Dunk Nadine M, Lalonde Jennifer, Callaghan Jack P
Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Ontario, Canada N2L 3G1.
J Manipulative Physiol Ther. 2005 Jul-Aug;28(6):386-92. doi: 10.1016/j.jmpt.2005.06.006.
A repeated measures design was used to test the reliability of standing spine postures within subjects using a biologically relevant measure determined by digitization of images and to compare the results to a previously tested vertical reference method.
Twenty subjects attended 3 sessions consisting of 5 trials each. Photographs of the sagittal and posterior views of normal upright standing were taken. Landmarks were digitized and cervical, thoracic, and lumbar spinal angles were calculated using the algebraic dot product. Intraclass correlation coefficients were used to evaluate intrasubject reliability across sessions.
According to the intraclass correlation coefficients, posture had good to excellent reliability in the sagittal view and provided a more stable measure of spinal angles than the posterior view. Mean repositioning errors were less than 6 degrees and 2 degrees in the sagittal and posterior views, respectively.
Although the repeatability of posture was improved in the sagittal view, when a biological measure was used instead of an external vertical reference to calculate spinal angles, individual subject posture was still variable. This brings into question the effectiveness and validity of using surface skin markers to track postural changes due to clinical interventions. If the postural analysis approach is to be used to detect changes due to clinical treatment, such changes must be larger than the baseline repositioning errors seen in healthy subjects.
采用重复测量设计，使用通过图像数字化确定的生物学相关测量方法来测试受试者站立脊柱姿势的可靠性，并将结果与先前测试的垂直参考方法进行比较。
20名受试者参加了3个阶段，每个阶段包括5次试验。拍摄了正常直立站立的矢状面和后面观照片。对地标进行数字化处理，并使用代数点积计算颈椎、胸椎和腰椎的脊柱角度。组内相关系数用于评估各阶段内受试者的可靠性。
根据组内相关系数，姿势在矢状面具有良好至优秀的可靠性，并且比后面观提供了更稳定的脊柱角度测量。矢状面和后面观的平均重新定位误差分别小于6度和2度。
尽管姿势在矢状面的可重复性有所提高，但当使用生物学测量方法而非外部垂直参考来计算脊柱角度时，个体受试者的姿势仍然存在变化。这对使用表面皮肤标记来跟踪临床干预引起的姿势变化的有效性和正确性提出了质疑。如果要使用姿势分析方法来检测临床治疗引起的变化，那么这种变化必须大于健康受试者中观察到的基线重新定位误差。
