Objective. to verify the validity and reproducibility of using the flexicurve to measure the angles of the thoracic and lumbar curvatures. Method. 47 subjects were evaluated by: (1) palpation and marking of the spinous processes using lead markers, (2) using X-rays in the sagittal plane to measure the Cobb angles, (3) molding the flexicurve to the spine, and (4) drawing the contour of the flexicurve onto graph paper. The angle of curvature was determined with the flexicurve based on a 3rd order polynomial. Results. No differences were found between the Cobb angles and the angles obtained using the flexicurve in thoracic and lumbar curvatures (P > 0.05). Correlations were strong and significant for the thoracic (r = 0.72, P < 0.01) and lumbar (r = 0.60, P < 0.01) curvatures. Excellent and significant correlations were found for both the intraevaluator and interevaluator measurements. Conclusion. The results show that there is no significant difference between the values obtained using the flexicurve and those obtained using the X-ray procedure and that there is a strong correlation between the two methods. This, together with the excellent level of inter- and intraevaluator reproducibility justifies its recommendation for use in clinical practice.

The results suggest that the DIPA protocol constitutes a valid simple, practical and low-cost non-invasive tool for the evaluation of the spine in the frontal plane which can be used to obtain reproducible measurements (inter and intra-evaluators).

With photogrammetry, the aim of the assessment, whether it is for clinical, research or collective health purposes, must be considered when choosing which protocol to use to evaluate spinal posture.

No abstract

RESUMOO objetivo do estudo foi avaliar o grau de fidedignidade de um protocolo de avaliação postural com o uso um software como ferramenta de avaliação. Foram avaliados 15 indivíduos, em dois dias diferentes, com intervalo de uma semana entre eles, pelo mesmo avaliador. O protocolo de avaliação postural consistiu na preparação da sala, palpação e marcação de pontos anatômicos, registros fotográficos digitais da postura ereta, na postura de perfil direito e de costas e análise da postura, utilizando o software APPID (Avaliação postural a partir de imagem digital). As informações fornecidas pelo APPID obtiveram correlações fortes e significativas para a totalidade das variáveis estudadas, além de apresentar um grau de fidedignidade superior a 75% para todas as variáveis nominais e numéricas. Destarte, o conjunto do protocolo de avaliação postural apresenta fidedignidade e consegue repetir o resultado, desde que respeitados os padrões metodológicos do estudo. Palavras INTRODUÇÃOProcedimentos que avaliem a postura dos indivíduos vêm sendo muito utilizados tanto nos âmbitos escolar e clínico quanto no local de prática de exercícios físicos, para a prescrição de exercícios e tratamento, servindo de referência para intervenções futuras. Tradicionalmente, a postura tem sido avaliada pelo procedimento denominado "Avaliação Postural", o qual consiste em observação da postura do indivíduo, ao vivo ou por fotografia. Este método tende a ser um tanto subjetivo, pois depende muito da experiência, do tato e da visão dos avaliadores (VERDERI, 2001). Outra desvantagem é a ausência de números que possam quantificar o desvio e sua progressão, de modo que o resultado do procedimento de avaliação fornecido pelo método também é subjetivo.Na tentativa de amenizar essas desvantagens, têm sido desenvolvidos métodos quantitativos para avaliar a postura (LEROUX et al., 2000;WILLNER, 1981;CHARRIÈRE;ROY, 1975;BRYANT et al., 1989;BARAÚNA et al., 2005; TEIXEIRA; CARVALHO, 2007;ÖHLÉN et al., 1989;MELLIN, 1986;D'OSUALDO et al., 1997;SOUZA et al., 2009). Mais recentemente, softwares de avaliação postural (MERCADANTE et al., 2005;PEREIRA, 2003; COSTA et al., 2007;SILVA, 2005;SINGER, 1990;NORMAND et al., 2007;FERREIRA et al., 2010) têm procurado suprir esta lacuna, mas muitas vezes estes softwares não apresentam um protocolo rigoroso a ser seguido, além de não fornecerem uma classificação da postura de cada indivíduo. Em vista destas questões, entende-se que ainda urge a necessidade do desenvolvimento de ferramentas que permitam uma avaliação postural menos subjetiva, com identificação quantitativa das alterações posturais, de maneira que englobe um rigoroso protocolo de avaliação a ser seguido.Independentemente do dispositivo utilizado, é fundamental que a metodologia empregada seja confiável e que a avaliação seja feita em várias etapas. Ademais, o protocolo deve ter as características de reprodutibilidade, fidedignidade,

No abstract

Objective: To evaluate and compare proprioception, body balance and knee functionality of individuals with or without unilateral anterior cruciate ligament (ACL) reconstruction. Methods: Forty individuals were divided in two groups: Experimental group, 20 individuals with ACL reconstruction at six months postoperative, and control group, 20 individuals with no history of lower limb pathologies. In the experimental group, we assessed lower limbs with reconstructed ACL and contralateral limb; in the control group the dominant and the non-dominant lower limbs were assessed. All subjects were submitted to joint position sense test to evaluate proprioception, postural control measure in single-limb, and step up and down (SUD) test for functional assessment. Results: There were no deficits in proprioception and postural control. In the SUD test, a 5% decrease in lift up force was found in reconstructed ACL lower limbs, however, a statistically not significant difference. The impact and step down force during the course of test were 30% greater in anatomic ACL than in control lower limbs. Conclusion: The individuals with ACL reconstruction at six months postoperative did not show changes in proprioception and postural control, but showed motor control changes, influencing knee functionality. Level of Evidence IV, Prognostic Studies.

The aim of this study was to evaluate the behaviour of postural variables and the associated factors, like back pain and life habits, in schoolchildren during a period of four years. Forty-two school children underwent a postural assessment using Digital Image-Based Postural Assessment software. They also answered the self-administered questionnaire titled, "Back Pain and Body Posture Evaluation Instrument" to evaluate their back pain and life habits. We observed a significant trend of forward head, thoracic hyper kyphosis, and lumbar hyper lordosis in the entire group, as well as a trend of cervical rectification in girls. Both boys and girls presented a constant frequency in back pain, but girls presented higher prevalence along the years. We found a high prevalence of poor sitting posture in male (between 72.2-89.5%) and female (between 73.3-100%). We also found that girls had poor posture due to the way they carried their school supplies. However, occurred a decrease of time spent in front of television for male (from 87% to 10.5%) and female (from 93.3% to 0%). Significant changes occurred in analysed variables over evaluation period.