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Vol. 22. Num. 4.01 July 2018
Pages 255-344
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Vol. 22. Num. 4.01 July 2018
Pages 255-344
Original Research
DOI: 10.1016/j.bjpt.2018.02.005
Is the inclinometer a valid measure of thoracic kyphosis? A cross-sectional study
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Donald J. Hunter
Corresponding author
donald.hunter@uon.edu.au

Corresponding author at: The University of Newcastle, School of Health Sciences, Discipline of Physiotherapy, Callaghan, NSW 2308, Australia.
, Darren A. Rivett, Sharmain McKiernan, Ishanka Weerasekara, Suzanne J. Snodgrass
The University of Newcastle, School of Health Sciences, Discipline of Physiotherapy, Callaghan, NSW, Australia
Highlights

  • Validity of the gravity-dependent inclinometer for thoracic kyphosis established.

  • The inclinometer was comparable to radiographic measurements of thoracic kyphosis.

  • Using the inclinometer reduces need for repeated radiographs for measuring kyphosis.

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Tables (2)
Table 1. Regression analyses where the dependent variable is the modified Cobb angle from the lateral radiographs and the independent variable is the angle calculated from the inclinometer measurements for the pain (SIS) and healthy (no shoulder symptoms) subgroups, and for all participants in total, with age included in the model as a confounder.
Table 2. Regression analyses where the dependent variable is the modified Cobb angle from the lateral radiographs and the independent variable is the angle calculated from the inclinometer measurements for the pain (SIS) and healthy (no shoulder symptoms) subgroups, and for all participants in total, with BMI included in the model as a confounder.
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Abstract
Background

Radiographs are used to monitor thoracic kyphosis in individuals with certain pathologies (e.g. osteoporosis), exposing patients to potentially harmful radiation. Thus, other measures for monitoring the progression of thoracic kyphosis are desirable. The gravity-dependent inclinometer has been shown to be reliable but its validity as a measure of thoracic kyphosis has not been investigated.

Objectives

To determine the validity of the gravity-dependent (analogue) inclinometer for measuring thoracic kyphosis.

Design

Cross-sectional study.

Method

Participants (n=78) were recruited as part of a larger study of shoulder impingement syndrome. Healthy participants (n=39) were age and gender matched to the shoulder impingement syndrome group (n=39). Measurements of thoracic kyphosis using a gravity-dependent inclinometer were compared with modified Cobb angle results obtained from a sagittal view of lateral radiographs. A Bland–Altman plot assessed agreement. The Pearson correlation coefficient and linear regression was used to determine the association between modified Cobb angles and inclinometer measurements.

Results

The Bland–Altman plot demonstrated good agreement. The Pearson correlation coefficient, r=0.62 (p<0.001), and linear regression model established a strong association between the thoracic kyphosis angle from the inclinometer readings and the modified Cobb angle measured from the radiographs (β=0.47, 95% CI 0.29, 0.65, p<0.001, R2=0.52, n=78). Age as a confounder was included in the model (β=0.35, 95% CI 0.19, 0.51, p<0.001).

Conclusions

The gravity-dependent (analogue) inclinometer produces angles that are comparable to the modified Cobb angle obtained from radiographs, establishing its criterion validity as a safe clinical tool for measuring thoracic kyphosis.

Keywords:
Kyphosis
Validity
Reliability
Thoracic vertebrae
Scheuermann's disease
Osteoporosis

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