Dunk Nadine M, Chung Yin Yin, Compton Diana Sullivan, Callaghan Jack P
Faculty of Applied Health Sciences, Department of Kinesiology, University of Waterloo, Ontario, Canada.
J Manipulative Physiol Ther. 2004 Feb;27(2):91-6. doi: 10.1016/j.jmpt.2003.12.003.
To assess the reliability of posture across and within subjects, specifically the repeatability of spinal angles determined by digitization of images in the anterior, posterior, and sagittal views.
A repeated measure design was used in which subjects were required to attend 3 sessions, each consisting of 3 trials. Photographs of the anterior, posterior, and lateral views of normal, relaxed upright standing were taken during each trial. Landmarks were digitized and cervical, thoracic, and lumbar angles were calculated with respect to a vertical reference line.
Fourteen healthy and active subjects (7 male subjects and 7 female subjects) were recruited from a university student population. All had been free of low back pain during the previous 6 months.
When comparing mean angles, no significant differences were detected for any angle in any view. However, large variability within subjects was observed, likely leading to the lack of significance found with respect to the main factors in the analysis of variance (ANOVA). Large coefficients of variance (CVs) reflect the substantial intrasubject variability, as well as poor to moderate agreement indicated by intraclass correlation coefficients (ICCs). There were no apparent trends indicating that gender affected repeatability of posture.
The poor repeatability of postures documented using the studied method brings into question the validity of this postural analysis approach for either diagnostic use or tracking changes in response to treatment. Users of such postural analysis tools should interpret postural deviations from a vertical reference with caution, as there are many inherent factors that can contribute to the variability of these measured postures.
评估受试者之间及受试者自身姿势的可靠性，特别是通过对前视图、后视图和矢状面视图图像进行数字化处理所确定的脊柱角度的可重复性。
采用重复测量设计，要求受试者参加3次测试，每次测试包含3次试验。在每次试验过程中，拍摄正常、放松直立站立姿势的前视图、后视图和侧视图照片。对标志点进行数字化处理，并相对于垂直参考线计算颈椎、胸椎和腰椎角度。
从大学生群体中招募了14名健康且活跃的受试者（7名男性受试者和7名女性受试者）。所有人在过去6个月内均无腰痛病史。
比较平均角度时，在任何视图中，任何角度均未检测到显著差异。然而，观察到受试者内部存在较大变异性，这可能导致方差分析（ANOVA）中关于主要因素的结果缺乏显著性。较大的变异系数（CV）反映了受试者内部的显著变异性，以及组内相关系数（ICC）所表明的较差至中等程度的一致性。没有明显趋势表明性别会影响姿势的可重复性。
使用所研究方法记录的姿势可重复性较差，这使得这种姿势分析方法用于诊断或跟踪治疗反应变化的有效性受到质疑。使用此类姿势分析工具的人员应谨慎解释相对于垂直参考线的姿势偏差，因为有许多内在因素可能导致这些测量姿势的变异性。
