Reliability of four tests to assess body posture and the range of selected movements in individuals with spinal muscular atrophy

Abstract

BackgroundThe majority of individuals with spinal muscular atrophy (SMA) experience progressive skeletal deformities which may affect the quality of life and mobility. To date, no studies have evaluated the reliability of tests assessing body posture and joint mobility in SMA patients. The purpose of this study was to assess the reliability of Cervical Rotation test (CR), Supine Angle of Trunk Rotation test (SATR), Hip Extension test (HE) and Pelvic Obliquity test (PO) developed to evaluate the musculoskeletal system in SMA individuals.MethodsThirty individuals (12 girls and 18 boys) aged 4–15 with SMA type II (n = 24) and III (n = 6) confirmed by genetic examinations were qualified for the study. The participants were examined twice by three physiotherapists on the same day. The examination included four tests, i.e. CR, SATR, HE and PO tests aimed at assessing ranges of rotation in the cervical spine, chest deformities, ranges of hip extension and pelvis position while sitting. Statistical calculations were made with the use of statistical software IBM SPSS Statistics version 20. Reliability was assessed using the Intraclass Correlation Coefficient (ICC).ResultsIntraobserver reliability was excellent for CR (ICC range 0.839–0.911), SATR (ICC range 0.918–0.939 - the upper part of the sternum; ICC range 0.951–0.975 - the lower part of the sternum), HE (ICC range 0.988–0,991) and PO (ICC range 0.896–0.935) tests.The interobserver ICC reached the excellent values in CR (ICC range 0.912–0.920), SATR (ICC = 0.888 - the upper part of the sternum, ICC = 0.951 - the lower part of the sternum), HE (ICC range 0.922–0.923) and PO (ICC = 0.928) tests.ConclusionsCR, SATR, HE and PO tests are reliable and may be used for examining individuals with SMA. The application of these tests provides a possibility to detect early changes in the musculoskeletal system in children and adolescents and to assess the effectiveness of the implemented pharmacotherapy and rehabilitation.

Cervical rotation, chest deformity and pelvic obliquity in patients with spinal muscular atrophy

“…Cervical Rotation test (CR) – the measurement of the range of cervical spine rotation on the left (CR left) and right (CR right) side of the body in a supine position performed with the use of Rippstein’s plurimeter (Rippstein, Switzerland), zeroed parallel to the surface and placed on the corpus mandibulae [ 28 ] (Fig. 1 b, c).…”

“…The scoliometer was set across the chest in the upper part of the sternum at the level of the 2nd-3rd rib (SATR Upper – SATRU) and in a lower part of the sternum (SATR lower – SATRL) (Fig. 1 d) [ 28 ].…”

“…Pelvic Obliquity test (PO) – the measurement of pelvic obliquity was performed with the use of the scoliometer placed at the posterior superior iliac spines in a sitting position with supported lower limbs [ 28 ] (Fig. 1 e).…”

“…The tests, performed with Rippstein’s plurimeter (Rippstein, Switzerland) and scoliometer (Orthopedic Systems Inc. OSI 1995), have been originally assessed in previous studies in the group of 30 patients aged 4–15 with type II and III SMA. The tests manifested excellent intraobserver and interobserver reliability [ 28 ].…”

Assessment of anterior-posterior spinal curvatures in children suffering from hypopituitarism

“…Disorders of posture may cause dysfunctions that affect quality of life [3]. Certain severe posture dysfunctions can affect the basic vital functions, such as breathing, swallowing, and maintaining the body against gravity [4]. Maintenance of correct body posture requires the proper distribution of muscle tone.…”