A noninvasive tool for postural assessment in young students at school: validation, sensibility, specificity and accuracy

Abstract

The literature presents several tools and technics for postural evaluation but spine radiographs are still the gold standard method. Spine alignment assessment by visual scan is the most known method, however small postural alterations are hard to detect. The aim of this study was to assess the validity, sensitivity, specificity and accuracy of a noninvasive method of postural assessment in adolescents at school. Vertebral column misalignments were detected by an experimental instrument (based in a symetrograph). C7-L5 spinous processes and the intergluteal fold were used as anatomic landmarks to visually detect asymmetries. Subjects were also clinically inspected by a spine surgeon and made long standing radiographs. The Spearmen's correlation test between the experimental data and X-Ray evaluated the validity. The true and false negative and positives cross-tabulation, assessed the test sensitivity, specificity and accuracy. A significant and positive correlation confirmed the test validity.

INTRODUCTION

The literature presents several tools and technics for postural evaluation but spine radiographs are still the gold standard method (Kilinc, Yaman & Atay, 2009; Guimaraes, Saco & Joao, 2007). Spine alignment assessment by visual scan is the most known method, however small postural alterations are hard to detect (Singla & Vegar, 2014; lunes et al., 2009). The aim of this study was to assess the validity, sensitivity, specificity and accuracy of a noninvasive method of postural assessment in adolescents at school.

METHODS

The sample was composed by 81 subjects aged 14.23 (± 3.11). Table 1 presents the sample characteristics.

Vertebral column misalignments were detected by an experimental instrument (based in a symetrograph). C7-L5 spinous processes and the intergluteal fold were used as anatomic landmarks to visually detect asymmetries (Fransoo, 2003). Subjects were also clinically inspected by a spine surgeon and made long standing radiographs. The Spearmen's correlation test between the experimental data and X-Ray evaluated the validity. The true and false negative and positives cross-tabulation, assessed the test sensitivity, specificity and accuracy.

RESULTS

Table 2 presents the frequency of postural asymmetries for the experimental test and X-Ray. Table 3 presents the true and false negatives analysis. A significant and positive correlation was observed between the experimental test and X-Ray (rs = 0.763; p< 0.001). The instrument sensitivity was 97%, the specificity was 67% and the accuracy 88%.

CONCLUSIONS

A significant and positive correlation confirmed the test validity. The evaluation of true and false negative and positives cases allowed to conclude that the instrument present sensibility, specificity and accuracy for postural analysis at schools.

References

References

Kilinç, F., Yaman, H., & Atay, E. (2009). Investigation of the effects of intensive one-sided and double-sided training drills on the postures of basketball playing children. Journal of Physical Therapy Science, 21 (1), 23-28.

Guimaräes, M.M.B., Sacco I.C.N., Joäo S.M.A. (2007). Postural characterization of young female Olympic gymnasts. Rev. Bras. Fisioter. 2007; 11(3): 185-90.

Singla, D., & Veqar, Z. (2014). Methods of postural assessment used for sports persons. Journal of clinical and diagnostic research: JCDR, 8(4), LE01.

Iunes, D.H., Bevilaqua-Grossi, D., Oliveira, A.S., Castro, F.A., Salgado, H.S. (2009). Comparative analysis between visual and computerized photogrammetry postural assessment. Rev Bras Fisioter;13(4): 308-15.

Fransoo, P. (2003). Examen Clínico del Paciente con Lumbalgia - Compendio práctico de reeducación. Barcelona, Espanha: Editorial Paidotribo.