriptive study consisted of a convenience sample of 400 children and adolescents from public schools in Itapevi-SP, Brazil. The Physical Activity Checklist Interview or LAF "Lista de Atividades Físicas" in a Brazilian version, was administered in a face-to-face interview on a school day and allowed assessment of sedentary behavior and physical activity on the previous day. Anthropometric measurements included body weight, sex, age, and lower limb posture. The participants were photographed in the frontal and sagittal planes, and the photos were analyzed using postural assessment software (PAS/SAPO). Pearson's tests were applied to analyze correlations.

RESULTS

Children and adolescents show a greater tendency toward valgus knees with increasing body mass (r = ‒0.33). On average, girls have a larger Q angle. Ankles are less likely to become valgus with increasing age and mass (r = ‒0.18 and ‒0.23, respectively). The horizontal alignment of the pelvis is mostly in anteversion with a significant increase with age (r = 0.27) and a slight increase with mass (r = 0.15). The knee and ankle tend to be less hyperextended and more dorsiflexed from the age of 10, with no correlation with the other variables. It was not possible to observe a clear relationship between the time spent in physical activity and sedentary behavior and the postural angles mentioned above.

CONCLUSION

Although correlations were found between age, sex and body mass, and postural angles, notably pelvis alignment, Q angle, knee, ankle, sex, and body weight, there was no correlation between the time spent in physical activity, sedentary behavior, and lower limb posture.

Odds ratio of occurrence of pain, postural changes, and disabilities of violinists

The objective of this study is to evaluate the odds ratio of occurrence of pain, postural changes, and disabilities of violinists. Thirty-eight violinists were assessed. Photographs from anterior, posterior, and lateral views were taken and analyzed using Software of Postural Analysis. Pain was assessed by the Visual Analogue Pain Scale and the musculoskeletal disability of the arm, shoulder, and hand questionnaire (DASH). A logistic regression model was employed and all variables related to posture, age, gender, hours of practice, and duration of practice were considered. The results regarding the VAS and DASH were analyzed using multivariate techniques. The most important variables for the discrimination between the groups regarding the VAS scores were head and shoulder and thoracic kyphosis. For the DASH index, the key variables were the lateral spinal deviation and the head tilt. The odds ratio of occurrence pain was associated with the duration of the practice and the following postural variables: shoulder asymmetries, head postures, and lumbar lordosis. Scapular postures and thoracic kyphosis were associated with hours of practice, and the scapular postures with the duration of practice. This article provides new evidence of occurrence of pain, postural changes and disabilities in violinists. The odds ratio of occurrence pain was associated with the duration of the professional practice.

Unlocking the Potential: Increasing Muscle Strength in Lower Limbs of Youth Soccer Players over Five Weeks through Mat Pilates Training-A Pilot Study

The interest in soccer generally starts during childhood, with children and young people often looking for opportunities in sports. New exercise techniques can be effective in improving training. The aim of this study was to compare the effects on the strength and physical posture of a group practicing Pilates with another not practicing Pilates, both undergoing continuous football training. In this controlled randomized clinical trial, the participants were 15 soccer club members, who had a training frequency of least three times weekly. The sample was divided into a control group (n = 7) of players who did not undergo any therapeutic intervention (only the usual training) and a Pilates group (n = 8) of players who participated in the mat Pilates program. The intervention consisted of fifteen sessions. Postural evaluations were performed using biophotogrammetry and force analysis. Significant improvements were obtained in terms of increased muscle strength (p = 0.001) for the Pilates group, but there were no significant postural alterations when comparing the two groups. Five weeks of mat Pilates was sufficient to increase lower limb muscle strength in young football players. This pilot study indicates that Mat Pilates as a method that could be planned to be included in training.

Measurement of human body parameters for human postural assessment via single camera

We present a camera-based human body parameters measurement approach and develop a human postural assessment system. The approach combines the conventional contact measurement method and the non-contact measurement method to overcome some shortcomings in terms of time, expense, and professionalism in early methods. The entire measurement system consists of a computer, a high-definition camera, and the sticky points that are applied to the participant's body before the measurement. The camera captures the triple view image of human body. Then, the human body outline and the joint points of the human skeleton are extracted to locate the bone feature points. Finally, measurements and extractions of the human parameters are made. Experimental results demonstrate that the global postural assessment system provides quantitative guidance for human postural evaluation, and it completely changes how human postural is evaluated. The postural assessment system is significant for early diagnosis of diseases and medical rehabilitation treatment.

PosturAll: A Posture Assessment Software for Children

From an early age, people are exposed to risk factors that can lead to musculoskeletal disorders like low back pain, neck pain and scoliosis. Medical screenings at an early age might minimize their incidence. The study intends to improve a software that processes images of patients, using specific anatomical sites to obtain risk indicators for possible musculoskeletal problems. This project was divided into four phases. First, markers and body metrics were selected for the postural assessment. Second, the software's capacity to detect the markers and run optimization tests was evaluated. Third, data were acquired from a population to validate the results using clinical software. Fourth, the classifiers' performance with the acquired data was analyzed. Green markers with diameters of 20 mm were used to optimize the software. The postural assessment using different types of cameras was conducted via the blob detection method. In the optimization tests, the angle parameters were the most influenced parameters. The data acquired showed that the postural analysis results were statistically equivalent. For the classifiers, the study population had 16 subjects with no evidence of postural problems, 25 with mild evidence and 16 with moderate-to-severe evidence. In general, using a binary classification with the train/test split validation method provided better results.

A feasibility study of applying two-dimensional photogrammetry for screening and monitoring of patients with adolescent idiopathic scoliosis in clinical practice

Standing posteroanterior radiographs have been the golden standard to quantify the severity of scoliosis deformity. However, it exposes ionizing radiation to scoliosis patients, and cannot be used for routine screening and monitoring. This study aimed to develop a protocol of measuring postural indexes by using the noninvasive and radiation-free two-dimensional (2D) photogrammetry method and identify its clinical value in scoliosis screening and monitoring. The five postural indexes were measured from the posterior view of 110 participants. One-way ANOVA with post hoc Tukey HSD/Games-Howell analysis was used to compare the differences between the participants in the scoliosis group and the non-scoliosis group. Pearson coefficients of correlation were analyzed to identify the relationships between Cobb angles and each of the five quantitative postural indexes. Based on 2D photogrammetry, the postural indexes of C7 deviation (p = 0.02), shoulder alignment (p < 0.001), scapula alignment (p < 0.001), waist angle discrepancy (p < 0.001), and PSIS alignment (p < 0.001) could significantly differentiate scoliosis and non-scoliosis patients during screening. The waist angle discrepancy (r = 0.4, p = 0.01; r = 0.8, p = 0.03; r = 0.7, p = 0.01) and shoulder alignment (r = 0.6, p = 0.03) had moderate to strong positive correlations with the Cobb angles, which supported their clinical values in monitoring scoliotic curvature changes of adolescent idiopathic scoliosis (AIS) patients.

Intra and interrater reliability for lower limb flexibility assessment using photogrammetry

INTRODUCTION

Photogrammetry represents an advancement in the flexibility evaluation, and although it was highly explored for postural assessment, there is a scarcity of studies analyzing lower limb angular measurements using it. The purpose of this study is to verify the reliability of intrarater and interrarater photogrammetry in assessing lower limb flexibility.

METHODS

This was a randomized cross-sectional observational study with test-retest design and a two-day interval. Thirty healthy, physically active adults were included. Three novice raters assessed the participants through flexibility tests of iliopsoas, hamstring, quadriceps and gastrocnemius on two occasions, and independently analyzed the captured images to establish reliability. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable change (MDC) were calculated.

RESULTS

Intrarater reliability was excellent for iliopsoas (ICC = 0.96; SEM = 1.4; MDC = 3.8), hamstring (ICC = 0.99; SEM = 1.1; MDC = 3.1), quadriceps (ICC = 0.99; SEM = 0.8; MDC = 2.3) and gastrocnemius (ICC = 0.98; SEM = 0.9; MDC = 2.5). Interrater reliability was excellent for iliopsoas (ICC = 0.94; SEM = 1.7; MDC = 4.6) and gastrocnemius (ICC = 0.91; SEM = 2.1; MDC = 5.8), but good for hamstring (ICC = 0.90; SEM = 2.8; MDC = 7.9) and quadriceps (ICC = 0.85; SEM = 3.0; MDC = 8.3).

CONCLUSIONS

The excellent intrarater and good to excellent interrater reliability suggest that photogrammetry assessment of lower limb flexibility by novice raters is reliable. However, clinicians should consider the higher threshold of range of motion change necessary to outweigh measurement error due to interrater variability.

Short-Term Changes in Posture and Pain of the Neck and Lower Back of Women Undergoing Lipoabdominoplasty: A Case Series Report

Objective

The purpose of this study was to analyze short-term variations in posture and intensity of neck and lower back pain in women undergoing lipoabdominoplasty.

Methods

This prospective case series study involved 17 women (age 43 ± 12 years, presurgical body mass index 27.0 ± 3.7 kg/m2). Participants were assessed preoperatively (T0) and at 15 (T15) and 30 days (T30) after surgery for clinical data (number of pregnancies, number of deliveries, presurgical body mass), neck and lower back angles calculated by photogrammetry, and pain intensity by numeric pain rating scale. Postoperative complications were assessed at T15 and T30.

Results

After adjusting for age and presurgical body mass index, there was an increase in forward head position in T15 and a return by T30 (marginal R2 = 0.411). The lower back showed an increase in flexion at T15 and return by T30 (marginal R2 = 0.266). No statistical evidence of significance was observed for changes in the intensity of neck (P > .355) or lower back (P > .293) pain. Complications were mild and common at T15; most of them resumed at T30.

Conclusion

A transient, nonlinear compensatory change in neck and lower back lordosis was observed 15 days after lipoabdominoplasty, with almost full recovery in the short term (30 days). No systematic change in pain intensity was observed within this period. Postsurgical complications were mild and common, and most of them resumed shortly after surgery.

Can We Quantify Aging-Associated Postural Changes Using Photogrammetry? A Systematic Review

BACKGROUND

Aging is widely known to be associated with changes in standing posture. Recent advancements in the field of computerized image processing have allowed for improved analyses of several health conditions using photographs. However, photogrammetry's potential for assessing aging-associated postural changes is yet unclear. Thus, the aim of this review is to evaluate the potential of photogrammetry in quantifying age-related postural changes.

MATERIALS AND METHODS

We searched the databases PubMed Central, Scopus, Embase, and SciELO from the beginning of records to March 2021. Inclusion criteria were: (a) participants were older adults aged ≥60; (b) standing posture was assessed by photogrammetric means. PRISMA guidelines were followed. We used the Newcastle-Ottawa Scale to assess methodological quality.

RESULTS

Of 946 articles reviewed, after screening and the removal of duplicates, 11 reports were found eligible for full-text assessment, of which 5 full studies met the inclusion criteria. Significant changes occurring with aging included deepening of thoracic kyphosis, flattening of lumbar lordosis, and increased sagittal inclination.

CONCLUSIONS

These changes agree with commonly described aging-related postural changes. However, detailed quantification of these changes was not found; the photogrammetrical methods used were often unvalidated and did not adhere to known protocols. These methodological difficulties call for further studies using validated photogrammetrical methods and improved research methodologies.

Improvement in postural alignment is associated with recovery of mobility after complex acquired brain injury: An observational study

PURPOSE

Determine how mobility changes over 6 months in people unable to walk at 8-weeks post-Acquired Brain Injury (ABI); if there is an association over time between postural alignment and mobility post-ABI; and if alignment after ABI becomes closer to healthy alignment over time.

METHODS

Fourteen adults with ABI, evaluated over 6 months, and a reference sample of 30 healthy adults were studied. The primary measure for changes in mobility was the Clinical Outcome Variables Scale (COVS). Secondary measures were sit-to-stand, timed standing holding rails, independent walking speed and number of testing conditions achieved. The Functional Independence Measure (FIM) was scored at rehabilitation admission and discharge. To analyze postural alignment, participants were recorded in sitting and standing, each repeated holding rails, and walking if able. Three-dimensional kinematic data were used to quantify whole-body postural alignment, equal to mean segment displacements from the base of support in the transverse plane. Associations between three-dimensional kinematic alignment scores and COVS scores were calculated using Linear Mixed-Effects Models.

RESULTS

Participants made significant improvements in COVS scores, most secondary mobility scores, and FIM scores over time (p ≤ .001). Relationships between increasing COVS scores and decreasing sitting and standing mal-alignment scores were statistically significant. Visual analysis of graphed segment positions indicated that sitting and standing alignment became more similar to healthy alignment over time; this was not clear for walking.

CONCLUSION

Improvement in postural alignment may be a factor for improving mobility in people with severe impairments after ABI.

Is There a Difference in Whole Body Standing Posture in Women With Urinary Incontinence Based on the Presence of Myofascial Dysfunction in the Pelvic Floor Muscles?

OBJECTIVE

The purpose of this study was to assess the prevalence of postural changes in women who had urinary incontinence (UI) with myofascial dysfunction (MD) and women who had UI without MD in the pelvic floor muscles (PFM).

METHODS

A cross-sectional study was performed with 234 women who had UI and were at least 18 years old at the urogynecology outpatient clinic of a tertiary academic hospital. The International Consultation on Incontinence Questionnaire-Short Form and the International Consultation on Incontinence Questionnaire-Overactive Bladder were used to collect urinary data. Standing postural assessment was performed using photogrammetry in anterior, posterior, and right and left lateral views and was analyzed with Postural Assessment Software. MD was defined as pain of any intensity during palpation of the PFM, and the strength of these muscles was evaluated using the Modified Oxford Scale.

RESULTS

The prevalence of MD in women with UI was 51.7% (121/234). Women with MD had significantly smaller angles in the horizontal alignment of the pelvis in the right-side view (mean [SD] = -11.9 [6.9] degrees and -9.6 [7.1] degrees), left-side view (-13.6 [6] degrees and -11.5 [6.6] degrees), and vertical alignment of the body in the left-side view (3 [1.5] degrees and 3.4 [1.5] degrees), showing anterior pelvic tilt and posterior displacement of the body.

CONCLUSION

Women with UI and MD had greater anterior pelvic tilt and posterior displacement of the body than women without dysfunction.

IMPACT

This study informs physical therapists and other health care professionals about the prevalence of MD in the pelvic floor muscles of women with UI and highlights the need to rule out MD, because it appears to be a concomitant impairment in women who self-report UI. During a postural screen, health care professionals should look for anterior pelvic tilt relative to horizon when evaluating posture in women with UI and MD. The findings of postural changes in women with MD and UI may influence the PFM assessment.

LAY SUMMARY

Women with involuntary urinary loss, pain, and stiffness in the pelvic area may show changes in posture associated with this condition.

Spinal postural alignment measurements using markerless digital photography

BACKGROUND

A device that can measure posture alignment repeatedly is important for the prevention of hyperkyphosis.

OBJECTIVE

We devised a markerless measurement method for hyperkyphosis using digital photography and investigated the correlation with other noninvasive measurements and the validity and accuracy of this method.

METHODS

The study included 27 participants. The craniovertebral angle in supine (CVAS) and craniohorizontal angle in supine (CHAS) were calculated from digital photographs of the head and neck areas of the studied subjects with ImageJ. The correlations of CVAS and CHAS with the kyphosis index (KI) and block method (BM) were investigated. Intrarater correlation coefficient and Bland-Altman analyses were used to verify the reliability and accuracy of the measured results.

RESULTS

CHAS exhibited an excellent correlation with the KI and the BM. The intra- and interrater reliabilities of CHAS were almost perfect. Bland-Altman analysis revealed that CHAS was associated with minor addition errors.

CONCLUSION

CHAS founded an excellent correlation and reliability with the conventional spinal postural alignment measurements. The addition error suggested that the manual was needed to confirm the landmark. The CHAS is a method used to measure the spinal postural alignment in a supine position without markers and without exposing the skin surface.

Mat pilates method improve postural alignment women undergoing hormone therapy adjunct to breast cancer treatment. Clinical trial

The purpose of the study is to analyze the effects of a mat Pilates intervention on the postural alignment and balance of breast cancer women receiving hormone therapy. A two-arm randomized clinical trial included 34 breast cancer survivors divided randomly between a mat Pilates group (n = 18), that performed 16 weeks of mat Pilates exercises, and a control group (n = 16), who were invited to maintain their daily routine activities and received three educational sessions. Data collection occurred at baseline and at post-intervention time. The postural alignment was assessed using the Postural Assessment Software (SAPO) and the balance was assessed by the MINIBESTest. When the two-way ANOVA was performed on postural alignment results, a significant statistical difference was found in the angle between acromions and the anterior-superior iliac spines of the mat Pilates group (p = 0.036). When compared to the post-intervention period, the mat Pilates method had an improved horizontal alignment of the anterior-superior iliac spines (p = 0.039) and vertical alignment of the acromion head on the right side (p = 0,016). Also, the participants of the Pilates group showed a significant statistical difference in the balance (p = 0.034). The control group had an improved vertical trunk alignment on the left side (p = 0,048). The control group and the mat Pilates method group improved in some aspects, however the mat Pilates method was effective in improving the postural alignment and the balance of breast cancer survivors receiving hormone therapy and may be recommended in oncological rehabilitation as a type of complementary therapy.

Concurrent and discriminant validity of Nintendo Wii Fit exergame for the assessment of postural sway

[Purpose] The purpose of this study was to determine the concurrent validity of Wii Fit center-of-pressure parameters with Clinical Test of Sensory Integration for Balance and to evaluate the discriminant validity of the Wii Fit center-of-pressure parameters for adults and the elderly for the assessment of postural sway. [Participants and Methods] This study used an observational cross-sectional correlational design. All 70 participants were required to complete a questionnaire for eligibility screening, followed by a center-of-pressure assessment using three Wii Fit balance activities (snowboard slalom, ski slalom, and balance bubble) and Clinical Test of Sensory Integration for Balance using a force platform. [Results] For center-of-pressure assessment, our results showed there was concurrent validity of Wii Fit ski slalom and balance bubble with Clinical Test of Sensory Integration for Balance conditions 6 and 4, respectively. Our results also demonstrated that the three Wii Fit balance activities selected in this study could be used to discriminate between adults and the elderly. [Conclusion] Our results suggest that Wii Fit is a viable and affordable alternative method for center-of-pressure assessment.

Does passive hip stiffness or range of motion correlate with spinal curvature and posture during quiet standing?

BACKGROUND

It has been postulated that hip muscle stiffness can be inferred from postural assessment, and that predictable relationships exist between passive stiffness of opposing muscles. Despite a lack of evidence to demonstrate such relationships, manual therapy textbooks continue to direct clinicians to treat hip muscles following postural analysis.

RESEARCH QUESTION

Do significant correlations exist between standing posture, and hip muscle stiffness and range of motion?

METHODS

20 participants volunteered for this observational study. Passive hip stiffness was calculated as the derivative of the moment-angle curve measured during leg raising in a variety of lying postures. Stiffness was measured during hip flexion, extension, abduction and adduction. Stiffness data was obtained during the first degree and at ROM, and at the highest common angle achieved by participants in each posture Spinal curvature and other postural components were measured using a motion tracking device. Spearman rank coefficients were determined to assess any correlations between passive stiffness, range of motion, spinal curvature and other postural components.

RESULTS

Consistent relationships were found between maximum range of motion and hip stiffness at the common angles (P < 0.01), but not at maximum stiffness (P > 0.05). Consistent correlations were found between abductor stiffness and Q-angle (P < 0.05). Hip extensor range of motion correlated with lumbar lordosis (r = -0.472, P = 0.036). Other correlations were reported, but typically lacked consistency between left and right sides. Spinal curvature did not correlate with hip stiffness in frontal or sagittal planes (P > 0.05).

SIGNIFICANCE

Significant correlations were few compared with where correlations lacked statistical significance. This study demonstrates that overly simplistic assumptions about spinal posture and hip stiffness cannot be supported. Hip muscle stiffness should only be targeted in treatments where testing has demonstrated a direct need, and not assumed based upon postural assessment alone.

Comparison of pelvic rotation angle in the transverse plane in the supine position and during active straight leg raise between people with and without nonspecific low back pain

BACKGROUND

Faults in postural alignment and movement of the pelvis are associated with non-specific low back pain. However, limited studies have investigated the differences in pelvic rotation angle in the transverse plane in the supine position and during active straight leg raise between subjects with and without non-specific low back pain.

METHODS

Thirty-one subjects with non-specific low back pain and 31 subjects without non-specific low back pain were examined. Angular measures of the pelvic rotation angle in the transverse plane were obtained in the supine position and during active straight leg raise using a Smart KEMA measurement system.

FINDING

The pelvic rotation angle in the transverse plane during active straight leg raise was significantly greater in subjects with non-specific low back pain than in healthy subjects (p < 0.05). However, the pelvic rotation angle in the transverse plane in the supine position and asymmetry index of the pelvic rotation angle during active straight leg raise were not significantly different between subjects with and those without non-specific low back pain.

INTERPRETATION

This indicates that a greater pelvic rotation angle in the transverse plane during active straight leg raise could be contributing factors to the development of a non-specific low back pain related to lumbopelvic instability.

Global Postural Re-education in non-specific neck and low back pain treatment: A pilot study

BACKGROUND

Spinal pain is an important public health issue that brings biopsychosocial problems. Global Postural Re-education (GPR) is one of its treatments.

OBJECTIVE

Evaluate the effects of GPR on pain, flexibility, and posture of individuals with non-specific low back pain and/or neck pain for more than six weeks.

METHODS

The study enrolled 18 individuals, which were randomized into two groups: GPR group (GPRG; n= 09), submitted to 10 sessions of GPR and control group (CG; n= 09), not submitted to any technique. The evaluations were done before and after the GPRG sessions, for pain perception (Visual Analogue Scale - VAS), flexibility (finger-floor test) and posture (SAPO). The re-evaluation was done in the GPRG after the end of 10 treatment sessions and, in the GC, after the time equivalent to 10 sessions. The level of significance was set at p< 0.05.

RESULTS

This pilot study has no homogeneity between groups. GPRG presented improvement in pain and flexibility, but showed no changes in posture. In the CG, there was no difference in the variables evaluated in this study.

CONCLUSION

GPR had positive effects on pain and flexibility, but did not present a significant effect on posture.

Craniocervical Posture Assessed With Photogrammetry and the Accuracy of Palpation Methods for Locating the Seventh Cervical Spinous Process: A Cross-sectional Study

OBJECTIVE

The purpose of this study was to compare craniocervical posture assessed by photogrammetry using 2 distinct palpation methods for locating the spinous process of the seventh cervical vertebra (C7SP).

METHODS

This cross-sectional study was conducted in 2 phases. In phase I (n = 42), the assessor's accuracy in locating the C7SP using the flexion-extension and the modified thorax-rib static methods was compared to radiography. In phase II (n = 68), the craniocervical posture was analyzed with photogrammetry after palpation using the 2 methods. Neck pain intensity and disability were also determined.

RESULTS

The accuracy in locating the C7SP was higher using the modified thorax-rib static method (67%, 95% confidence interval [CI], 55-79) compared to the flexion-extension method (38%, 95% CI, 26-50, P = .016). Lower values of the craniocervical angle were obtained with the flexion-extension method than the modified thorax-rib static method (mean difference = -1.1°, 95% CI, -1.6 to -0.6, P < .001). However, both palpation methods resulted in similar classifications of participants as with or without forward head posture (P = .096). Weak correlations were observed between the craniocervical angle and neck pain intensity (ρ = -0.088 and -0.099, respectively) and disability (ρ = -0.231 and -0.249, respectively).

CONCLUSION

Craniocervical angles obtained using palpation methods with different accuracies were different, although the magnitude of the difference was insufficient to lead to different classifications of a forward head posture in adults with mild neck pain and disability. Craniocervical posture was weakly correlated with neck-pain intensity and disability.

A novel multi-study intervention investigating the short and long term effects of a posture bra on whole body and breast kinematics

BACKGROUND

Poor standing posture has been reported in women with larger breasts, increasing the risk of back pain. Whilst breast reduction surgery can improve posture, conservative measures such as special bras may offer short or long-term relief of symptoms without surgical intervention.

RESEARCH QUESTION

This study aimed to utilise a multi-study intervention to investigate the short and long-term kinematic effects of wearing a posture bra.

METHODS

Study one utilised biomechanics and physiotherapy expertise to modify the design of a prototype bra to improve posture and breast kinematics; resulting in a second-generation posture bra. To test this bra, 24 females were randomly assigned to control and intervention groups. The control group wore their everyday bra; the intervention group wore the generation 2 posture bra in place of their everyday bra for three months. Pre and post intervention, posture (spine curvature, scapula position, whole body alignment) and breast kinematics were assessed during sitting, standing and walking. Short-term effects of the posture bra were compared to an everyday bra and no bra (study two), whilst the long-term effects were compared using the no bra condition (study three).

RESULTS

Biomechanical intervention improved posture and breast kinematics in a prototype posture bra resulting in a second-generation prototype. Pre-intervention, the generation 2 posture bra significantly improved scapula retraction by 6° during both sitting and standing, but also increased deviation of whole body alignment compared to everyday bra and no bra conditions. During walking the posture bra reduced breast motion by 17 % compared to the everyday bra. Following the three-month wearer intervention, scapula depression significantly improved in the intervention group.

SIGNIFICANCE

A biomechanically informed posture bra was able to effectively support the breasts and improve scapula position without compromising spinal curvature, reducing the risk of musculoskeletal pain associated with poor posture.

Variable Lower Limb Alignment of Clinical Measures With Digital Photographs and the Footscan Pressure System

OBJECTIVE

This study examines the effect of the lower limb misalignment and its possible compensatory effect on plantar pressure in a normal population. The aim of this paper is to present a structured method for the analysis of posture and its changes using a standardized digital photography technique and plantar pressure measuring device.

DESIGN

Cohort.

SETTING

Laboratory.

PARTICIPANTS

A total of 200 adult volunteers between 18 and 22 years of age who had no current symptoms of pain and foot or ankle pathology participated in the study.

MAIN OUTCOME MEASURES

The gold standard measure of lower limb alignment with weight-bearing status is the mechanical axis and their angles using Image J software. Structural and functional measurements of the same foot were taken using a plantar pressure measuring device. In this study, 5 alignment (thigh, knee, leg, ankle, and foot) characteristics were measured on the lower limb using the 2 techniques, and, additionally, the foot contact area, peak pressure, foot axis, rearfoot angle, and subtalar joint flexibility score were analyzed in 10 different regions of the foot.

RESULTS

This study has shown a reasonable correlation between digitalized measurements and plantar pressures values. Quadriceps angle affected midfoot impulse, foot axis angle, subtalar joint minimum angle, and rearfoot angle positively. Subtalar joint flexibility scores were analyzed in 10 different regions of the foot. There was a positive correlation between rearfoot angle and quadriceps angle (P = .009, r = .261). Results of both methods show that they endorse each other.

CONCLUSIONS

The posture of the standing feet may have influence on lower limb alignment. Currently, there are no studies carried out by using digital photogrammetry and foot scan. The authors claim that patient-friendly digital photogrammetry would have a positive contribution to the monitoring of patients, even including new ones in the treatment programs, reducing any possible loss in the personal and national economy.

Global physiotherapy approach to thoracolumbar junction syndrome. A case report

BACKGROUND AND OBJECTIVES

The thoracolumbar junction syndrome or Maigne's syndrome is one of the causes of low back pain, for which no comprehensive treatment has yet been proposed. This case report aims to assess the effectiveness of a global physiotherapy approach, such as the Mézières method, to reduce pain and improve posture and mobility in a patient with thoracolumbar junction syndrome (TLJS).

CASE DESCRIPTION

A 42-year-old woman patient presented a chronic nonspecific low back pain associated with severe pain in the right inguinal fold which has disabled her for two years. She described her pain as deep and intermittent. She complained of difficulties performing tasks that involved on long walks and bending forward lumbar flexion.

OUTCOMES

After ten sessions the pain completely disappeared (numeric rating scale-NRS improved from 6 to 0). A slight improvement in certain morphostatic parameters in the frontal and sagittal planes was reported, analyzed by ADiBAS software. Six months after the final session, the patient was asymptomatic, with improved bodily awareness and muscular extensibility.

CONCLUSION

The TLJS patient responded well to the Mézières Method, whose global physiotherapy approach resulted in a lessening of nociceptive pain, and also improved posture and functionality.

The effect of backpack load position on photographic measures of craniovertebral posture in 150 asymptomatic young adults

BACKGROUND

Altering the horizontal position of the weight in a backpack will influence the magnitude of the external torque it creates but the effect on posture is unclear.

OBJECTIVE

To use photogrammetry to determine if changes in the horizontal position of a fixed backpack weight affect external measures of craniovertebral posture in 150 asymptomatic young adults.

METHODS

A backpack was attached to a steel frame with a bar protruding posteriorly. A fixed load (5% body mass) was placed at three distances along the bar -0 m, 0.20 m, and 0.40 m. Sagittal and frontal plane photogrammetry was used to measure the craniovertebral angle (CVA), upper cervical gaze angle (UCGA) and lateral head tilt angle (LHTA). A comparison was made across unloaded (no backpack) and loaded conditions.

RESULTS

There was a significant decrease in the CVA between unloaded and loaded conditions. Changes in the UCGA were small and, while significant, may not have practical importance. There were no differences in the LHTA between the conditions.

CONCLUSIONS

Changes in the horizontal position of a fixed load affect external measures of craniovertebral posture so consideration needs to be given to not only the weight of a backpack but how the weight is positioned within the backpack.

Relationship between Unilateral Posterior Crossbite and Human Static Body Posture

Background: We compared photogrammetry-assessed body posture between young adults with and without unilateral posterior crossbite (UPCB). Assessments were controlled by vision, mandibular position and sitting/standing position. In addition, we aimed to determine the relationship between UPCB laterality and the direction of body posture using photogrammetry and a static postural platform. Methods: Adults with natural dentition, with and without UPCB, were enrolled. Static body posture was assessed by photogrammetry based on horizontal acromial alignment and horizontal anterior-superior iliac spine (ASIS) alignment. Frontal photographs were taken with participants asked to open or close their eyes and hold their jaws at rest, at an intercuspal position, and at left or right lateral positions. Distribution of foot pressure was recorded using a static postural platform at different visual input and mandibular positions. General linear models with repeated measures were used to assess the effect of the various within- and between-subject factors. Results: In total, 36 adults (left UPCB = 12; Right UPCB = 6; controls = 18) participated. There were significant differences between the control and UPCB groups in horizontal alignment at the acromion (p = 0.035) and ASIS (p = 0.026) levels when controlled by visual input and mandibular position. No significant differences in horizontal alignment or foot pressure distribution were observed by laterality in the UPCB group. Conclusion: The presence of UPCB affects static body posture, but the side of crossbite is not related to the direction of effect on static body posture.

Internal and external sagittal craniovertebral alignment: A comparison between radiological and photogrammetric approaches in asymptomatic participants

BACKGROUND

Photogrammetric measures are a commonly applied, highly reliable tool for appraising craniovertebral postures during clinical assessments, rehabilitation, and research interventions.

OBJECTIVE

This study aimed to compare and contrast three external measures of postural alignment (EMPA) using photogrammetric and radiological approaches, and to discuss whether the craniovertebral angle (CVA) reflects the shape of the underlying cervical spine.

DESIGN

Cross Sectional Correlation Study.

METHOD

Young adults attended three assessment sessions (S1, S2 and S3). S1 involved a standardised photogrammetric protocol. S2 involved radiographic image acquisition. S3 followed the same protocol in S1 but excluded the self-balancing procedure. Each session's EMPA were compared through either paired or independent samples t-tests. The different radiographic cervical subtypes and their corresponding CVAs were assessed.

RESULTS

There were no significant differences in any EMPA between the two photogrammetric sessions. The CVA was the only EMPA to show a significant difference between photogrammetric (S3) and radiographic approaches. Cervical subtype variability is present throughout the full CVA range.

CONCLUSIONS

Despite the statistically significant difference in the CVA between approaches, the mean difference was small and unlikely to be clinically meaningful. Accordingly, the quantification of EMPA can be undertaken with high levels of precision and reliability using standardised photogrammetric procedures. The CVA, however, does not provide an indication of the shape of the underlying cervical spine. The distinct radiological differences in the inter-segmental orientation of each vertebral motion segment in conjunction with the differences in the overall global cervical alignment, both within and between participants, negate this possibility.

Validity and Reliability of Standing Posture Measurements Using a Mobile Application

OBJECTIVE

The purpose of this study was to evaluate the validity and reliability of standing posture assessments in asymptomatic men using the PostureScreen Mobile (PSM) iOS application.

METHODS

The standing posture of 50 asymptomatic male participants (24.04 ± 1.81 years) was measured during 3 trials on the same day. The following 10 measurements using the PSM app were compared to the criterion VICON 3-dimensional analysis: from the frontal plane, shift and tilt of the head, shoulders, and hips; and from the sagittal plane, shift of the head, shoulders, hips, and knees. We used Bayesian methods to analyze the data.

RESULTS

Compared with the VICON measurements, PSM assessments of head tilt, shoulder tilt and shift, and hip tilt and shift in the frontal plane were biased. In the sagittal plane, PSM measurements of shoulder, hip, and knee shift were biased. Only head shift in the frontal and sagittal planes were comparable between the VICON and the PSM. The VICON and PSM had similar intraclass correlations in 6 of 10 measurements. The PSM assessments of head shift and tilt and shoulder tilt in the sagittal plane were significantly less reliable than with VICON.

CONCLUSION

The use of the PSM app introduced significant bias in postural measurements in the frontal and sagittal plane. Until further research reports additional validity and reliability data of the PSM app, we suggest caution in the use of PSM app when highly accurate postural assessments are necessary.

Differences in body positional bilateral symmetry between stance and supine positions, and the impact of attention and awareness on postural symmetry

BACKGROUND AND PURPOSE

Postural asymmetries may cause structural pathological conditions and impaired movement pattern. The influence of body position and awareness towards symmetry has not yet been elucidated. The aim of this study was twofold: First, to compare the body positional bilateral symmetry between standing and supine positions, and second, to examine whether the awareness to symmetry can modify posture perception and body positional bilateral symmetry.

METHODS

We analyzed the degree of anterior postural alignment symmetry of 34 healthy subjects by photogrammetric method (three photographs in a standing position and three in a supine position). Each photo captured different state of awareness: Subjective Comfortable Posture (SCP), Subjective Perceived Symmetrical Posture (SPSP), and Guided Posture Protocol (GPP).

RESULTS

The standing position increased the symmetrical alignment of the neck (p < 0.013) and the upper limbs (p < 0.011). However, the supine position demonstrated increased symmetrical alignment of the upper trunk (p < 0.019) and the feet (p < 0.002). In the standing position, GPP showed greater symmetry of the neck (p < 0.022), the shoulders (p < 0.014), the thorax midline (p < 0.009), the upper trunk (p < 0.000) and the upper limbs (p < 0.029). No significant changes were observed in the supine position between the three states of awareness.

CONCLUSIONS

Study results indicate that the supine position shows greater degree of upper trunk's symmetrical alignment than the standing position. It also indicates that while standing, focusing attention into symmetry improves body positional bilateral symmetry. These results might have clinical implications when working with patients who suffer from asymmetric posture.

Thoracic Kyphosis and Lumbar Lordosis Assessment by Radiography and Photogrammetry: A Review of Normative Values and Reliability

OBJECTIVE

The purpose of this study was to review referential values for thoracic kyphosis and lumbar lordosis for radiography and photogrammetry analysis and search for information about the interrater and intrarater reliability.

METHODS

The databases PubMed/Medline and LILACS were searched using the following keywords: radiograph and posture, postural alignment, and photogrammetry or photometry or biophotogrammetry. Studies containing values of thoracic kyphosis and lumbar lordosis or a reliability test assessed by radiography and photogrammetry were selected. Random numbers were generated in MATLAB from each study individually to establish normative values for the thoracic kyphosis and lumbar lordosis for both methods. After that, frequencies (median, first quartile, and third quartile) were obtained in SPSS 20.0 (IBM Corp, Armonk, New York).

RESULTS

Twenty-six articles were selected, of which 23 studies contained values for thoracic kyphosis and lumbar lordosis and 10 tested the intra- and interrater reliability of both methods. For the studies with radiography that calculated the angle by the same method of assessment, the mean was 44.07° (4.75) for L1 to L5 and 58.01° (5.75) for L1 to S1, and for T1 to T12 the mean was 48.33° (6.24). Most studies used the intraclass correlation coefficient test, showing strong reliability.

CONCLUSION

No concordance among the results for both methods was shown. Also, it was not possible to perform the same procedure with the photogrammetry studies because of the great discrepancy in procedures and angle calculations. To assess the reliability, it is necessary to use the proper statistical test.

Computerized photogrammetric assessment of postural alignment in visually impaired athletes

OBJECTIVE

The aim of the study was to provide a computerized photogrammetric description of the postural alignment of visually impaired athletes.

METHODS

Twenty-six athletes were evaluated. Athletes were asked to stand at easy with styrofoam balls placed on selected anatomical landmarks, and photographic images were acquired in four viewpoints. Postural Assessment Software (PAS/SAPO) was applied for image analysis. Body's angles and distances were calculated and transformed in absolute (nonnegative) values for analysis. Factor analysis was applied for data reduction.

RESULTS

Absolute values of PAS/SAPO variables resulted in lower coefficient of variation (CV) than raw values (average of 57% versus 500%, respectively), which potentially enhances the comparative use of these measures. Head's forward positioning and rightward inclination were among the most prevalent postural deviation, being observed in more than 70% of the athletes. With respect to the magnitude of the deviation, large variability was observed in data derived from anterior/posterior compared with lateral viewpoint. For instance, head's rightward inclination (head horizontal alignment in the anterior view) achieved 2.9 ± 2.5° (mean ± SD), with a CV of 86%, while head's forward positioning (C7 horizontal alignment in left viewpoint) reaches 42.7 ± 6.6°, with a CV of only 16%. Factor analysis did not result in significant data reduction, although anterior body's angles and distances were identified as important sources of data variability.

CONCLUSIONS

The PAS/SAPO values described here can be adopted as reference for future investigations of postural alignment in visually impaired athletes.

The relation of the pelvis and the perineal function in incontinent women: A neglected subject

AIMS

To Compare the angular parameters of the pelvis of continents and incontinent women and to correlate them with the electrical activity and the function of the pelvic floor muscles.

METHODS

Cross-sectional study. Incontinent and continent women, aged between 18 and 59 years. The anatomical points were marked following the SAPO protocols, the photographic records were made and analyzed through the SAPO Software. The evaluation of the function of the MPF was performed by bidigital vaginal palpation, using the PERFECT scheme. Surface electromyographic analysis was performed in dorsal decubitus and orthostasis.

RESULTS

The sample consisted of 40 women, 20 with SUI (IG) and 20 continents (CG), matched by age. The mean age in the CG was 43.5 years (SD 8.4), while in the IG it was 47.1 years (SD 7.8) (P = 0.16). The pelvic angle in the CG presented a mean of -14.3 ± 4.6 and the IG -16.6 ± 4.4 (P = 0.02). When compared to normality, IG presented an accentuation of anterior slope in both analyzed views (P = 0.01). There was a moderate correlation in the IG between the electrical activity of the basal pelvis in orthostasis and the anterior pelvic tilt angles in the right lateral views r = 0.51 (P = 0.02) and left lateral r = 0.46 (P = 0.04). No correlation was found in the CG.

CONCLUSIONS

In the present sample, incontinent women have a greater anterior slope of the pelvis, and the greater the degree of anterior slope, the greater the electrical activity of the PFM, during rest, and in orthostasis.

Postural assessment in class III patients before and after orthognathic surgery

PURPOSE

This study aimed to assess body posture before and after bimaxillary orthognathic surgery by photogrammetry in skeletal class III patients.

METHODS

Thirty-one patients with skeletal class III dentofacial deformities (14 men, 17 women) who underwent orthodontic preparation for surgery were included in this non-randomized controlled trial. Of these, 15 who did not undergo orthognathic surgery during the period of this study served as controls. Postural assessment was performed by photogrammetry using SAPO® (Postural Assessment Software) based on anterior-, posterior-, and lateral-view images taken 1 month before and 4 months after bimaxillary orthognathic surgery with internal rigid fixation (or 4 months after the initial assessment, for the control group). The study was approved by PUCRS Research Ethics Committee, and written informed consent was obtained from all individual participants prior to their inclusion in the study.

RESULTS

There was no significant difference between groups for age, gender, and GAP. In the intervention group, the right leg/hindfoot angle, which initially indicated a valgus deformity, normalized after intervention (P < 0.048). Posterior displacement of the head (P < 0.005) and trunk (P < 0.004) were observed after intervention.

CONCLUSIONS

These results suggest that correction of class III dentofacial deformities by bimaxillary orthognathic surgery can produce systemic postural adjustments, especially posterior displacement of the head and trunk and knee and ankle valgus.

Development and preliminary evaluation of a new anatomically based prosthetic alignment method for below-knee prosthesis

The objectives of current study were to a) assess similarities and relationships between anatomical landmark-based angles and distances of lower limbs in unilateral transtibial amputees and b) develop and evaluate a new anatomically based static prosthetic alignment method. First substudy assessed the anthropometrical differences and relationships between the lower limbs in the photographs taken from amputees. Data were analyzed via paired t-test and regression analysis. Results show no significant differences in frontal and transverse planes. In the sagittal plane, the anthropometric parameters of the amputated limb were significantly correlated to the corresponding variables of the sound limb. The results served as bases for the development of a new prosthetic alignment method. The method was evaluated on a single-subject study. Prosthetic alignment carried out by an experienced prosthetist was compared with such alignment adjusted by an inexperienced prosthetist but with the use of the developed method. In sagittal and frontal planes, the socket angle was tuned with respect to the shin angle, and the position of the prosthetic foot was tuned in relation to the pelvic landmarks. Further study is needed to assess the proposed method on a larger sample of amputees and prosthetists.

Quantitative Postural Analysis of Children With Congenital Visual Impairment

OBJECTIVES

The aim of this study was to compare the postural alignment of children with visual impairment with that of children without visual impairment.

METHODS

The sample studied was 74 children of both sexes ages 5 to 12 years. Of these, 34 had visual impairment and 40 were control children. Digital photos from the standing position were used to analyze posture. Postural variables, such as tilt of the head, shoulder position, scapula position, lateral deviation of the spine, ankle position in the frontal plane and head posture, angle of thoracic kyphosis, angle of lumbar lordosis, pelvis position, and knee position in the frontal and sagittal planes, were measured with the Postural Assessment Software 0.63, version 36 (SAPO, São Paulo, Brazil), with markers placed in predetermined bony landmarks.

RESULTS

The main results of this study showed that children with visual impairment have increased head tilt (P < .001), shoulder deviation in frontal plane (P = .004), lateral deviation of the spine (P < .001), changes in scapula position (P = .012), higher thoracic kyphosis (P = .004), and lower lumbar lordosis (P < .001).

CONCLUSIONS

Visual impairment influences postural alignment. Children with visual impairment had increased head tilt, uneven shoulders, greater lateral deviation of the spine, thoracic kyphosis, lower lumbar lordosis, and more severe valgus deformities on knees.

Análise intra e interavaliadores da projeção do centro de massa do corpo obtido por fotogrametria

RESUMO Para o ótimo controle postural, o centro de massa (COM) do corpo é uma variável que se projeta verticalmente entre os pés, dentro de uma base de suporte. Este estudo teve por objetivo avaliar a confiabilidade inter e intra-avaliadores da projeção do COM na base de sustentação, mensurada com auxílio do Software de Avaliação Postural (SAPO). Cinquenta e sete voluntárias foram avaliadas e todas foram submetidas ao registro fotográfico nas vistas anterior, lateral direita e esquerda, no mesmo instante temporal. As imagens foram entregues a dois examinadores, os quais utilizaram o SAPO. Para a análise estatística, foi utilizado o coeficiente de correlação intraclasse (ICC) e, para estimar a mínima mudança detectável (MMD), foi utilizado o erro padrão (EP). Os resultados demonstraram excelentes níveis de confiabilidade interexaminador e intraexaminador para assimetrias nos planos frontal, sagital e para a projeção do centro de gravidade no plano frontal e lateral (ICC>0,90; 95%IC>0,95; MDD entre 2,16 - 4,87). Os resultados do estudo demonstraram que a análise do COM obtida por meio do SAPO apresentou boa confiabilidade nas análises inter e intra-avaliadores.

Efficacy of corrective exercise strategy in subjects with hyperkyphosis

BACKGROUND

Age-related hyperkyphosis causes deleterious effects on health, physical function, and quality of life. Recently, health care providers recognized it as a major health concern.

OBJECTIVE

To identify the effect of corrective exercise strategy on hyperkyphosis and compare it with that of conventional exercise.

METHODS

Subjects were randomly categorized into two groups. Each group comprised 30 subjects. Group A received the corrective exercise strategy, and group B received conventional exercises for 8 weeks of the study duration (15 repetitions of each exercise for three sessions/day for a total duration of 45 min and 4 days/week. Pre- and post-interventional hyperkyphosis were analyzed according to posture number using the Posture Pro 8 postural analysis software. In addition, pectoralis minor flexibility was assessed using the ruler scale method in centimeters.

RESULTS

Both groups showed highly significant postural alteration and changes in pectoralis minor muscle length (p< 0.001)CONCLUSIONS:The corrective exercise strategy seems to promote scapular stability and produce a more upright posture of the upper thoracic spine.

Implication of Posture Analysing Software to Evaluate the Postural Changes after Corrective Exercise Strategy on Subjects with Upper Body Dysfunction-A Randomized Controlled Trial

INTRODUCTION

The postural adaptation is very common now a days in school going children, office desk oriented job, computer users and frequent mobile users, and in all major industrial workers. Several studies have documented a high incidence of postural abnormalities in a given population; however, methods of postural measurement were poorly defined. The implication of postural pro software to analyse the postural imbalance of upper body dysfunction is very rare and literature studies says that the kinematic changes in particular segment will produce pain/discomfort and thereby lesser productivity of subjects.

AIM

To evaluate the postural changes in subjects with upper body dysfunction after a corrective exercise strategy using postural analysis software and pectoralis minor muscle length testing.

MATERIALS AND METHODS

After explaining the procedure and benefits, informed consent was taken from the participating subjects (age 25-55 years). Subjects with upper body dysfunction were randomly allocated into two groups (each group 30 subjects). The Group-A received the corrective exercise strategy and Group-B received the conventional exercise for eight weeks of study duration (15 reps each exercise, total duration of 40 min; four days/week. Pre and Post posture analysis were analysed using posture pro software along with flexibility of pectoralis minor was assessed using ruler scale method.

RESULTS

After interpretation of data, both the group showed the postural alteration and pectoralis minor muscle length changes, p-value (p<0.01) of both group showed highly significant changes. But comparing the both groups, the subjects who received the corrective exercise strategy shown more percentage of improvement in posture alteration (56.25%), pectoralis minor muscle length changes (68.69%) than the conventional exercise received subjects in posture alteration (24.86%) and pectoralis minor muscle length changes (21.9%).

CONCLUSION

Altered postural changes and pectoralis minor muscle flexibility before and after the corrective exercise strategy evaluated by postural analysis software method shown to be a significant tool in clinical practice, which is easier and reproducible method.

Normative 3D opto-electronic stereo-photogrammetric posture and spine morphology data in young healthy adult population

Design: Observational cross-sectional study. The current study aims to yield normative data: i.e., the physiological standard for 30 selected quantitative 3D parameters that accurately capture and describe a full-skeleton, upright-standing attitude. Specific and exclusive consideration was given to three distinct categories: postural, spine morphology and pelvic parameters. To capture such 3D parameters, the authors selected a non-ionising 3D opto-electronic stereo-photogrammetric approach. This required the identification and measurement of 27 body landmarks, each specifically tagged with a skin marker. As subjects for the measurement of these parameters, a cohort of 124 asymptomatic young adult volunteers was recruited. All parameters were identified and measured within this group. Postural and spine morphology data have been compared between genders. In this regard, only five statistically significant differences were found: pelvis width, pelvis torsion, the “lumbar” lordosis angle value, the lumbar curve length, and the T12-L5 anatomically-bound lumbar angle value. The “thoracic” kyphosis mean angle value was the same in both sexes and, even if, derived from skin markers placed on spinous processes it resulted in perfect agreement with the X-ray based literature. As regards lordosis, a direct comparison was more difficult because methods proposed in the literature differ as to the number and position of vertebrae under consideration, and their related angle values. However, when the L1 superior–L5 inferior end plate Cobb angle was considered, these results aligned strongly with the existing literature. Asymmetry was a standard postural-spinal feature for both sexes. Each subject presented some degree of leg length discrepancy (LLD) with μ = 9.37mm. This was associated with four factors: unbalanced posture and/or underfoot loads, spinal curvature in the frontal plane, and pelvis torsion. This led to the additional study of the effect of LLD equalisation influence on upright posture, relying on a sub-sample of 100 subjects (51 males, 49 females). As a result of the equalisation, about 82% of this sub-sample showed improvement in standing posture, mainly in the frontal plane; while in the sagittal plane less than 1/3 of the sub-sample showed evidence of change in spinal angles. A significant variation was found in relation to pelvis torsion: 46% of subjects showed improvement, 49% worsening. The method described in study presents several advantages: non-invasive aspect; relatively short time for a complete postural evaluation with many clinically useful 3D and 2D anatomical/biomechanical/clinical parameters; analysis of real neutral unconstrained upright standing posture.

Investigation of associations between recurrence of major depressive disorder and spinal posture alignment: A quantitative cross-sectional study

The aim of this study was to investigate associations between poor spinal posture and the recurrence of major depressive episodes and severity of symptoms in patients with major depressive disorder (MDD). This was a cross-sectional quantitative study of MDD patients. Outpatients were recruited from consecutive admissions at a mood disorders unit of a tertiary psychiatric hospital. Of 136 MDD patients, 72 (53 women, 19 men; mean age, 42.4±9.1years) met all the criteria and completed the study. Forty-one patients were classified with a recurrent episode (RE) of MDD and 31 with a single episode (SE). Quantitative assessments of postural deviations were made using photogrammetry, including kyphosis, shoulder protraction, and head inclination. The severity of depressive episodes was assessed using the Hamilton Depression Rating Scale. The diagnosis and classification of patients were performed according to DSM-IV-TR and SCID criteria. Multivariate analysis of variance indicated that the RE group had greater anterior head inclination (35.39; SD: 1.57), greater scapular abduction (1.69; SD: 0.93), and worse thoracic kyphosis (139.38; SD: 1.19) than the SE group (p<0.001 for all). Multivariate analysis of covariance showed an interaction between the severity of depressive symptoms and the degree of thoracic kyphosis (p=0.002). Recurrence of depressive episodes is associated with measures of postural misalignment.

Procedures of assessment on the quantification of thoracic kyphosis and lumbar lordosis by radiography and photogrammetry: A literature review

The quantification of thoracic kyphosis and lumbar lordosis can be assessed in different ways; among them radiography and photogrammetry. However, the assessment procedures are not consistent in the literature for either method. The objective of this study was to conduct a literature review about postural assessment through radiography and photogrammetry, for delineating the procedures for both methods. In total 38 studies were selected by an online search in the MEDLINE and LILACS databases with the keywords: radiograph and posture, postural alignment, photogrammetry or photometry or biophotogrammetry. For the radiographic method, the results showed divergences in arm positioning and in the calculation of thoracic and lumbar angles. The photogrammetry demonstrated differences in relation to the camera, tripod, plumb line and feet positioning, angle calculation, software utilization, and the use of footwear. Standardization is proposed for both methods to help establish normative values and comparisons between diagnoses.