Assessment of the posture of adolescents in everyday clinical practice: Intra-rater and inter-rater reliability and validity of a posture index.

Objectives: The assessment of the posture of children and adolescents using photometric methods has a long tradition in paediatrics, manual therapy and physiotherapy. It can be well integrated into the clinical routine and enables objective documentation. One-dimensional parameters such as angle sizes are mostly used in the diagnosis of postural defects in children and adolescents by means of photogrammetry. This study examined the posture index, a complex parameter, which evaluates the alignment of several trunk segments in the sagittal plane and is suitable for use as a screening parameter in everyday clinical practice.
Methods: For this postural photographs were taken in the sagittal plane of the habitual posture in a subgroup of 105 adolescents (12.9 ± 2.6 years) for analysing validity, and in a subgroup of 25 adolescents (12.1 ± 2.8 years) for analysing reliability and objectivity. Marker spheres (12 mm) were placed on five anatomical landmarks. The posture was also evaluated clinically by experienced investigators (PT, MD, DSc). The distances of the marker points to the plumb line through the malleolus lateralis were calculated and the posture index calculated from these. In order to determine the objectivity, reliability and validity of the posture index, statistical parameters were calculated.
Results: The posture index demonstrated very good objectivity (intraclass correlation coefficient ICC = 0.865), good reliability (Cronbach's alpha = 0.842) and good validity compared to the posture assessment done by the medical experts (Spearman's rho = 0.712).
Conclusions: The posture index reflects a doctor's assessment of the posture of children and adolescents and is suitable as a clinical parameter for the assessment of postural defects.
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