Prowse Ashleigh, Pope Rodney, Gerdhem Paul, Abbott Allan
Department of Physiotherapy, Faculty of Health Science and Medicine, Bond University, Robina, QLD, Australia.
Department of Orthopaedics, Karolinska University Hospital, Stockholm, Sweden.
Eur Spine J. 2016 Feb;25(2):450-66. doi: 10.1007/s00586-015-3961-7. Epub 2015 Apr 28.
As accurate and reproducible measurements of spinal curvature are crucial in the examination of patients with adolescent idiopathic scoliosis (AIS), this systematic review aims to report on the reliability and validity of a range of inexpensive and easily administered anthropometric methods of postural asymmetry measurement in an AIS population, to inform practice in a clinical setting.
A systematic search of health research databases located studies assessing reliability and validity of inexpensive and easily administered anthropometric measures.
Fourteen studies satisfied eligibility criteria. The methodological quality of included studies ranged from low to high. Validity studies were of moderate to high quality. In total, nine clinically applicable, inexpensive and easily administered anthropometric methods were identified, for assessing AIS curvature. All methods demonstrated high to very high inter-observer and intra-observer reliability. Reported criterion validity of the scoliometer and 2D photographs, when compared to Cobb angle assessed from radiographs, ranged from low to very high. iPhone measurements correlated well with scoliometer measurements. 2D photography results had a moderate to high correlation with 3D topography results.
Overall, strong levels of evidence exist for iPhone and scoliometer measurements, with a high to very high reliability and moderate to very high validity. Moderate levels of evidence exist for scoliometer with mathematical formula and clinical examination with moderate and low validity, respectively. Limited evidence exists for aesthetic tools TRACE and AI and 2D photography. These results indicate there are accurate and reproducible anthropometric measures that are inexpensive and applicable in therapy settings to assess postural asymmetry; however, these only exist for measurement in the transverse plane, despite 3D characteristics of AIS. Further research is required into an inexpensive and easily administered method that can assess postural asymmetry in all anatomical planes.
由于准确且可重复的脊柱曲率测量对于青少年特发性脊柱侧凸（AIS）患者的检查至关重要，本系统评价旨在报告一系列用于测量AIS患者姿势不对称的廉价且易于实施的人体测量方法的可靠性和有效性，为临床实践提供参考。
对健康研究数据库进行系统检索，以查找评估廉价且易于实施的人体测量方法的可靠性和有效性的研究。
14项研究符合纳入标准。纳入研究的方法学质量从低到高不等。效度研究的质量从中等到高。总共确定了9种临床适用、廉价且易于实施的人体测量方法，用于评估AIS的曲率。所有方法均显示出观察者间和观察者内的可靠性高至极高。与从X线片评估的Cobb角相比，脊柱侧凸测量仪和二维照片的报告标准效度范围从低到极高。iPhone测量值与脊柱侧凸测量仪测量值相关性良好。二维摄影结果与三维地形结果具有中等至高的相关性。
总体而言，有充分证据支持iPhone和脊柱侧凸测量仪测量，其可靠性高至极高，效度中等至极高。对于使用数学公式的脊柱侧凸测量仪和效度分别为中等和低的临床检查，存在中等水平的证据。对于美学工具TRACE和AI以及二维摄影，证据有限。这些结果表明，存在准确且可重复的人体测量方法，它们廉价且适用于治疗环境以评估姿势不对称；然而，尽管AIS具有三维特征，但这些方法仅适用于横断面测量。需要进一步研究一种廉价且易于实施的方法，该方法可以评估所有解剖平面的姿势不对称。
