Inter- and intra-rater agreement of static posture analysis using a mobile application

Abstract

[Purpose] To determine the intra- and inter-rater agreement of a mobile application, PostureScreen Mobile® (PSM), that assesses static standing posture. [Subjects and Methods] Three examiners with different levels of experience of assessing posture, one licensed physical therapist and two untrained undergraduate students, performed repeated postural assessments of 10 subjects, fully clothed or minimally clothed, using PSM on two nonconsecutive days. Anterior and right lateral images were captured and seventeen landmarks were identified on them. Intraclass correlation coefficients (ICCs) were calculated for each of 13 postural measures to evaluate inter-rater agreement on the first visit (fully or minimally clothed), as well as intra-rater agreement between the first and second visits (minimally clothed). [Results] Eleven postural measures were ultimately analyzed for inter- and intra-rater agreement. Inter-rater agreement was almost perfect (ICC≥0.81) for four measures and substantial (0.60<ICC≤0.80) for three measures during the fully clothed exam. During the minimally clothed exam, inter-rater agreement was almost perfect for four measures and substantial for four measures. Intra-rater agreement between two minimally clothed exams was almost perfect for two measures and substantial for five measures. [Conclusion] PSM is a widely available, inexpensive postural screening tool that requires little formal training. To maximize inter- and intra-rater agreement, postural screening using this mobile application should be conducted with subjects wearing minimal clothing. Assessing static standing posture via PSM gives repeatable measures for anatomical landmarks that were found to have substantial or almost perfect agreement. Our data also suggest that this technology may also be useful for diagnosing forward head posture.

Vertebral Malalignment among Male Dentists with Workrelated Musculoskeletal Pain in the United Arab Emirates

“…Before each assessment, a room was set up in a standardized way to ensure uniform conditions throughout the test. According to Boland et al, 8 a horizontal mark was placed on the floor to indicate where the participant standing position for the anterior photograph. Another vertical mark was placed perpendicular to the first to indicate positioning for the lateral photograph.…”

Functional postural-stabilization tests according to Dynamic Neuromuscular Stabilization approach: Proposal of novel examination protocol

“…Such tools use photographic analysis to identify positioning of anatomical landmarks. The use of these posture screening mobile applications demonstrates good rater reliability (Boland et al, 2016;Szucs and Brown, 2018). Furthermore, it is possible to evaluate not only standing or sitting posture but also other positions such as squatting or pushup-plank.…”

“…Increasingly, therapists who routinely perform postural and functional movement assessments have started to use modern screening tools available as mobile applications (Boland et al, 2016;Szucs and Brown, 2018). Such tools use photographic analysis to identify positioning of anatomical landmarks.…”

“…Boland states that novel, commercially sold photographic mobile applications enable the identification of deviations from the ideal standing posture (Boland et al, 2016).…”

“…Still, more than 40 years later, the exact definition of optimal posture remains nebulous due to extreme postural variability. Numerous authors emphasize the most common postural situations such as standing and sitting (Claus et al, 2009;Czaprowski et al, 2017;D'amico et al, 2018;Korakakis et al, 2019;MD, 1974), evaluating muscle activity and tone (Korakakis et al, 2019;Koskelo et al, 2007;O'Sullivan et al, 2012O'Sullivan et al, , 2006, assessing spinal curves and measuring various body angles (Boland et al, 2016;Claus et al, 2009;D'amico et al, 2018;Korakakis et al, 2019;O'Leary et al, 2015;O'Sullivan et al, 2006) or analyzing balance parameters (D'amico et al, 2018;Hsu et al, 2007).…”