Inclinometer-based measures of standing posture in older adults with low bone mass are reliable and associated with self-reported, but not performance-based, physical function

MacIntyre, Norma J.; Lorbergs, Amanda L.; Adachi, Jonathan D.

doi:10.1007/s00198-013-2484-5

Cited by 18 publications

(27 citation statements)

References 32 publications

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“…Recently, we reported that kyphotic angle is associated with self-reported activities of daily living (ADLs) and performance on a balance test in 36 patients attending an osteoporosis clinic. In our sample of high functioning older adults, 50% were hyperkyphotic according to normative 2 ISRN Rehabilitation values for digital inclinometer measures whereas only three participants had morphometric vertebral fractures [5]. These findings confirm previous observations that age-related hyperkyphosis develops due to a variety of reasons, only one of which is osteoporotic vertebral fracture.…”

Section: Introductionsupporting

confidence: 86%

“…Previously, the first author's group assessed the reliability of the flexicurve ruler and the digital inclinometer measures of spine curvatures taken by the same rater and determined that minimal gains in reliability are achieved when performing more than one trial using the digital inclinometer versus a minimum of three measures using the flexicurve ruler [9]. Moreover, test-retest reliability of a single measure of lumbosacral angle, lumbothoracic angle, and thoracocervical angle taken by an experienced rater using the digital inclinometer was very high in older adults attending a rheumatology clinic specializing in osteoporosis care [5]. The factory-calibrated digital inclinometer is relatively inexpensive ($500 USD) and it only takes a few minutes to acquire and manually record the measurements.…”

Section: Introductionmentioning

confidence: 99%

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Spine Curve Measures Taken in Individuals with Osteoporosis and Osteopenia Using the IONmed Mobile Phone Application Are Highly Consistent with Digital Inclinometer Measures

MacIntyre

Recknor

2014

ISRN Rehabilitation

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Introduction. This study determined the agreement between measures of standing posture in individuals at risk of osteoporotic fracture obtained using the IONmed mobile phone application and a digital inclinometer. Methods. One experienced rater assessed 20 adults, aged 55-88 years, attending an outpatient osteoporosis clinic. A standardized protocol was duplicated to acquire a single measure of spine curvature (lumbosacral angle, lordosis, kyphosis) using the IONmed mobile phone application and a digital inclinometer. Interdevice agreement was determined using the intraclass correlation coefficient (ICC) with 95% confidence intervals (CI) and standard error of the measurement (SEM) with 95% CI and Bland-Altman plots. Results. ICC (95% CI) for lumbosacral angle, lordosis, and kyphosis is 0.97 (0.92, 0.99), 0.97 (0.92, 0.99), and 0.99 (0.98, 1.0), respectively. SEM (95% CI) for lumbosacral angle, lordosis, and kyphosis is 0.99 ∘ (0.75, 1.44), 1.33 ∘ (1.01, 1.94), and 1.23 ∘ (0.94, 1.80), respectively. Measurement bias is small. Conclusions. In our sample, the IONmed mobile phone application provides measures highly consistent with the digital inclinometer measures of standing posture. This method offers clinicians a quick, convenient way of identifying alterations in spine alignment which require followup and remediation.

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Section: Introductionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Spine Curve Measures Taken in Individuals with Osteoporosis and Osteopenia Using the IONmed Mobile Phone Application Are Highly Consistent with Digital Inclinometer Measures

MacIntyre

Recknor

2014

ISRN Rehabilitation

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“…32,41 It may also deal with the location and the lordosis of L5-S1. 9,17,28,29,39 Due to lordosis, the angle at L5-S1 not only experiences axial forces but also shear forces. This angle influences forces such that greater angles should cause greater shear forces and less axial forces.…”

Section: Discussionmentioning

confidence: 99%

“…The authors believe that this is due to the angle of L-5 with respect to S-1-which is generally higher than any other lumbar segment. 1,19,28,36 To achieve this angle, the anatomy is such that the posterior edge of the annulus is shorter in height than the anterior. 39 The authors believe that this shorter annulus could affect the intact rigidness by resisting compressive loads, which would cause higher stiffness.…”

Section: Discussionmentioning

confidence: 99%

The role of sacral slope in lumbosacral fusion: a biomechanical study

Drazin¹,

Hussain

Harris

et al. 2015

SPI

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OBJECT Abnormal sacral slope (SS) has shown to increase progression of spondylolisthesis, yet there exists a paucity in biomechanical studies investigating its role in the correction of adult spinal deformity, its influence on lumbosacral shear, and its impact on the instrumentation selection process. This in vitro study investigates the effect of SS on 3 anterior lumbar interbody fusion constructs in a biomechanics laboratory. METHODS Nine healthy, fresh-frozen, intact human lumbosacral vertebral segments were tested by applying a 550-N axial load to specimens with an initial SS of 20° on an MTS Bionix test system. Testing was repeated as SS was increased to 50°, in 10° increments, through an angulated testing fixture. Specimens were instrumented using a standalone integrated spacer with self-contained screws (SA), an interbody spacer with posterior pedicle screws (PPS), and an interbody spacer with anterior tension band plate (ATB) in a randomized order. Stiffness was calculated from the linear portion of the load-deformation curve. Ultimate strength was also recorded on the final construct of all specimens (n = 3 per construct) with SS of 40°. RESULTS Axial stiffness (N/mm) of the L5–S1 motion segment was measured at various angles of SS: for SA 292.9 ± 142.8 (20°), 277.2 ± 113.7 (30°), 237.0 ± 108.7 (40°), 170.3 ± 74.1 (50°); for PPS 371.2 ± 237.5 (20°), 319.8 ± 167.2 (30°), 280.4 ± 151.7 (40°), 233.0 ± 117.6 (50°); and for ATB 323.9 ± 210.4 (20°), 307.8 ± 125.4 (30°), 249.4 ± 126.7 (40°), 217.7 ± 99.4 (50°). Axial compression across the disc space decreased with increasing SS, indicating that SS beyond 40° threshold shifted L5–S1 motion into pure shear, instead of compression-shear, defining a threshold. Trends in ultimate load and displacement differed from linear stiffness with SA > PPS > ATB. CONCLUSIONS At larger SSs, bilateral pedicle screw constructs with spacers were the most stable; however, none of the constructs were significantly stiffer than intact segments. For load to failure, the integrated spacer performed the best; this may be due to angulations of integrated plate screws. Increasing SS significantly reduced stiffness, which indicates that surgeons need to consider using more aggressive fixation techniques.

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“…Inclinometer is reliable [16], handy and affordable, as a result of which it is often used in examinations [17,18]. On the other hand, photogrammetry is based on the phenomenon of projection Moiré, and enables accurate and reliable quantitative assessment of numerous parameters, both in sagittal and frontal plane [19], yet the tool is frequently too costly for owners of average-size physiotherapy facilities.…”

mentioning

confidence: 99%

Concurrent validity of photogrammetric and inclinometric techniques based on assessment of anteroposterior spinal curvatures

et al. 2017

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Purpose The purpose of the study was to investigate correlations between parameters of anteroposterior spinal curvatures in the sagittal plane, measured with the use of photogrammetric technique and inclinometer in healthy elderly women. Methods Randomized study involved 50 females, ranging from 50 to 70 years of age (mean 62.26 ± 6.94); mean body mass index (BMI) 27.69 ± 4.79. The examined parameters included angle of inclination in lumbosacral spine (ALFA), thoracolumbar transition (BETA), upper thoracic segment (GAMMA), angle of lumbar lordosis (LLA) and thoracic kyphosis (TKA). Results obtained with gravitational inclinometer were compared with those identified with photogrammetry method. Statistical analyses were performed with Mann-Whitney U test, regression analysis and Bland-Altman analysis. Results In Mann-Whitney U test, with correction due to continuity, no statistically significant differences for any variable were found. Regression analysis was significant only for the variable of BETA angle. Bland-Altman coefficient for the respective angles was: ALFA 2.0%, BETA 4%, GAMMA 0%, LLA 2% and TKA 0%. Conclusions The results acquired with gravitational inclinometer and with photogrammetric technique are comparable, as the parameters of anteroposterior spinal curvatures acquired with these two methods are found to be compatible in the case of measurements of lumbar lordosis and thoracic kyphosis.

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Inclinometer-based measures of standing posture in older adults with low bone mass are reliable and associated with self-reported, but not performance-based, physical function

Cited by 18 publications

References 32 publications

Spine Curve Measures Taken in Individuals with Osteoporosis and Osteopenia Using the IONmed Mobile Phone Application Are Highly Consistent with Digital Inclinometer Measures

Spine Curve Measures Taken in Individuals with Osteoporosis and Osteopenia Using the IONmed Mobile Phone Application Are Highly Consistent with Digital Inclinometer Measures

The role of sacral slope in lumbosacral fusion: a biomechanical study

Concurrent validity of photogrammetric and inclinometric techniques based on assessment of anteroposterior spinal curvatures

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