Validity and Reliability Testing of the Scoliometer®

Abstract

This study was designed to evaluate the Scoliometer, an instrument that measures axial trunk rotation in individuals with scoliosis. The objectives included determining 1) the Scoliometer's screening capability and validity and 2) the intrarater and interrater reliability of Scoliometer measurements. Scoliometer measurements made by two raters on 65 persons with idiopathic scoliosis were correlated with radiographic assessment of vertebral (pedicle) rotation and lateral curvature (Cobb method). Correlation ranged from .32 to .46 with pedicle rotation and from .46 to .54 with the Cobb angle. Frequency analysis revealed relatively good specificity, sensitivity, and predictive capability of the Scoliometer. Intrarater and interrater reliability coefficients were high (r = .86-.97). These results indicate good measurement reproducibility. The less-than-optimal between-method correlation coefficients suggest that the validity of Scoliometer measurements is not sufficient to use this method alone for determining patient diagnosis and management. Based on the positive-frequency analysis, however, the use of this tool as a screening device would be appropriate.

Confiabilidade interavaliadores e intra-avaliador do escoliômetro

“…The prevalence of scoliosis ranges from 0.5% to 3.0% in the general population affecting mainly young adults and women 1,2 . The diagnosis and clinical follow-up of idiopathic scoliosis are performed by anteroposterior radiography of the spine, in which the Cobb angle is measured, which is considered the gold standard measure for the diagnosis of scoliosis 3 .…”

Rasterstereographic analysis of axial back surface rotation in standing versus forward bending posture in idiopathic scoliosis

“…Later the surface rotation was quantified with the so-called scoliometers which enable measuring an angle between the horizontal plane and a plane across the posterior part of the trunk at the level of maximum deformity [2,3,5,10,12,13,18,20,21]. The scoliometer is applied to the back surface laterally to the spinous processes and therefore it measures the rotation of the rib cage and not the vertebral rotation.…”

“…The scoliometer is applied to the back surface laterally to the spinous processes and therefore it measures the rotation of the rib cage and not the vertebral rotation. Several authors postulated the scoliometer measurement as a useful and objective criterion for scoliosis screening and quantification, since it is cheap, easy and reliable, provided the measurement is carried out by a single trained observer [2,3,19]. Other authors found high inter-observer errors and do not recommend the scoliometer as a standard examination tool in idiopathic scoliosis [6].…”

No effect of osteopathic treatment on trunk morphology and spine flexibility in young women with adolescent idiopathic scoliosis

“…Trunk rotation-rib hump and lumbar prominence-was assessed with a Bunnell scoliometer TM (Orthopedic Systems, Inc., Hayward, CA, USA) in a standing, bent-over position (arms dangling, palms pressed together) with the pelvis horizontalised (wooden blocks) and the subject standing on a foot template [15]. The scoliometer measurement is a reliable non-invasive method when used by a single trained observer, with the best reproducibility in a standing, forward-bending position [16,17]. The intrarater agreement is excellent (intraclass correlation coefficient Rho = 0.995 and Rho = 0.998 for the thoracic and lumbar regions, respectively) and the accuracy was 2° [15,[17][18][19].…”

“…The scoliometer measurement is a reliable non-invasive method when used by a single trained observer, with the best reproducibility in a standing, forward-bending position [16,17]. The intrarater agreement is excellent (intraclass correlation coefficient Rho = 0.995 and Rho = 0.998 for the thoracic and lumbar regions, respectively) and the accuracy was 2° [15,[17][18][19]. There is a statistically significant correlation between scoliometer values and the radiographic Cobb angles for each of the segments measured (Pearson's correlation coefficient r = 0.685, 0.572 and 0.677 for thoracic, thoracolumbar and lumbar curves, respectively) [20].…”