Aim. To evaluate in a clinical setting the inter-examiner reliability of three non invasive measurement used in everyday clinical Practice. -angle of trunk rotation according to Bunnel (ATR; °); -height of the hump during the Adam’s test (HH; mm); -distance of C7,T12 and L3 spinous processes from the plumbline in standing (DP; mm). To correlate these measurements with the “gold standard"; measurement in spinal deformities: the Cobb angle (CA). Materials and Methods. Retrospective study in a clinical setting. Two expert examiners during their everyday practice measured independently and in the same conditions all patients. The CA was obtained according to the individual clinical needs. The Intra-class Correlation Coefficient (ICC) and the Pearson's product-moment correlation coefficient were used. Population: 116 adolescents (78 females), scoliosis 22.1±11.2, kyphosis 45.9±12.5, lordosis 50.6±10.7 Cobb degrees. Results. Range according to the location of the curvature of lCC. HH 90-91%, ATR 86-89%, DP 69-86%. Range of correlation (Pearson’s coefficient) with radiographic exam: HH 0.04-0.42, ATR 0.01-0.27, DP 0.03-0.36. Conclusion. The high repeatability of ATR obtained in experimental settings was confirmed in clinical everyday practice. Surprisingly HH, commonly considered not reliable, showed to be even better than ATR. Nor ATR or HH demonstrated to be correlated with CA. This was expected, even if in the literature a correlation between CA and ATR has been reported, because both ATR and HH measure the rotation of the spine in the horizontal plane, while CA measures the lateral flexion in the frontal plane: CA, ATR and HH are measurements of two different phenomenons of the same deformity. Interesting were also the results on the sagittal plane, where data in the literature are sparse.
Validity of clinical examination in adolescent spinal deformities
Monticone M;
2004-01-01
Abstract
Aim. To evaluate in a clinical setting the inter-examiner reliability of three non invasive measurement used in everyday clinical Practice. -angle of trunk rotation according to Bunnel (ATR; °); -height of the hump during the Adam’s test (HH; mm); -distance of C7,T12 and L3 spinous processes from the plumbline in standing (DP; mm). To correlate these measurements with the “gold standard"; measurement in spinal deformities: the Cobb angle (CA). Materials and Methods. Retrospective study in a clinical setting. Two expert examiners during their everyday practice measured independently and in the same conditions all patients. The CA was obtained according to the individual clinical needs. The Intra-class Correlation Coefficient (ICC) and the Pearson's product-moment correlation coefficient were used. Population: 116 adolescents (78 females), scoliosis 22.1±11.2, kyphosis 45.9±12.5, lordosis 50.6±10.7 Cobb degrees. Results. Range according to the location of the curvature of lCC. HH 90-91%, ATR 86-89%, DP 69-86%. Range of correlation (Pearson’s coefficient) with radiographic exam: HH 0.04-0.42, ATR 0.01-0.27, DP 0.03-0.36. Conclusion. The high repeatability of ATR obtained in experimental settings was confirmed in clinical everyday practice. Surprisingly HH, commonly considered not reliable, showed to be even better than ATR. Nor ATR or HH demonstrated to be correlated with CA. This was expected, even if in the literature a correlation between CA and ATR has been reported, because both ATR and HH measure the rotation of the spine in the horizontal plane, while CA measures the lateral flexion in the frontal plane: CA, ATR and HH are measurements of two different phenomenons of the same deformity. Interesting were also the results on the sagittal plane, where data in the literature are sparse.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
