Objective: The purpose of this study was to validate the photogrammetric measurement of the angle of trunk rotation in relation to the scoliometer instrument. Methods: Fifty-eight prominences from individuals with ages between 7 and 18 and with suspicion of spinal asymmetry (SA) were evaluated through the scoliometer and photogrammetry. The photographs were analyzed in the Digital Image-based Postural Assessment software. For statistical purposes, we used Pearson's correlation test (r), root mean square error, Bland-Altman graphical analysis, and receiver operating characteristic curve. The level of significance was P .05. Results: Excellent correlation for the angle of trunk rotation was obtained between the scoliometer and photogrammetry, with a root mean square error of 3 . The Bland-Altman graphical analysis showed equally dispersed data with no participants outside the limits of agreement. The receiver operating characteristic curve evidenced that (1) the cutoff point for the identification of the presence of spinal asymmetry is 4 ; (2) mild to moderate SA is between 4 and 7 ; (3) moderate to severe SA is above 8 ; and (4) sensitivity and specificity were above 83% and 78%, respectively, with an area under the curve ! 90%. Conclusion: Photogrammetry is validated for measuring the angle of trunk rotation, being an accurate and accessible tool for the evaluation of patients with spinal asymmetries.
Objective: This prospective study aimed to assess the concurrent validity and diagnostic accuracy of a mathematical procedure for measurement of the spinal inclination angle, analogous to the Cobb angle, by means of photogrammetry. Methods: Sixty-one subjects (aged 7 to 18 years), male and female, underwent radiographic (Cobb angle) and photogrammetric (DIPA [Digital Image-based Postural Assessment] angle) evaluations. The measurement of spinal inclination angle obtained through photogrammetry followed the Digital Image-Based Postural Assessment software protocol. Concurrent validity was appraised using Spearman rank correlation, the coefficient of determination, the root-mean-square error, Bland-Altman plot analysis, and receiver operating characteristic analysis, adopting P .05. Results: The analyses were divided according to the topography of the scoliotic curve (thoracic, lumbar, or thoracolumbar). The correlations were excellent (from 0.72 to 0.81) and significant for all the regions of the spine, and the coefficients of determination ranged between 0.75 and 0.88. The root-mean-square error was between 5°and 11°, and the mean difference was very close to 0. The area under the curve was excellent and significant, ranging between 95% and 99%. Conclusion:The mathematical procedure presented is valid to evaluate the spinal inclination angle in photogrammetry, analogous to the Cobb angle in radiography. (
O objetivo deste estudo foi verificar a relação entre a flexibilidade da cadeia posterior, os ângulos das curvas sagitais da coluna vertebral, e a presença de dor nas costas com a graduação de praticantes de Jiu-jítsu. Oitenta e dois homens com idade entre 14 e 55 anos que praticavam Jiu-jítsu duas vezes por semana com duração mínima 1 hora e 30 minutos, e com prática ininterrupta por pelo menos um mês, foram submetidos a três avaliações: (1) curvaturas sagitais da coluna vertebral por meio do flexicurva; (2) flexibilidade da cadeia posterior por meio do banco de Wells; e (3) dor nas costas por meio do questionário BackPEI adaptado. De acordo com o tempo de prática, os participantes foram divididos em dois grupos: grupo faixa branca, composto por atletas faixa branca; e grupo faixa graduada, composto pelas demais graduações. No Software SPSS 20.0 foi realizada estatística descritiva com média, desvio-padrão e frequências e análise inferencial com teste de correlação de Spearman e o teste t independente (?=0,05). Os praticantes apresentaram, em média, curvaturas dentro da normalidade. Em relação à flexibilidade, a mesma foi classificada como fraca com valores semelhantes ao da população em geral. Quanto à dor nas costas, dos 82 praticantes de Jiu-jítsu, 57,3% (n=47) apresentaram dor. Foi encontrada apenas correlação fraca, positiva e significativa entre a intensidade da dor nas costas com a graduação do praticante. Foi possível verificar que a graduação dos praticantes de Jiu-jítsu se correlaciona com a intensidade de dor nas costas, de modo que quanto maior a graduação, maior é o nível da intensidade da dor.
The MADAAMI (Método de Avaliação Dinâmica do Alinhamento Articular dos Membros Inferiores-Dynamic Evaluation Method of Lower Limb Joint Alignment) is an instrument that has been developed and validated with the aim of providing direct, simple, and practical support for the identification of compensations and misalignments of joints. The first version of the instrument had some limitations. The goals of the present study are to update the instrument (MADAAMI-II), evaluate its content validity, and verify inter-rater and intra-rater reproducibility during the execution of demi-plié, grand plié, and fondu in two turnout positions of classical ballet (120° and self-reported) and in parallel foot position. The study was approved by the local university's Ethics Committee, and 20 ballet dancers from different levels of the Bolshoi Theater School in Brazil participated. Each dancer was digitally recorded executing the three steps in the different foot positions. To verify inter-rater reproducibility, three independent raters used the MADAAMI-II's score sheet. To verify intra-rater reproducibility, a single rater repeated the evaluation after a 7-day interval. Cohen's Kappa Coefficient (α = 0.05) was used. The results showed kappa values ranging from 0.062 to 0.357 in the inter-rater reproducibility analysis and from 0.431 to 0.806 in the intra-rater reproducibility analysis. We concluded that MADAAMI-II is, due to its practicality, valid, reproducible, and suitable for use by the same rater engaged in the classical ballet teaching-training process.
RESUMO A técnica do ballet clássico exige a realização máxima do en dehors ou turnout, caracterizado pela rotação externa de membros inferiores. Considerando a sua importância, diversos protocolos para a sua avaliação e mensuração têm sido propostos. O objetivo desta revisão foi investigar sistematicamente quais os métodos utilizados para avaliar o turnout de bailarinos clássicos e/ou praticantes de ballet clássico existentes atualmente. A busca foi feita nas bases de dados Scopus, Science Direct e PubMed, no mês de fevereiro de 2016, e os artigos encontrados deveriam: estar redigidos na língua inglesa, avaliar bailarinos clássicos ou dançarinos que praticassem ballet clássico e mensurar o en dehors ou turnout. Foram encontrados 593 artigos, dos quais 25 foram pré-selecionados para esta revisão, apresentando quinze diferentes métodos e instrumentos de mensuração do turnout: cinemetria; inclinômetro; turnout protactor ou transferidor para medir o turnout; goniômetro; Dupuis Tropometer; transferidor original; fotos dos sujeitos; discos rotacionais; teste de flexibilidade de Nicholas; flexímetro; desenho clínico dos pés; sujeito sobre um pedaço de papel ou solo ou quadro branco; ressonância magnética; filmagem do sujeito executando sequência de passos; Dasco Pro Angle Finder. Esta revisão apresenta forte evidência para afirmar que não há, até o presente momento, um método ou instrumento padrão-ouro para mensuração do turnout de bailarinos, de modo que esta costuma ser adaptada e escolhida de acordo com o objetivo de cada estudo.
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