Assessment and retraining of back shape and spinal posture during physiotherapy practice is routine, yet few objective measures exist to this end. Evaluation of posture by physiotherapists is generally based on subjective observations and patients’ self report. At present not many simple clinical measurement instruments have been reported in the literature for the measurement of postures and back shape of patients that present with mild AIS (<30 degrees). Standardized objective measurement tools are also crucial to assess Improvements from treatment. Currently they may be detected subjectively, but it is difficult to compare patients or to quantify improvements (Lafferty-Braun and Amundsen, 1989, Magee, 2002). Further, difficulties arise when trying to compare measures taken by different physiotherapists as standardized objective assessment tools may not have been used. This lack of objective measures for assessing posture does not agree with standards set out by governing bodies, which stipulate that treatments should be based on objective markers and evidence-based practice (Chartered Society of Physiotherapy, 2000). SOSORT Statute 22.2 states “
This will be a prospective international multi-centre cohort study. It is anticipated that 5-6 centres from different countries will be asked to participate. It is hoped these will include the more commonly known as well as less published ones. These could include the lyon method, the Israeli method, schroth methods, the SEAS method, the Bagnet methods , the Dobomed and American resistance exercise methods using Medx.
It is suggested that The same standardised assessment tools will be used at all centres. Pilot work will initially be undertaken to establish the reliability and validity of the instrumentation tools between different assessors. The scoliometer, the scoliosis meter, flexicurve, Oxford cobbometer are objective assessment tools that could be used for objective measurements.
Method (Delphi modified Négrini Technique):
1 - the first round of Consensus is not already answering to the questions prepared by the Chair, but is to ask for a suggestion from the Board on the contents of the questionnaire.
2 - The other rounds will follow with the SOSORT Members.
3 - The responsible prepared a draft article approved by all co-author members of the Board (if someone did not agree or do not give input at this stage is not any more a co-author) that is sent before the Meeting to all registered participants.
4 - The responsible gave a presentation of the draft article during the Meeting with free discussion.
Pelvic tilt in degrees
The blocks are released and the rods are placed over the crest of the ilium. The blocks are then pressed firmly toward the midline. Read the angle from the level. If the gauge reads over 21?2°, the result is listed as positive.
Shoulder tilt in degrees
With the patient in a standing position, place the rods on the acromioclavicular articulation.
Read the angle from the level gauge. If the gauge reads over 2 1?2°, the reading is listed
as positive. NOTE: to read the level gauge and obtain the degree measurement, look for
the ball on the gauge.
Shoulder tilt in mm
Placing the ends of the rods on the acromioclavicular articulation, you can get the degree measurement. If you release the rod on the higher side and move the bar down until “0” is indicated on the gauge, you will be able to calculate the distance by counting the markings above the block on the high side. This indicates the distance deviation.
Shoulder asymmetry (TRACE)
Shoulder asymmetry, as evaluated in TRACE, ranges from 0 to 3. For the shoulders it is easy to detect some intermediate values, so we defined asymmetry (from the top) slight (1), moderate (2) and important (3).
Frontal plane translation in mm
The plumbline is used to assess the sagittal and frontal profiles of the spine, normally C7 and the intergluteal line. The plumbline is set along the median sacral crest, and the discrepancy from the plumbline is measured at C7 (vertebra proeminens)
Considering the sagittal profile, the distance from the plumbline is measured at the spinous process of C7 (cervical distance) and L3 (lumbar distance) with respect to the most prominent points of the thoracic kyphosis.
Adams Forward Bend test
The Adams forward bend test is used to look for prominence of the ribs or changes in the spine. From a standing position, the child slowly bends forward at the waist as if diving into a pool.
The test consists in measuring the amount of time a person can hold the unsupported upper body in a horizontal prone position with the lower body fixed to the examining table.
The Shirado test is a static endurance test of the abdominal muscles.
Waist asymmetry (TRACE)
Waist asymmetry as evaluated in TRACE: it was quite easy to define a total asymmetry (a score of 4) when one flank was straight or when there was a lateral decompensation of the trunk. It was easy as well to define a very slight (a score of 1) and an important but not complete (a score of 3) asymmetry; between these points we defined a mild asymmetry (a score of 2). In the figure, from the top: slight (1), mild (2), moderate (3) and important (4) asymmetry.
Waist asymmetry in mm
We measure on the same horizontal line with a rigid tape measure, the distance trunk-arm at the point of maximum concave curvature. The asymmetry is the difference A-B in millimeters.
Leg length Discrepancy
A Measure from one fixed bony point to another to find true leg length
B True leg length discrepancy
C Tibial length discrepancy
D Femoral length discrepancy