No abstract

Data for this study was collected at the 1988 Texas Physical Therapy Association Annual Conference with approval through the state Research Committee. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Army, the Department of Defense, or the US. Government. The purpose of this study was to evaluate the validity of physical therapists' visual postural evaluation skills in assessing lumbar lordosis using photographs of clothed subjects compared to actual radiographic measurements. The study also addressed the efficacy of the use of a plumb line in postural assessment. Forty-eight physical therapists (raters) participated. After completing a demographic questionnaire, raters were given a set of pictures showing sagittal views of three subjects and asked to rank order the subjects from most to least amount of lumbar lordosis. Raters were then given a second set of pictures with different subjects to evaluate. During this second trial, raters were given a plastic overlay with a hairline to use as a plumb line. Each rater evaluated one set of subjects with 7-8 degrees of difference in lordosis and one set with 13- 14 degrees of difference as measured radiographically. The raters' rank order of the pictures was interpreted as either correct or incorrect. For 96 trials, 9 responses were correct for an accuracy rate of 9.3%. The use of the hairline as a plumb line did not improve the raters' accuracy. A chi-square test showed no relationship between ratings except under circumstances related to the gluteal prominence body contour. The strongest trend in interrater reliability identified was that the raters' perception of increased lordosis may have been influenced by gluteal prominence. The results indicate low validity in assessing relative amounts of lumbar lordosis using photographs of clothed subjects. This preliminary study indicates the need for more research in this area using both pictures and live subjects. J Orthop Sports Phys Ther 1990;12(1):24-29.

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Army, the Department of Defense, or the U.S. Government. The purpose of this study was to investigate the validity of the flexible ruler as a noninvasive measure of lumbar lordosis in black and white adult females. The bony landmarks of the second lumbar vertebra (L2) and the intersection of the posterior superior iliac spines (PSIS) were palpated and marked on 45 adult females (21 blacks, 24 whites). Potential subjects with a previous history of activity-limiting low-back pain, spinal surgery, or spinal anomaly were excluded from the study. A lateral lumbosacral roentgenograph was taken of each subject, and an actual (skeletal) lumbosacral lordosis angle (ALS) was calculated from the roentgenograph. A flexible ruler was then molded to the contour of the subject's lumbosacral spine, and the previously marked L2 and PSIS intersection bony landmarks were located on the flexible ruler. The flexible ruler lordosis angle (FRA) was then calculated and correlated to the subject's ALS. The criterion validity of the flexible ruler as a measure of actual lumbosacral lordosis was poor (Pearsons' Correlation Coefficient = 0.30, N = 45). Because of the poor criterion validity of the flexible ruler compared to roentgenographically confirmed lumbar lordosis, the flexible ruler has questionable clinical value in the assessment of lumbar lordosis. J Orthop Sports Phys Ther 1989;11(1):3-7.