Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Catania, Italy.
Catholic University of Murcia (UCAM), PhD program in Sports Science, Universidad de Murcia, Murcia, Spain.
PeerJ. 2024 Nov 13;12:e18121. doi: 10.7717/peerj.18121. eCollection 2024.
The plumb line (PL) is a common tool for assessing the sagittal curvatures of the spine, but its accuracy depends on the ability of the physician to use it correctly. This study aimed to present a fixed plumb line (FPL) no longer held by a physician but fixed to a support, evaluating the reliability in posture assessment, comparing it with PL in both adolescent with and without scoliosis.
The study evaluated the sagittal distances of the spine using a PL and a FPL in 80 young adults aged between 28.7 ± 7.2 and 55 adolescents aged between 12.4 ± 2.3, with and without scoliosis. Two expert and two novice clinicians tested the patients to evaluate the intra-rater and inter-rater reliability of FPL. Each clinician assessed participants twice on the same day, with a predetermined time interval (>1 h) to reduce recall bias. Multi-factor multivariate analysis of variance and two-way analysis of variance assessed the statistical significance, while intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimum detectable change (MDC) validated FPL consistency.
FPL provided an ICC coefficient >0.90 for all the measures, while PL an average of 0.70. On AIS patients, PL and FPL showed a significant difference for C7 < 0.001 and T12 < 0.001. The measured parameters were sensitive to gender and age for the FPL, furthermore, the C7 and L3 measurements were statistically different between PL and FPL ( < 0.001). Intra-rater reliability results for FPL ranged from 0.94 to 0.98 across various parameters, while the SEM and MDC values underscore the valuable precision of the FPL with changes exceeding 1 cm being meaningful. These findings suggest that FPL could be a reliable and accurate tool for measuring sagittal distances of the spine in both scoliotic and non-scoliotic patients.
铅垂线（PL）是评估脊柱矢状曲度的常用工具，但它的准确性取决于医生正确使用它的能力。本研究旨在介绍一种不再由医生手持而是固定在支撑物上的固定铅垂线（FPL），评估其在姿势评估中的可靠性，并将其与脊柱侧凸青少年和非脊柱侧凸青少年的 PL 进行比较。
本研究使用 PL 和 FPL 评估了 80 名年龄在 28.7±7.2 岁至 55 岁之间的年轻成年人和 80 名年龄在 12.4±2.3 岁之间的青少年的脊柱矢状距离，包括有和没有脊柱侧凸的患者。两名专家和两名新手临床医生对患者进行了测试，以评估 FPL 的内部和外部可靠性。每位临床医生在同一天对参与者进行两次评估，间隔时间较长（>1 小时）以减少回忆偏倚。多因素多变量方差分析和双向方差分析评估了统计学意义，而组内相关系数（ICC）、测量标准误差（SEM）和最小可检测变化（MDC）验证了 FPL 的一致性。
FPL 为所有测量值提供了>0.90 的 ICC 系数，而 PL 的平均 ICC 系数为 0.70。在 AIS 患者中，PL 和 FPL 在 C7<0.001 和 T12<0.001 处存在显著差异。FPL 的测量参数对性别和年龄敏感，此外，PL 和 FPL 在 C7 和 L3 测量值之间存在统计学差异（<0.001）。FPL 的内部可靠性结果在各种参数之间从 0.94 到 0.98 不等，而 SEM 和 MDC 值强调了 FPL 的有价值的精度，变化超过 1 厘米才有意义。这些发现表明，FPL 可能是一种可靠且准确的工具，可用于测量脊柱侧凸和非脊柱侧凸患者的脊柱矢状距离。
