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Titcomb DA, Melton BF, Bland HW, Miyashita T. Evaluation of the Craniovertebral Angle in Standing versus Sitting Positions in Young Adults with and without Severe Forward Head Posture. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2024; 17:73-85. [PMID: 38665167 PMCID: PMC11042887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
The purpose of this study was to examine the effects of standing versus sitting body position on the craniovertebral angle (CVA) in young adults without pathology; and to investigate whether mean differences between positional CVA measures in subjects with severe forward head posture (FHP) are distinct from age-matched controls with normal head posture. Ninety-eight young adults (68 women, 30 men) without pathology (OVERALL; n = 98) volunteered for the study; those with CVA > 53° were also included in a normal posture group (NORM; n = 14); those with CVA < 45° were also included in a severe FHP group (SEV; n = 15). CVA assessments were conducted in standing and sitting. Mean difference comparison of change in mean CVA between conditions revealed significantly (p < 0.05) higher CVA values in standing condition (OVERALL: 50.0 ± 5.2°; NORM: 56.6 ± 2.7°; SEV: 41.2 ± 3.2°) compared to sitting condition (OVERALL: 47.8 ± 5.7°; NORM: 55.9 ± 2.8°; SEV: 39.0 ± 4.0°). Mean difference comparison of between-group change in mean CVA between conditions revealed greater CVA change (p < 0.05) in the SEV group (2.2 ± 2.1°) versus the NORM group (0.8 ± 1.2°). Sitting CVA values may be lower (indicating greater FHP) than standing CVA values in young adults. Differences between standing and sitting CVA measures may be greater in young adults with severe FHP compared to peers with normal head posture. Study findings support standing as a standardized body position for CVA assessment in young adults without pathology.
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Affiliation(s)
- David A Titcomb
- Department of Allied Health Professions, Liberty University, Lynchburg, VA, USA
- Department of Health Sciences and Human Performance, Concordia University-Chicago, River Forest, IL, USA
| | - Bridget F Melton
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA, USA
| | - Helen W Bland
- Department of Health Policy and Community Health, Georgia Southern University, Statesboro, GA, USA
| | - Theresa Miyashita
- Department of Health Sciences and Human Performance, Concordia University-Chicago, River Forest, IL, USA
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Metwaly MM, Salem EE, Abbass ME. Correlation between scapular alignment and upper extremity function in children with hemiparetic cerebral palsy. Physiother Theory Pract 2023; 39:2163-2170. [PMID: 35430957 DOI: 10.1080/09593985.2022.2066587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To investigate the relationship between scapular alignment and upper extremity function. METHODS Eighty-five children (63 boys and 22 girls) with spastic hemiplegic cerebral palsy aged 3 to 6 years were included in the study. Scapular upward rotation was assessed using Postural Zone software, and upper extremity function was assessed using the Pediatric Arm Function Test. RESULTS There was a significant difference (p = .0001) in the degree of upward scapular rotation between less affected and affected sides (-41.78 ± 4.87 and -26.42 ± 6.34, respectively). There was a significant difference (p = .0001) between the function of the upper extremity of the affected side and the less affected sides (48.15 ± 14.37, 62.1 ± 6.62, respectively). Pearson Correlation Coefficient (r) was calculated, and there was a strong negative significant correlation between the degree of scapular upward rotation of the affected side, a unilateral score of the affected side, and the total score of the Pediatric Arm Function Test (r = -0.976, p = .0001 and r = -0.973, p = .0001, respectively). The correlation between symmetry index and total score of the Pediatric Arm Function Test was a strong positive significant correlation (r = 0.946, p = .0001). CONCLUSION The degree of upward scapular rotation was less on the affected side. Scapular alignment and symmetry may contribute to upper extremity function in children with hemiplegic cerebral palsy. Clinically, correction of scapular deviations may be considered in the rehabilitation program for children with hemiplegic cerebral palsy. This study suggests further experimental studies to find the cause and effect.
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Affiliation(s)
- Mahmoud Mohammed Metwaly
- Department of Pediatric Physical Therapy, Faculty of Physical Therapy, Cairo University, Giza, Eygpt
| | - Elham Elsayed Salem
- Department of Pediatric Physical Therapy, Faculty of Physical Therapy, Cairo University, Giza, Eygpt
| | - Mai Elsayed Abbass
- Department of Pediatric Physical Therapy, Faculty of Physical Therapy, Cairo University, Giza, Eygpt
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Debucean D, Mihaiu J, Maghiar AM, Marcu F, Marcu OA. A Multidisciplinary Approach to Swallowing Rehabilitation in Patients with Forward Head Posture. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1580. [PMID: 37763700 PMCID: PMC10536936 DOI: 10.3390/medicina59091580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023]
Abstract
(1) Background and Objectives: The forward head posture (FHP) is characterized by increased extensions of upper cervical vertebrae and flexion of the lower cervical vertebrae and upper thoracic regions, associated with muscle shortening. The compressive loading on the tissues in the cervical spine negatively impacts suprahyoid and infrahyoid muscles and generates increased tension of the masticatory muscles. The tongue has relations with the suprahyoid and the infrahyoid muscles. The pattern of swallowing evolves gradually from birth to the age of four. If this developmental transition does not occur, the result is persistent infantile or atypical swallowing-an orofacial myofunctional disorder with the tongue in improper position during swallowing, causing strain and stress on the jaw, face, head and neck. In FHP, muscles crucial to swallowing are biomechanically misaligned. The lengthening of the suprahyoid muscles necessitates stronger contractions to achieve proper hyolaryngeal movement during swallowing. This study assesses the added benefits of physiotherapy to the traditional myofunctional swallowing rehabilitation for patients with FHP. The underlying hypothesis is that without addressing FHP, swallowing rehabilitation remains challenged and potentially incomplete. (2) Materials and Methods: A total of 61 participants (12-26 years) meeting the inclusion criteria (FHP and atypical swallowing) were divided into two similar groups. Group A attended one orofacial myofunctional therapy (OMT) and one physiotherapy session per week, group B only one OMT session per week, for 20 weeks. Exclusion criteria were as follows: ankyloglossia, neurological impairment affecting tongue and swallowing, cervical osteoarticular pathology, other previous or ongoing treatments for FHP and atypical swallowing. (3) Results: There is a significant improvement in terms of movement and use of the orofacial structures (tongue, lips, cheeks), as well as in breathing and swallowing in both groups. Group A achieved better outcomes as the CVA angle was directly addressed by manual therapy and GPR techniques. (4) Conclusions: The combined therapy proved to be more effective than single OMT therapy.
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Affiliation(s)
- Daiana Debucean
- Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania;
| | - Judit Mihaiu
- Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania;
| | - Adrian Marius Maghiar
- Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (A.M.M.); (O.A.M.)
| | - Florin Marcu
- Department of Psychoneuroscience and Rehabilitation, University of Oradea, 410087 Oradea, Romania;
| | - Olivia Andreea Marcu
- Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (A.M.M.); (O.A.M.)
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Belli G, Toselli S, Mauro M, Maietta Latessa P, Russo L. Relation between Photogrammetry and Spinal Mouse for Sagittal Imbalance Assessment in Adolescents with Thoracic Kyphosis. J Funct Morphol Kinesiol 2023; 8:jfmk8020068. [PMID: 37218864 DOI: 10.3390/jfmk8020068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/13/2023] [Accepted: 05/17/2023] [Indexed: 05/24/2023] Open
Abstract
The evaluation of postural alignment in childhood and adolescence is fundamental for sports, health, and daily life activities. Spinal Mouse (SM) and photogrammetry (PG) are two of the most debated tools in postural evaluation because choosing the proper instrument is also important to avoid false or misleading data. This research aims to find out the best linear regression models that could relate the analytic kyphosis measurements of the SM with one or more PG parameters of body posture in adolescents with kyphotic posture. Thirty-four adolescents with structural and non-structural kyphosis were analyzed (13.1 ± 1.8 years; 1.59 ± 0.13 m; 47.0 ± 12.2 kg) using SM and PG on the sagittal plane in a standing and forward-bending position, allowing us to measure body vertical inclination, trunk flexion, and sacral inclination and hip position during bending. The stepwise backward procedure was assessed to estimate the variability of the grade of inclination of the spine and thoracic spine curvature with fixed upper and lower limits, evaluated with SM during flexion. In both models, the PG angle between the horizontal line and a line connecting the sacral endplate-C7 spinous process and the PG hip position were the best regressors (adjusted-R2 SM bend = 0.804, p < 0.001; adjusted-R2 SM fixed bending = 0.488, p < 0.001). Several Spinal Mouse and photogrammetry parameters showed significant correlations, especially when the Spinal Mouse measurements were taken when the adolescents were in the forward-bending position. Physicians and kinesiologists may consider photogrammetry as a good method for spinal curve prediction.
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Affiliation(s)
- Guido Belli
- Department of Sciences for Life Quality Studies, University of Bologna, 47921 Rimini, Italy
| | - Stefania Toselli
- Department of Sciences for Life Quality Studies, University of Bologna, 47921 Rimini, Italy
| | - Mario Mauro
- Department of Sciences for Life Quality Studies, University of Bologna, 47921 Rimini, Italy
| | | | - Luca Russo
- Department of Human Sciences, IUL Telematic University, 50122 Florence, Italy
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Ludwig O, Dindorf C, Schuh T, Haab T, Marchetti J, Fröhlich M. Effects of Feedback-Supported Online Training during the Coronavirus Lockdown on Posture in Children and Adolescents. J Funct Morphol Kinesiol 2022; 7:jfmk7040088. [PMID: 36278749 PMCID: PMC9624311 DOI: 10.3390/jfmk7040088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
(1) Background. The coronavirus pandemic had a serious impact on the everyday life of children and young people with sometimes drastic effects on daily physical activity time that could have led to posture imbalances. The aim of the study was to examine whether a six-week, feedback-supported online training programme could improve posture parameters in young soccer players. (2) Methods. Data of 170 adolescent soccer players (age 15.6 ± 1.6 years) were analyzed. A total of 86 soccer players of a youth academy participated in an online training program that included eight exercises twice per week for 45 min (Zoom group). The participants’ exercise execution could be monitored and corrected via smartphone or laptop camera. Before and after the training intervention, participants’ posture was assessed using photographic analysis. The changes of relevant posture parameters (perpendicular positions of ear, shoulder and hips, pelvic tilt, trunk tilt and sacral angle) were statistically tested by robust mixed ANOVA using trimmed means. Postural parameters were also assessed post hoc at 8-week intervals in a control group of 84 participants of the same age. (3) Results. We found a statistically significant interaction (p < 0.05) between time and group for trunk tilt, head and shoulder protrusion and for hip anteversion in the Zoom group. No changes were found for these parameters in the control group. For pelvic tilt no significant changes were found. (4) Conclusions. Feedback-based online training with two 45 min sessions per week can improve postural parameters in adolescent soccer players over a period of six weeks.
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Affiliation(s)
- Oliver Ludwig
- Department of Sports Science, Technische Universität Kaiserslautern, 67663 Kaiserslautern, Germany
- Correspondence:
| | - Carlo Dindorf
- Department of Sports Science, Technische Universität Kaiserslautern, 67663 Kaiserslautern, Germany
| | - Torsten Schuh
- Sport Performance Education, 66386 Sankt Ingbert, Germany
| | - Thomas Haab
- Institute of Sports Science, Saarland University, 66123 Saarbrücken, Germany
| | - Johannes Marchetti
- Department of Sports Science, Technische Universität Kaiserslautern, 67663 Kaiserslautern, Germany
- Institute of Sports Science, Saarland University, 66123 Saarbrücken, Germany
| | - Michael Fröhlich
- Department of Sports Science, Technische Universität Kaiserslautern, 67663 Kaiserslautern, Germany
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Christensen SWM, Johansson SS, Jensen MD, Jensen AE, Knudsen TH, Palsson TS. Effect of a Posture-Cueing Shirt on Sitting Posture During a Functional Task in Healthy Participants: A Randomized Cross-Over Study. J Manipulative Physiol Ther 2022; 44:725-733. [PMID: 35701242 DOI: 10.1016/j.jmpt.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 02/18/2022] [Accepted: 03/08/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the effect of a posture-cueing shirt on sitting posture during a functional task. METHODS Thirty healthy male participants were seated at a standardized workstation while completing 3 laptop writing tasks of 15-minute duration wearing either a posture-cueing shirt, a compression shirt, or no shirt. Posture was assessed based on photos taken at minutes 1 and 15 into the writing task from which the head and shoulder angles were measured and extracted for analysis. After each task, participants rated any potential pain they felt during the task on an 11-point numeric rating scale (NRS). RESULTS The results showed that none of the shirts significantly affected the head or shoulder angles at any time point. Participants reported lower pain levels after using the posture-cueing shirt (NRS 0 [0-1]) compared with no shirt (NRS 1 [0-2]; P = .012). No significant difference in pain levels was observed between shirts. CONCLUSION Although posture did not change in any conditions for these healthy male subjects, the posture-cueing shirt resulted in a lower pain intensity compared with no shirt but not with a compression shirt. Although a significant difference was found for pain intensity favoring the posture-cueing shirt, this difference was negligible, and thus its value to reduce pain or improve posture in healthy subjects remains in question.
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Affiliation(s)
- Steffan W M Christensen
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark; Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark.
| | - Steffen S Johansson
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark
| | - Mikkel D Jensen
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark
| | - Anne E Jensen
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark
| | - Trine H Knudsen
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark
| | - Thorvaldur S Palsson
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark; Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark
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Chodankar A, Gurudut P, Welling A. Bruegger's exercises vs deep cervical flexor training in asymptomatic participants with forward head posture: a randomised controlled trial. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2022. [DOI: 10.12968/ijtr.2020.0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims Forward head posture is the most frequent postural deviation in typically healthy individuals and is associated with rounding of the shoulders. Prevention should be considered when it is at the asymptomatic stage by screening and early exercise intervention. The aim of the study was to examine the effects of Bruegger's exercises compared to deep cervical flexor training in asymptomatic participants with forward head posture. Methods This randomised controlled trial included 51 participants with asymptomatic forward head posture, who were allocated to one of three groups. One group undertook Bruegger's exercises with an elastic resistance band, another group performed deep cervical flexor training with a pressure biofeedback unit and the control group performed isometric neck exercises. Outcomes measured were the craniovertebral angle, the craniocervical flexion endurance test and the Pectoralis Minor Index, which were assessed at baseline on day 1 and at the end of the 3-week intervention. Follow-up assessment was undertaken for craniovertebral angle at 6 and 9 weeks from day 1 of the intervention. Statistical analysis included paired t-tests, the Wilcoxon signed-rank test, analysis of variance and the Kruskal–Wallis test. Results All three groups showed improvements in craniovertebral angle and the craniocervical flexion endurance test when compared between pre- and post-intervention. Only those in the Bruegger's exercises group showed an increase in the length of the pectoralis minor according to the Pectoralis Minor Index. Deep cervical flexor muscle endurance increased significantly (P<0.0002) for those in the Bruegger's exercises group and deep cervical flexor training group. At the end of the intervention (week 3) (P<0.0205) and follow up at week 9 (P<0.0029), individuals in the Bruegger's exercises group had maintained the craniovertebral angle correction for longer than those in the deep cervical flexor training and control group. Conclusions Bruegger's exercises with an elastic resistance band was found to be an effective intervention exercise to correct posture from head to scapula and can be included in the treatment of patients with postural head and neck issues.
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Affiliation(s)
- Ashma Chodankar
- Department of Orthopedic Physiotherapy, Karnataka Lingayat Education Academy of Higher Education and Research Institute of Physiotherapy, Belagavi, India
| | - Peeyoosha Gurudut
- Department of Orthopedic Physiotherapy, Karnataka Lingayat Education Academy of Higher Education and Research Institute of Physiotherapy, Belagavi, India
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Kadu DV, Shetye JV. Reliability of “MB-Ruler Software” to Measure Craniovertebral Angle Using the Photographic Method. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2022. [DOI: 10.1055/s-0041-1741415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Background The craniovertebral angle (CV angle) measurement is a convenient and easy clinical method for the cervical posture assessment. “Markus Bader (MB) ruler software” assists to measure angles and distances on the computer screen. The MB-ruler protractor is almost transparent; hence, it can be easily used on the computer screen. Many studies in physiotherapy have used this software for postural assessment with the photographic method, but the reliability of this software is not available to our knowledge in the Indian population.
Aim The aim of this study was to find inter-rater and intra-rater reliabilities of “MB-Ruler software”, by using the photographic method to measure the CV angle for the cervical postural assessment.
Study Design This is an observational study in healthy young population.
Subjects and Method Total 30 young student volunteers with no clinical symptoms were enrolled for this study. A single standard lateral view image in a sitting position was used for CV angle measurement with “MB ruler software.” Three readings of the CV angle were taken by three different observers (A, B, and C) separately at intervals of time. The CV angle measured by three observers was compared.
Results Cronbach's ɑ coefficient value for intra-rater (ICC 0.999) (intra-class correlation coefficient) as well as inter-rater (ICC 0.892) reliability for measuring CV angle was very high.
Conclusion MB ruler demonstrates high intra-rater and inter-rater reliabilities and can be used for the photographic evaluation of posture by assessing the CV angle.
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Affiliation(s)
- Dipti Vilas Kadu
- Department of Physiotherapy, Seth G. S. Medical College and K.E.M. Hospital, Parel, Mumbai, Maharashtra, India
| | - Jaimala Vijay Shetye
- Department of Physiotherapy, Seth G. S. Medical College and K.E.M. Hospital, Parel, Mumbai, Maharashtra, India
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A mobile application tool for standing posture analysis: development, validity, and reliability. Ir J Med Sci 2021; 191:2123-2131. [PMID: 34716535 PMCID: PMC8556145 DOI: 10.1007/s11845-021-02827-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 10/21/2021] [Indexed: 11/05/2022]
Abstract
Background Using mobile application for postural assessments has been drawing a rising interest due to widespread use of smartphones. Although there are some mobile applications in use, validated mobile tools for accurate postural assessment are still warranted. Aims This study aimed to develop Fizyoprint mobile application tool to assess standing posture and investigate the validity and reliability of the application in young adults. Methods A convenience sample of 20 young adults (12 men and 8 women with a mean age of 21.3 ± 2.2 years) and 2 physiotherapists as raters participated in the study. The participant’s digital images were obtained from the anterior, posterior, and right lateral sides. The raters selected the anatomic reference points by using digital markers in the app screen, and the Fizyoprint application, with Turkish language option, calculated a total of 26 posture variables, including 11 distance and 15 angle variables. Each participant was assessed twice (1-week interval) by 2 raters with Fizyoprint. Inter- and intra-rater reliabilities were estimated using the intraclass correlation coefficient. The BioTonix™ posture analysis system was used for validation. Results A total of 80.7% (21 variables) indicated acceptable to excellent intra-rater reliability results. A total of 57.7% (15 variables) were found to be acceptable to excellent for inter-rater measurements. The results confirmed the validity of the Fizyoprint application for testing the standing posture. Conclusions Fizyoprint application is a new, valid, free mobile tool with acceptable concordance with BioTonix™ postural analysis system for assessing standing posture. Further studies are warranted to test the current application in different populations and musculoskeletal conditions.
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Blanchard S, Bellaïche L, Kuliberda Z, Behr M. Influence of Footwear on Posture and Comfort in Elite Rugby Players. Int J Sports Med 2021; 43:269-277. [PMID: 34560788 DOI: 10.1055/a-1255-2803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Influence of footwear on posture in athletes is poorly documented despite its potential impact on biomechanics and injury risk. The aim of this study was to investigate effects of different footwear geometries on comfort and posture on a cohort of 48 elite rugby players. Spine posture was characterized by photogrammetry, while center of pressure was measured by means of a force platform. Three different footwear outsoles architectures (one rugby shoe with flat outsole, one rugby shoe with a 10 mm heel rise and foot arch support, and a running shoe with a 10mm heel rise and foot arch support) were compared to non-shod in randomized order. Then comfort felt at the level of foot and spine was also estimated by subjective questionnaires. Compared to the flat rugby model, both other models induced significantly (p<0.05) greater comfort at the level of foot and spine, a slight shift toward of center of pressure and a spinal posture closer to that observed when non-shod. The footwear geometry influences comfort and posture at the level of the foot as well as spine and should be considered in a dual purpose of injury prevention and performance.
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Affiliation(s)
- Sylvain Blanchard
- Racing 92 Rugby Club, Scientific & Medical Department, Le Plessis-Robinson.,Aix-Marseille I University, IFSTTAR, LBA UMR T24, Marseille
| | | | - Zbigniew Kuliberda
- EtioSYSTEMS, Evaluation Sportive, Strasbourg Aix-Marseille I University, IFSTTAR, LBA UMR T24, Marseille
| | - Michel Behr
- Aix-Marseille I University, IFSTTAR, LBA UMR T24, Marseille
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Salahzadeh Z, Rezaei-Hachesu P, Gheibi Y, Aghamali A, Pakzad H, Foladlou S, Samad-Soltani T. A mechatronics data collection, image processing, and deep learning platform for clinical posture analysis: a technical note. Phys Eng Sci Med 2021; 44:901-910. [PMID: 34398390 DOI: 10.1007/s13246-021-01035-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 07/13/2021] [Indexed: 10/20/2022]
Abstract
Static and dynamic posture analysis was a critical clinical examination in physiotherapy and rehabilitation. It was a time-consuming task for clinicians, so a semi-automatic method can facilitate this process as well as provide well-documented medical records and strong infrastructure for deep learning scenarios. The current research presents a mechatronics platform for static and real-time dynamic posture analysis, which consisted of hybrid computational modules. Our study was a developmental and applied research according to a system development life cycle. The designed modules are as follows: (1) a mechanical structure includes patient place, 360-degree engine, mirror, laser, distance meter, and cams; (2) a software module includes data collection, electronic medical record, semi-automatic image analysis, annotation, and reporting, and (3) a network to exchange raw data with deep learning server. Patients were informed about the research by their healthcare provider and all data were transformed into a Fourier format, in which the patients remained autonomous without a bit of information. The results show acceptable reliability and validity of the instruments. Also, a telerehabilitation application was designed to cover the patients after diagnosis. We suggest a longer time for data acquisition. It will lead to a more accurate and fully automated dynamic posture analysis. The result of this study suggest that the designed mechatronics device used in conjunction with smartphone application is a valid tool that can be used to obtain reliable measurements.
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Affiliation(s)
- Zahra Salahzadeh
- Physiotherapy Department, Faculty of Rehabilitation, Tabriz University of Medical Science, 29 Bahman St, Tabriz, Iran
| | - Peyman Rezaei-Hachesu
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yousef Gheibi
- Department of Artificial Intelligence, Faculty of Computer Engineering, University of Tabriz, Tabriz, Iran
| | - Ali Aghamali
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamed Pakzad
- Department of Research and Development, SanamSahand Health Promotion Industries, Tabriz, Iran
| | - Saeideh Foladlou
- Department of Biomedical Engineering, Islamic Azad University of Tabriz, Tabriz, Iran
| | - Taha Samad-Soltani
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
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Hida M, Wada C, Imai R, Kitagawa K, Okamatsu S, Ohnishi T, Kawashima S. Spinal postural alignment measurements using markerless digital photography. J Orthop Surg (Hong Kong) 2021; 28:2309499020960834. [PMID: 33191842 DOI: 10.1177/2309499020960834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
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.
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Affiliation(s)
- Mitsumasa Hida
- Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka City, Osaka, Japan
| | - Chikamune Wada
- Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, Wakamatsu-ku, Kitakyushu, Japan
| | - Ryota Imai
- Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka City, Osaka, Japan
| | - Kodai Kitagawa
- Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, Wakamatsu-ku, Kitakyushu, Japan
| | - Shogo Okamatsu
- Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, Wakamatsu-ku, Kitakyushu, Japan.,Kitakyushu Rehabilitation College, Karitacho-Kamikatashima, Miyako-gun, Fukuoka, Japan
| | | | - Satoshi Kawashima
- Geriatric Health Facilities, Kosen-Eluzu, Nishinomiya City, Hyogo, Japan
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Zaw AK, Olojede SO, Lawal SK, Offor U, Naidu EC, Rennie CO, Azu OO. Preliminary study on foramen transversarium of typical cervical vertebrae in KwaZulu-Natal population: Age and gender related changes. TRANSLATIONAL RESEARCH IN ANATOMY 2021. [DOI: 10.1016/j.tria.2020.100099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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14
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Yu Q, Huang H, Zhang Z, Hu X, Li W, Li L, Chen M, Liang Z, Lo WLA, Wang C. The association between pelvic asymmetry and non-specific chronic low back pain as assessed by the global postural system. BMC Musculoskelet Disord 2020; 21:596. [PMID: 32891129 PMCID: PMC7487478 DOI: 10.1186/s12891-020-03617-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 08/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Empirical evidence that demonstrates the relationship between pelvic asymmetry and non-specific chronic low back pain (NCLBP) is currently lacking. OBJECTIVE To establish the reliability of the Global Postural System (GPS) in assessing pelvic asymmetry and identify the association between pelvic asymmetry parameters and the occurrence of NCLBP in young adults. DESIGN A cross-sectional, regression study. METHODS People who were aged between 18 and 30 and were diagnosed with NCLBP were recruited. Healthy individuals who were matched for age, sex, and education level were recruited as controls. Global Postural System (GPS) was employed to assess pelvic asymmetry. Prior to exploring the association, the reliability of GPS was assessed by the ICC (2, k) for interrater reliability, ICC (3, k) for intra-rater reliability, standard error and minimal detectable difference. Bivariate correlation analysis and logistic regression analysis were used to determine the relationship between pelvic asymmetry and the occurrence of NCLBP. RESULTS Twenty-eight healthy participants and 28 people with NCLBP were recruited. Moderate to excellent ICCs were observed for the inter-rater and intra-rater reliability of most postural parameters. The bivariate correlation analysis indicated that age, body mass index and pelvic asymmetry parameters were related to the occurrence of NCLBP. Pelvic angle asymmetry (odds ratio = 1.17), and asymmetry of the distance between the posterior superior iliac spine and the floor (odds ratio = 1.21) were associated with NCLBP. LIMITATIONS This study did not explore the causal relationship between pelvic asymmetry in the sagittal plane/pelvic asymmetry in the transverse plane and the occurrence of NCLBP. The interpretation of the results may not be generalized beyond the sample population. CONCLUSIONS The GPS is a reliable method to assess pelvic asymmetry in a clinical setting. Two pelvic parameters were associated with the presence of NLBP. Measurement of pelvic asymmetry may assist in the early identification of potential occurrence of NCLBP but further work is required.
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Affiliation(s)
- Qiuhua Yu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhong Shan Er Lu, Guangzhou, 5100800, China
| | - Huanjie Huang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhong Shan Er Lu, Guangzhou, 5100800, China
| | - Zhou Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhong Shan Er Lu, Guangzhou, 5100800, China
| | - Xiaoqian Hu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhong Shan Er Lu, Guangzhou, 5100800, China
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Wenfeng Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhong Shan Er Lu, Guangzhou, 5100800, China
| | - Le Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhong Shan Er Lu, Guangzhou, 5100800, China
- Guangdong Engineering and Technology Research Centre for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Min Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhong Shan Er Lu, Guangzhou, 5100800, China
| | - Zhenwen Liang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Wai Leung Ambrose Lo
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhong Shan Er Lu, Guangzhou, 5100800, China.
- Guangdong Engineering and Technology Research Centre for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
| | - Chuhuai Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhong Shan Er Lu, Guangzhou, 5100800, China.
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Does the Type of Toeing Affect Balance in Children With Diplegic Cerebral Palsy? An Observational Cross-sectional Study. J Chiropr Med 2020; 18:229-235. [PMID: 32874163 DOI: 10.1016/j.jcm.2019.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 11/23/2018] [Accepted: 01/24/2019] [Indexed: 11/22/2022] Open
Abstract
Objective The purpose of the study was to find out effect of toeing on balance in children with diplegic cerebral palsy. Methods An observational study was conducted. Thirty children with spastic diplegic cerebral palsy, aged 5 to 8 years, participated in this study. They were classified into 2 groups: group A was children with out-toeing, and group B was children with in-toeing. Foot progression angle was measured by using dynamic footprint, and balance was evaluated using Biodex Balance System equipment. The outcome of interest was postural control (overall stability, anteroposterior stability, and mediolateral stability). Results Statistical analysis revealed a significant difference for the tested variables of interest between the 2 tested groups. Multiple pairwise comparison tests revealed that there was significantly better overall stability, anteroposterior stability, and mediolateral stability (P < .05) in group A. Conclusion It can be concluded that children with out-toeing have higher balance and stability than children with in-toeing.
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Ludwig O, Kelm J, Hammes A, Schmitt E, Fröhlich M. Neuromuscular performance of balance and posture control in childhood and adolescence. Heliyon 2020; 6:e04541. [PMID: 32775721 PMCID: PMC7398941 DOI: 10.1016/j.heliyon.2020.e04541] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/04/2020] [Accepted: 07/20/2020] [Indexed: 12/21/2022] Open
Abstract
This study examined a potential age-dependency of both posture and stability (balance) control in children and adolescents in a healthy population. Body posture with open and closed eyes was examined for a total of 456 test persons (age 6.7–17.6 years. Posture parameters (posture index, upper body tilt, trunk tilt) were assessed in the sagittal plane. Additionally, the oscillation of the center of pressure with open and closed eyes was additionally analyzed in a sub-sample of 318 subjects. Absolute values of stability control parameters changed significantly during childhood and adolescence for both boys (p = 0.005) and girls (p = 0.01). Relative changes of stability and posture parameters when closing the eyes did not change (p > 0.05) and were independent of age, gender or sports activity in healthy children and adolescents. The shifting of the body segments towards each other, as a result of the loss of visual information, does not seem to be primarily responsible for the increase in COP fluctuation. This is a further indication that stability control and posture control are complex interdependent mechanisms whose interaction is not yet fully understood.
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Affiliation(s)
- Oliver Ludwig
- Fachgebiet Sportwissenschaft, Technische Universität Kaiserslautern, 67663 Kaiserslautern, Germany
- Sportwissenschaftliches Institut, Universität des Saarlandes, 66123 Saarbrücken, Germany
- Corresponding author.
| | - Jens Kelm
- Chirurgisch-orthopädisches Zentrum, 66557 Illingen, Germany
| | - Annette Hammes
- Medicover Medizinisches Versorgungszentrum, 66111 Saarbrücken, Germany
| | - Eduard Schmitt
- Klinik für Orthopädie und Orthopädische Chirurgie, Universitätsklinikum des Saarlandes, 66424 Homburg, Germany
| | - Michael Fröhlich
- Fachgebiet Sportwissenschaft, Technische Universität Kaiserslautern, 67663 Kaiserslautern, Germany
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Abstract
Smartphones are increasingly incorporated with features such as sensors and high resolution cameras that empower their capabilities, enabling their use for varied activities including human posture assessments. Previous reviews have discussed methods used in postural assessment but none of them focused exclusively on mobile applications. This paper systematically reviews mobile applications proposed for analyzing human posture based on alignment of the body in the sagittal and coronal plane. The main digital libraries were searched, 26 articles published between 2010 and 2020 were selected, and 13 mobile applications were identified, classified and discussed. Results showed that the use of mobile applications to assist with posture assessment have been demonstrated to be reliable, and this can contribute to clinical practice of health professionals, especially the assessment and reassessment phases of treatments, despite some variations when compared to traditional methods. Moreover, in the case of image-based applications, we highlight the advantage that measurements can be taken with the assessor at a certain distance with respect to the patient’s position, which is an important function for assessments performed in pandemic times such as the outbreak of COVID-19.
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Role of physical fitness and functional movement in the body posture of children with overweight/obesity. Gait Posture 2020; 80:331-338. [PMID: 32599548 DOI: 10.1016/j.gaitpost.2020.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Childhood obesity is known to negatively impact body posture with severe consequences for the musculoskeletal system. Physical performance could play a positive role in the body posture conformation of these children, but there is little evidence to date. RESEARCH QUESTION Is physical performance (i.e., physical fitness and functional movement) associated with a better body posture in children with overweight/obesity (OW/OB)? If so, is physical performance more determinant than their obesity degree in the body posture conformation? METHOD A total of 62 children with OW/OB (10.86 ± 1.25 years, 58 % girls) were included. BMI, physical fitness components (one-repetition-maximum (1RM) arms and leg press, and ALPHA test battery), functional movement quality (Functional Movement Screen™) and body posture (two-dimensional photogrammetry) were evaluated. RESULTS Physical fitness components and functional movement were overall associated with a more aligned posture of the head, lumbar and thoracic spines and lower limb. BMI was associated with head protraction, thoracic hyperkyphosis, lumbar hyperlordosis and lower limb valgus. BMI was the best predictor of head and lumbar spine posture, cardiorespiratory fitness of lower limb posture in frontal plane, speed-agility of lower limb posture in the sagittal plane and functional movement of thoracic spine. SIGNIFICANCE Our findings reveal that physical fitness and functional movement are associated with a better global body posture in children with OW/OB, and that in some musculoskeletal structures are even better predictors than their obesity degree.
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Molina-Garcia P, Mora-Gonzalez J, Migueles JH, Rodriguez-Ayllon M, Esteban-Cornejo I, Cadenas-Sanchez C, Plaza-Florido A, Gil-Cosano JJ, Pelaez-Perez MA, Garcia-Delgado G, Vanrenterghem J, Ortega FB. Effects of Exercise on Body Posture, Functional Movement, and Physical Fitness in Children With Overweight/Obesity. J Strength Cond Res 2020; 34:2146-2155. [DOI: 10.1519/jsc.0000000000003655] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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20
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Martinez-Merinero P, Nuñez-Nagy S, Achalandabaso-Ochoa A, Fernandez-Matias R, Pecos-Martin D, Gallego-Izquierdo T. Relationship between Forward Head Posture and Tissue Mechanosensitivity: A Cross-Sectional Study. J Clin Med 2020; 9:jcm9030634. [PMID: 32120895 PMCID: PMC7141123 DOI: 10.3390/jcm9030634] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/19/2020] [Accepted: 02/19/2020] [Indexed: 01/19/2023] Open
Abstract
The relationship between forward head posture (FHP) and neck pain is not clear. FHP could possibly increase the mechanosensitivity of cervical tissues, which could lead to the development of pain depending on the adaptation capability of the central nervous system. The purpose of this study was to analyse the influence of FHP in the mechanosensitivity of articular, muscular, and neural tissues related to the cervical spine. The pressure pain threshold was bilaterally measured in different muscles and nerves and the second cervical vertebrae. The cervical spine’s range of movement was also examined. The measurements were obtained from people with (n = 32) and without (n = 64) FHP. The analyses included a 2-by-2 mixed analysis of variance (ANOVA), pairwise comparisons with Bonferroni correction, and point-biserial correlation coefficients. Subjects with FHP showed a less pressure pain threshold (PPT) in all locations except for the upper trapezius and scalenus medius muscles. They also showed less extension and right-rotation range of motion. There was no association between FHP, neck pain, disability, and headache. Nevertheless, more research is needed to evaluate the relationship between FHP, tissue mechanosensitivity, and neck pain.
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Affiliation(s)
- Patricia Martinez-Merinero
- Department of Physiotherapy, Faculty of Biomedical and Health Sciencies, Universidad Europea de Madrid, 28670 Madrid, Spain
- Research Institute of Physiotherapy and Pain, University of Alcalá, 28805 Madrid, Spain
| | - Susana Nuñez-Nagy
- Department of Physical Therapy, University of Alcalá, 28871 Madrid, Spain
| | | | | | - Daniel Pecos-Martin
- Department of Physical Therapy, University of Alcalá, 28871 Madrid, Spain
- Physiotherapy and Pain Group, University of Alcalá, 28871 Madrid, Spain
- Correspondence:
| | - Tomas Gallego-Izquierdo
- Research Institute of Physiotherapy and Pain, University of Alcalá, 28805 Madrid, Spain
- Department of Physical Therapy, University of Alcalá, 28871 Madrid, Spain
- Physiotherapy and Pain Group, University of Alcalá, 28871 Madrid, Spain
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Mandrekar S, Chavhan D, Shyam AK, Sancheti PK. Effects of carrying school bags on cervical and shoulder posture in static and dynamic conditions in adolescent students. Int J Adolesc Med Health 2019; 34:ijamh-2019-0073. [PMID: 31665119 DOI: 10.1515/ijamh-2019-0073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 05/19/2019] [Indexed: 11/15/2022]
Abstract
Background Neck and Back Pain in Students is closely related to the school bags that they carry. There is a dearth of literature in terms of postural changes due to school bags in adolescents, especially those discussing postural changes in static and dynamic loading conditions. Objective To assess the effects of weight, position, and time of school bag carriage in static and dynamic conditions on cervical and shoulder posture in adolescent students. Subjects Seventy adolescents (35 Females, 35 Males) between 10 and 15 years of age. Methods: Craniohorizontal Angle, Craniovertebral Angle, Sagittal Shoulder Posture, Anterior Head Alignment were assessed in 7 different conditions using Photographic Method and MB Ruler. Results and Conclusion Significant changes in Sagittal Shoulder Posture and Craniohorizontal Angle were found with unilateral school bag carriage as compared to minimal significant postural changes with bilateral carriage. Maximal significant postural changes, in terms of all outcome measures were noted during loaded dynamic activity. Craniovertebral Angle kept significantly reducing with time. Immediate assessments taken with a school bag weighing 13.5% of the body weight showed a significant decrement in the Craniohorizontal Angle. Even a bag weighing less than 10% of the body weight proved to bring about biomechanical changes, when assessments were taken during the activities that a child has to perform with a school bag (Post Standing, Post Walking, and During Walking).
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Affiliation(s)
- Shivani Mandrekar
- Bachelor of Physiotherapy, Sancheti Institute College of Physiotherapy, Pune, India
| | - Dinesh Chavhan
- Masters in Neurophysiotherapy, Assistant Professor, Sancheti College of Physiotherapy, 11/12, Thube Park, Shivajinagar, Pune 411005, Maharashtra, India
| | - Ashok K Shyam
- MS Orthopaedics, Research Officer, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, India
| | - Parag K Sancheti
- MS Orthopaedics, Chairman, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, India
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Greisberger A, Wolf B, Widhalm K, Kollmitzer D, Arbesser M, Putz P. Intrarater and Interrater Reliability of Angular Measures Using TEMPLO Two-dimensional Motion Analysis Software. J Manipulative Physiol Ther 2019; 42:425-429. [PMID: 31324376 DOI: 10.1016/j.jmpt.2018.11.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/04/2018] [Accepted: 11/02/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the intrarater and interrater reliability of marking 2 angles with the TEMPLO software and to provide relevant information for clinical practice. METHODS A prospective test-retest study has been conducted. Four raters took measures on 2 days, with 2 weeks in between. Craniovertebral angle and trunk forward lean were drawn on 22 video frames using TEMPLO. Reliability was examined using intraclass correlation coefficients including standard errors of measurement and minimal detectable change values as measures of precision expressed in the unit of the test (°). RESULTS Intraclass correlation coefficients for intrarater and interrater reliability ranged from 0.98 to 1.00. Standard errors of measurement and minimal detectable change values ranged from 0.4° to 0.8° and 0.8° to 2.3°, respectively. CONCLUSION These results indicate excellent reliability for craniovertebral angle and trunk forward lean assessed with TEMPLO software. Changes exceeding 2.3° may be expected to fall outside the test's variability.
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Affiliation(s)
| | - Brigitte Wolf
- Department of Health Sciences, FH Campus Wien, Vienna, Austria
| | - Klaus Widhalm
- Department of Health Sciences, FH Campus Wien, Vienna, Austria
| | | | | | - Peter Putz
- Department of Health Sciences, FH Campus Wien, Vienna, Austria
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Youssef ASA, Xia N, Emara STE, Moustafa IM, Huang X. Addition of a new three-dimensional adjustable cervical thoracic orthosis to a multi-modal program in the treatment of nonspecific neck pain: study protocol for a randomised pilot trial. Trials 2019; 20:248. [PMID: 31036033 PMCID: PMC6489278 DOI: 10.1186/s13063-019-3337-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 03/30/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Nonspecific neck pain (NSNP) is one of the most common musculoskeletal problems treated by orthopaedic physicians and physiotherapists. Posture has emerged as one of the major risk factors associated with NSNP, but most previous studies ignored correct posturing as an effective treatment. Therefore, one of the major challenges faced by clinicians is how to incorporate 3D posture findings into the treatment plane. The present study will evaluate the feasibility of conducting a larger randomized trial. This pilot study is designed to investigate the hypothesis that a multimodal programme supplemented with the addition of a 3D adjustable cervico thoracic posture corrective orthotic (CTPCO) will yield short- and long-term improvement on NSNP management outcomes. METHODS/DESIGN This pilot, single-blind, randomized controlled trial will divide 24 patients into two groups (study and control) using block randomization. Both groups will receive conventional treatment consisting of a moist hot pack, soft tissue mobilization, manual therapy and therapeutic exercise. The study group will undergo ambulatory mirror-image functional re-training wearing a 3D adjustable CTPCO. The primary outcome is feasibility, including recruitment (e.g., time to complete enrolment, recruitment rate), patient retention and adherence to treatment allocation (e.g., session attendance, home practice, use of non-study treatments). The secondary outcomes used to assess the effectiveness of the treatment will include neck pain (measures using the visual analogue scale (VAS)) and neck disability (measures using the neck disability index (NDI)), among other outcome measures, compared between the experimental and control groups. Three-dimensional posture parameters of head measurements will be provided by a Global Posture System (GPS). The outcome measures for determining the treatment effect will be assessed at three intervals: pre-treatment, after 10 weeks of intervention and after 3 months at follow-up. DISCUSSION This randomized controlled pilot trial will inform the design of a future full-scale trial. The outcomes will provide some resources for the incorporation of ambulatory mirror-image functional re-training intervention compared to a control group intervention for neck pain, disability and 3D posture parameters. TRIAL REGISTRATION Prospectively registered at ClinicalTrials.gov, NCT03331120 . Registered on 22 October 2017.
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Affiliation(s)
- Ahmed S A Youssef
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095#, Jiefang Avenue, Wuhan, 430030, Hubei, China
- Basic science department, Faculty of Physical Therapy, Beni-Suef University, Beni-Suef, Egypt
| | - Nan Xia
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095#, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | | | - Ibrahim M Moustafa
- Basic science department, Faculty of Physical Therapy, Cairo University, 7-Mohamed Hassan El-Gamel st, Naser City, Cairo, 002, Egypt.
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, UAE.
| | - Xiaolin Huang
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095#, Jiefang Avenue, Wuhan, 430030, Hubei, China.
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Lucha-López MO, Tricás-Moreno JM, Gaspar-Calvo E, Lucha-López AC, Vidal-Peracho C, Hidalgo-García C, Caudevilla-Polo S, Fanlo-Mazas P. Relationship between knee alignment in asymptomatic subjects and flexibility of the main muscles that are functionally related to the knee. J Int Med Res 2018; 46:3065-3077. [PMID: 29936873 PMCID: PMC6134663 DOI: 10.1177/0300060518771825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To assess the relationship between static frontal knee alignment in asymptomatic subjects and flexibility of the main muscles functionally related to the knee. Methods A descriptive cross-sectional study was performed in 33 healthy adults (19-31 years). The frontal knee angle (valgus/varus angle) was measured by photogrammetry and it was measured in the lateral side. Therefore, high values were assigned for genu varum and low values for genu valgum. Iliopsoas, gluteus maximus and medius, rectus femoris, biceps femoris, vastus of the quadriceps, and gastrocnemius muscles were stretched. Muscles were classified as normal, reflex hypomobile, or structural hypomobile. Results Women had significantly greater valgus than did men (right angle, women: 174.41°/men: 177.41°; left angle, women: 174.20°/men: 178.70°). The right frontal plane knee angle was higher in women with structural hypomobile vastus. The left frontal plane knee angle was higher in women with structural hypomobile iliopsoas. No relationships were found in men. Conclusions A tighter vastus of the quadriceps and tighter iliopsoas are related to greater genu varum in adult women. Stretching the vastus of the quadriceps and iliopsoas when there is a tendency for excess varus in the knee, to prevent overuse injury or early osteoarthritis, might be clinically relevant.
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Affiliation(s)
- María Orosia Lucha-López
- 1 Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Spain
| | - José Miguel Tricás-Moreno
- 1 Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Spain
| | - Elena Gaspar-Calvo
- 1 Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Spain
| | - Ana Carmen Lucha-López
- 1 Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Spain
| | - Concepción Vidal-Peracho
- 2 Specialty Medical Center Grande Covián, SALUD, Avda. Alcalde Caballero Zaragoza, Spain.,3 Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Spain
| | - César Hidalgo-García
- 1 Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Spain
| | - Santos Caudevilla-Polo
- 1 Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Spain
| | - Pablo Fanlo-Mazas
- 1 Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Spain
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Szucs KA, Brown EVD. Rater reliability and construct validity of a mobile application for posture analysis. J Phys Ther Sci 2018; 30:31-36. [PMID: 29410561 PMCID: PMC5788770 DOI: 10.1589/jpts.30.31] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 10/04/2017] [Indexed: 12/26/2022] Open
Abstract
[Purpose] Measurement of posture is important for those with a clinical diagnosis as well
as researchers aiming to understand the impact of faulty postures on the development of
musculoskeletal disorders. A reliable, cost-effective and low tech posture measure may be
beneficial for research and clinical applications. The purpose of this study was to
determine rater reliability and construct validity of a posture screening mobile
application in healthy young adults. [Subjects and Methods] Pictures of subjects were
taken in three standing positions. Two raters independently digitized the static standing
posture image twice. The app calculated posture variables, including sagittal and coronal
plane translations and angulations. Intra- and inter-rater reliability were calculated
using the appropriate ICC models for complete agreement. Construct validity was determined
through comparison of known groups using repeated measures ANOVA. [Results] Intra-rater
reliability ranged from 0.71 to 0.99. Inter-rater reliability was good to excellent for
all translations. ICCs were stronger for translations versus angulations. The construct
validity analysis found that the app was able to detect the change in the four variables
selected. [Conclusion] The posture mobile application has demonstrated strong rater
reliability and preliminary evidence of construct validity. This application may have
utility in clinical and research settings.
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Affiliation(s)
- Kimberly A Szucs
- Department of Occupational Therapy, Duquesne University: 600 Forbes Avenue, Pittsburgh, PA, USA
| | - Elena V Donoso Brown
- Department of Occupational Therapy, Duquesne University: 600 Forbes Avenue, Pittsburgh, PA, USA
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Photogrammetric Assessment of Upper Body Posture Using Postural Angles: A Literature Review. J Chiropr Med 2017; 16:131-138. [PMID: 28559753 DOI: 10.1016/j.jcm.2017.01.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 01/03/2017] [Accepted: 01/24/2017] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The purpose of this paper was to review the literature regarding the measurement properties of various angles used for postural assessment of the head, neck, shoulder, and thorax and to discuss the utility of these measures. METHODS The inclusion criteria for this literature review were use of postural angles to assess posture, measurement of upper body posture, and research studies conducted in last 3 decades that had free full-text available online entirely in the English language. The exclusion criteria were review articles; studies involving subjects having obesity, visual problems, any history of surgery, respiratory, cardiovascular, neurologic, or congenital pathology or disease; and research studies in which postural angles were measured with respect to vertical only. The following databases were searched: PubMed Central, PubMed, ResearchGate, Springer Link, ScienceDirect, Google Scholar and Scielo through February 20, 2016. RESULTS A total of 21 studies that were found to be best suited to explain the craniovertebral (CV) angle, sagittal head tilt, sagittal shoulder-C7 angle, coronal head tilt, coronal shoulder angle, and thoracic kyphosis angle were included in this review. Craniovertebral angle, sagittal head tilt, sagittal shoulder-C7 angle, coronal head tilt, and coronal shoulder angle possess moderate to high intrarater reliability. Craniovertebral angle, sagittal head tilt, sagittal shoulder-C7 angle and thoracic kyphosis angle possess high interrater reliability (except for sagittal head tilt when measured using the goniometer). Craniovertebral angle, sagittal head tilt, and sagittal shoulder-C7 angle have been proved to be valid measures of posture when compared with similar angles measured on radiographs. None of the studies reported intrarater reliability of thoracic kyphosis angle, interrater reliability of coronal head tilt and coronal shoulder angle, and validity of coronal angles and thoracic kyphosis angle. CONCLUSIONS We found several reliable methods to measure the postures of the head, neck, shoulder, and thoracic regions by measuring the CV angle, sagittal head tilt, sagittal shoulder-C7 angle, and thoracic kyphosis angle, respectively. Standardization of methods for angular measurement is recommended so that there is uniformity among studies regarding camera height, participant-camera distance, and type of software to generate normative data for postural angles.
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Karabicak GO, Balcı NC, Gulsen M, Ozturk B, Cetin N. The effect of postural control and balance on femoral anteversion in children with spastic cerebral palsy. J Phys Ther Sci 2016; 28:1696-700. [PMID: 27390397 PMCID: PMC4932038 DOI: 10.1589/jpts.28.1696] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 02/15/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of the study was to investigate the relationships between femoral
anteversion and functional balance and postural control in children with spastic cerebral
palsy. [Subjects and Methods] Twenty children with spastic cerebral palsy (mean age=12.4 ±
4.5) with grosss motor functional classification system levels I, II, and III were
recruited for this study. Functional balance was evaluated using the Pediatric Balance
Scale, postural control was evaluated using the Trunk Control Measurement Scale, and
femoral anteversion was assessed with a handheld goniometer using the great trochanter
prominence method. [Results] The results indicated that there was significant correlation
between femoral anteversion and Trunk Control Measurement Scale dynamic reaching score.
There were no significant correlation between femoral anteversion and the Trunk Control
Measurement Scale static sitting balance, Trunk Control Measurement Scale selective
movement control, total Trunk Control Measurement Scale and Pediatric Balance Scale
results. [Conclusion] Increased femoral anteversion has not correlation with functional
balance, static sitting, and selective control of the trunk. Femoral anteversion is
related to dynamic reaching activities of the trunk, and this may be the result of
excessive internal pelvic rotation. It is important for the health professionals to
understand that increased femoral anteversion needs to be corrected because in addition to
leading to femoral internal rotation during walking, it also effects dynamic reaching
activities of spastic children with cerebral palsy.
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Affiliation(s)
- Gul Oznur Karabicak
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Baskent University, Turkey
| | - Nilay Comuk Balcı
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Baskent University, Turkey
| | - Mustafa Gulsen
- Physiotherapy Program, Vocational School of Health Sciences, Baskent University, Turkey
| | - Basar Ozturk
- Ergotherapy Department, Faculty of Health Sciences, Biruni University, Turkey
| | - Nuri Cetin
- Department of Physical Medicine and Rehabilitation, Baskent University Ankara Hospital, Turkey
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Ludwig O, Mazet C, Mazet D, Hammes A, Schmitt E. Age-dependency of posture parameters in children and adolescents. J Phys Ther Sci 2016; 28:1607-10. [PMID: 27313382 PMCID: PMC4905921 DOI: 10.1589/jpts.28.1607] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 02/03/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Poor posture in children and adolescents is a well-known problem. Therefore,
early detection of incorrect posture is important. Photometric posture analysis is a
cost-efficient and easy method, but needs reliable reference values. As children’s posture
changes as they grow, the assessment needs to be age-specific. This study aimed to
investigate the development of both one-dimensional posture parameter (body inclination
angle) and complex parameter (posture index) in different age groups (childhood to
adolescence). [Subjects and Methods] The participants were 372 symptom-free children and
adolescents (140 girls and 232 boys aged 6–17). Images of their habitual posture were
obtained in the sagittal plane. High-contrast marker points and marker spheres were placed
on anatomical landmarks. Based on the marker points, the body inclination angle (INC) and
posture index (PI) were calculated using the Corpus concepts software. [Results] The INC
angle significantly increased with age. The PI did not change significantly among the age
groups. No significant differences between the corresponding age groups were found for PI
and INC for both sexes. [Conclusion] When evaluating posture using the body inclination
angle, the age of the subject needs to be considered. Posture assessment with an
age-independent parameter may be more suitable.
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Affiliation(s)
- Oliver Ludwig
- Institute of Sport Sciences, Saarland University, Germany
| | - Carola Mazet
- Institute of Sport Sciences, Saarland University, Germany
| | - Dirk Mazet
- Institute of Sport Sciences, Saarland University, Germany
| | | | - Eduard Schmitt
- Universitätsklinikum des Saarlandes, Klinik für Orthopaedie und Orthop. Chirurgie, Germany
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