Inter-and intra-observer reliability of scoliogauge app to assess the axial trunk rotation of scoliosis: Prospective reliability analysis study

Abstract

Background: Axial of trunk rotation is a key distinguishing feature in the diagnosis of structural scoliosis. The non-affordability, high cost, and non-availability of clinical scoliometer device and availability of the mobile application like scoliogauge to measure the angle of this rotation has led to frequent usage. However, the reliability of such applications should be assessed on the specific population before using them for screening scoliosis. Objective: To test the intra-rater and inter-rater reliability of the scoliogauge mobile application in children with scoliosis. Methods: Sixty-two children with a diagnosis of idiopathic scoliosis in both sexes were agreed to participate in this study. The mean age of the participant was 11.73 (±2.31) years; the mean height was 1.32 (±0.22) m and the mean weight was 31.92 (±7.82) kg. The scoliogauge measurement procedure was performed by two consultants senior musculoskeletal physiotherapists on an iPhone4 Scoliogauge. For statistical analysis, the measurements were divided by spinal levels into the upper thorax, medium thorax, lower thorax, and lumbar segments. The Intraclass Correlation Coefficient (ICC) was used to determine the intra-rater reliability and inter-rater reliability. Results: The observer intra-rater reliability of axial trunk rotation of subjects measured by the scolioguage was considered excellent for the upper, lower thorax, and lumbar segments range from (ICC = 0.871 to 0.932). The inter-rater reliability of axial trunk rotation measures was considered excellent for the upper thorax segment, excellent for the lower thorax, and lumbar segments (ICC, 0.884 to 0.925), and the lowest inter-rater reliability coefficients were in the lumbar spine segments (ICC = 0.884). Conclusion: The scoliogauge application in the iphone device has respectable intra and inter-rater reliability. Though the intra and inter-rater reliability for the lumbar spine region is relatively lower compared to that of the thoracic spine region. Highlights:

Study on the Reliability and Accuracy of Scolioscope, a New Digital Scoliometer

“…The reliability of Scoliogauge was also evaluated by Getnet et al [ 22 ] who used the iPhone 4 to evaluate intra- and inter-rater ICC. The observers did not choose to use a sleeve to place the device in, but rather used their thumbs to balance it on the back of their participants.…”

“…Even though the authors did not calculate the MDC, using the formula MDC 95%CI = SEM × √2 × 1.96, the result is 16.54°. Although the authors [ 22 ] provided evidence towards the excellent intra-rater reliability of Scoliogauge, the high standard error and the derived MDC prove that this application, in combination with the manner used to assess ATR, is not suitable for clinical application [ 6 ].…”

“…Only one of those applications has been most researched, the Scoliogauge (Ockendon Partners Ltd., Shrewsbury, UK). There have been studies that assessed this application’s validity without the use of a special phone adapter that has a notch for the spinous process [ 20 , 21 , 22 ] or with it [ 23 ]. These studies suggested that this application is reliable and valid against the scoliometer.…”