Inter- and intra-rater agreement of static posture analysis using a mobile application.
David M Boland, Eric V Neufeld, Jack Ruddell and 2 others
PMID 28174460WHAT IT FOUND
Different examiners and the experienced examiner on repeat visits produced similar results for several posture measurements from this posture app, especially head tilt and lateral hip shift.
Hip tilt and rib cage shift were less consistent. Minimal clothing helped upper-body landmark measurements.
Key findings
01With street clothes, seven posture measures were judged similarly by the examiners, including head tilt and lateral hip shift.
02With minimal clothing, shoulder tilt became very consistent, and hip tilt was the only measure below moderate.
03Between visits, the same experienced examiner was much less consistent for head shift lateral and shoulder shift lateral than different examiners were.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 10 young participants (mean age 21 ± 1 years) were studied, and they were recruited from a university community rather than as patients, so results may not apply to older or symptomatic clients. The study tested examiner agreement, not accuracy against x-ray or 3D motion capture. Intra-rater agreement was tested only for the experienced examiner, so consistency over time for the two undergraduate examiners was not measured. Some poor between-visit agreement may reflect real day-to-day posture change, not measurement error. Head weight and effective head weight were omitted from the agreement analysis.
Declared interests
This study did not receive any funding, and the authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that PostureScreen Mobile is an accurate diagnostic tool for posture problems. This study only showed how similarly three examiners scored photos of 10 young people, and hip tilt had poor agreement between examiners.