Reliability of novice physiotherapists for measuring Cobb angle using a digital method.
Patcharawan Suwannarat, Pattra Wattanapan, Arpassanan Wiyanad and 3 others
PMID 30931044WHAT IT FOUND
Three novice physiotherapists, after 45 minutes of training, measured sagittal Cobb angles from 15 adults' thoracic radiographs with excellent agreement among raters and across repeated trials.
Key findings
01Novice physiotherapist raters, trained by an expert, showed excellent agreement when measuring the same radiographs repeatedly and when comparing measurements with other raters.
02The average Cobb angle did not differ significantly among the four raters.
03The reported error range was 0.53 to 0.89 degrees, and the smallest change outside that error was 1.47 to 2.47 degrees.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 15 participants were recruited conveniently, and ages ranged from 20 to 78 years, so the sample may not represent all patients. Participants were selected by occiput wall distance greater than 0 cm, which the authors say may reflect other postural factors rather than kyphosis. Only three novice physiotherapist raters were tested, and they were trained by an expert until the expert was satisfied, so results may not apply to untrained raters. Results apply to SurgimapSpine software and lateral thoracic radiographs, not to all digital methods or all spinal measurements.
Declared interests
The authors declared no conflicts of interest. Funding support came from Research and Researcher for Industries, the Improvement of Physical Performance and Quality of Life research group at Khon Kaen University, and Suranaree University of Technology hospital.
The easy way to misread this
Do not read the excellent agreement as proof that any novice physiotherapist can measure kyphosis without training. The three novice raters were trained by an expert until the expert was satisfied, and only 15 adults were assessed.